More than 400 people, mainly children, have died in an outbreak of viral encephalitis in northern India, health officials say.
So far 2,300 patients have been admitted to a hospital in the affected Gorakhpur area of Uttar Pradesh state.
A doctor told the BBC that it was a "tragedy beyond imagination" with children dying every day.
Nearly 6,000 children have died of encephalitis in the hospital since the first case was detected in 1978.
Most of the deaths this year have happened since July, doctors say.
The disease occurs regularly during the monsoon in the Gorakhpur region bordering Nepal in the foothills of the Himalayas.
The low-lying areas are prone to floods and water-logging. Lack of sanitation provides a breeding ground for mosquitoes and leads to contamination of water supplies.
This happens because most people defecate in the open in villages of the area, while water is consumed mainly using shallow hand pumps. more