Mysterious cases of hepatitis in children have been reported in several countries, drawing the attention of health authorities. Until this month of April, there were almost 200 cases, 17 liver transplants and one death, enough to mobilize even the World Health Organization (WHO), which came to issue a general alert. THE Canaltech brings together everything that is known so far about this mystery.
Which countries have registered hepatitis in children?
In the WHO report, published on the 23rd, at least 169 cases of acute hepatitis of unknown origin were known, spread across 11 European countries and one American. Here is the list of countries and number of occurrences so far:
- United Kingdom (114)
- Spain (13)
- Israel (12)
- United States (9)
- Denmark (6)
- Ireland (5)
- Netherlands (4)
- Italy (4)
- Norway (2)
- France (2)
- Romania (1)
- Belgium (1)
Cause and symptoms of childhood hepatitis outbreak
The cases reported by the WHO affect children from one month to 16 years of age, but most patients are younger than 5 years. The most mysterious of all is that this public does not test positive for the typical hepatitis viruses (A, B, C, D or E), but still has a picture of acute hepatitis, that is: inflammation of the liver. The most common symptoms were:
- Abdominal pain
- loss of appetite
- Jaundice (yellow skin)
It turns out that hepatitis simply refers to inflammation of the liver in general, and it can have hundreds of causes: other viruses, medications, toxins, and even contaminated food. The cause of this specific outbreak is still unclear to medicine, but some experts already suspect that what is behind it all is an adenovirus.
What is adenovirus?
Human adenoviruses (HAdV) are the viruses that cause cold symptoms. During the investigation of this mysterious outbreak, 77% of cases tested positive for some form of adenovirus. One of the theories is that the adenovirus may have undergone a series of mutations, which caused a greater capacity to generate inflammation in the liver.
According to the WHO, the UK – where the majority of cases have been reported to date – has recently seen a significant increase in community adenovirus infections (particularly detected in fecal specimens in children) following low levels of circulation at the start of the COVID pandemic. -19. The Netherlands also reported a simultaneous increase in the presence of adenovirus in the community.
“However, due to improved laboratory testing for adenovirus, this may represent the identification of an existing rare result occurring at previously undetected levels and which is now being recognized due to increased testing.”
Although adenovirus is currently a hypothesis, it does not fully explain the severity of the clinical picture. Adenoviruses are common pathogens that usually cause self-limiting infections, and they spread from person to person and most commonly cause respiratory illness, but depending on the type, they can also cause other illnesses such as gastroenteritis (inflammation of the stomach or intestines), conjunctivitis, and cystitis ( bladder infection).
There are more than 50 immunologically distinct types of adenoviruses that can cause infections in humans. Adenovirus type 41 usually presents as diarrhea, vomiting, and fever, often accompanied by respiratory symptoms.
What is being done?
WHO is closely monitoring the situation and working with health authorities in some countries, and underscores the need for time to identify additional cases, both in currently affected countries and elsewhere. “The priority is to determine the cause of these cases to further refine control and prevention actions. Common preventive measures for adenovirus and other common infections involve regular hand washing and respiratory hygiene”, the WHO guides.
For now, in the face of these mysterious cases of hepatitis in children, the agency recommends that blood, serum, urine, feces and respiratory samples be performed, as well as liver biopsy samples, with sequencing. “Other infectious and non-infectious causes need to be thoroughly investigated”, he points out.
Source: WHO, ECDC, NBC News, Medical News Today