A new type of acute hepatitis – inflammation of the liver – is affecting healthy children and adolescents around the world, which has made the WHO (World Health Organization) issuedon April 23, an alert about the cases.
At least 14 countries have registered cases, which already total at least 200 affected – mainly in the United Kingdom. According to the WHO, about 10% of these children needed a liver transplant and there is a record of at least one death.
However, what amazes experts is that the cause is still unknown, but some hypotheses have been raised.
Check out what is known and what remains to be clarified about the disease:
What are the symptoms of this mysterious hepatitis?
According to the WHO, “many cases manifested gastrointestinal symptoms such as abdominal pain, diarrhea and vomiting before presenting with severe acute hepatitis and increased levels of liver enzymes—aspartate transaminase (AST) or alanine aminotransaminase (ALT) above 500 IU/ L— and jaundice (yellowing of the skin/eyes).” Most cases did not have fever.
Where did the outbreak come from?
The UK still has the highest number of concentrated cases: at least 114. Then 13 cases were reported in Spain, 12 in Israel, 9 in the US, 6 in Denmark, at least 5 in Ireland, 4 in the Netherlands, 2 in Norway, 2 in France, 1 in Romania and 1 in Belgium.
Will the disease reach Brazil?
As published by the UOL portal, it is possible that hepatitis will reach Brazil, as the news sparked an alert among Brazilian infectologists, who assess the emergence of the disease in Brazil as likely.
“This is very worrying because it is spreading rapidly. We are assuming that [o número de casos] will increase, even more so now with travel on the rise with the pandemic more controlled. The possibility of arriving in Brazil is great”, said Marcelo Simão, professor at UFU (Federal University of Uberlândia), to UOL.
Guidance for suspicion:
Parents and guardians should be aware to signs of hepatitis and seek medical attention immediately if in doubt. Children with symptoms of a gastrointestinal infection, including vomiting and diarrhea, should stay home and not return to school or day care until 48 hours after symptoms have stopped.
In addition, common hygiene measures such as thorough hand washing help to reduce the spread of many common infections, including adenovirus.
Check the symptoms of hepatitis:
- dark urine
- Pale or gray stools
- itchy skin
- Yellow eyes and skin (jaundice)
- Muscle and joint pain
- High temperature
- Sickness and nausea
- Tired all the time out of the ordinary
- loss of appetite
What could be causing mystery hepatitis?
The WHO says investigations to discover the causative agent are still ongoing. However, the entity classifies the disease as “acute hepatitis of unknown etiology”. However, some theories are being raised:
Adenovirus has been found so far in 74 samples from sick children. In 20 of the samples, the covid-19 virus was also found. The WHO said that while adenovirus is currently hypothesized as an underlying cause, it does not fully explain the severity of the clinical picture.
“Infection with adenovirus type 41 has not previously been associated with such a clinical presentation,” reads an excerpt from the note.
In Israel, the head of the pediatric unit Shaare Zedek Medical Center said that most children with hepatitis cases had been infected with the new coronavirus at some point in the past. And tests did not point to adenovirus infection, the doctor told the website of the US magazine Wired.
UK health officials have hypothesized that the lockdown adopted to contain the spread of the coronavirus at various times weakened the immunity of these children, leaving them more susceptible to the virus. There are also those who believe that the lockdown has prevented them from being exposed to common infections.
Another idea is that the offending pathogen may have mutated. So far, however, all this is nothing more than possible causes, at best correlations. Health authorities in affected countries are still looking for conclusive answers, but it is not yet known when they will be available.
Cases not related to coronavirus vaccine
The WHO has already highlighted that the cases are not related to the covid-19 vaccine. UK officials also ruled out the Covid-19 vaccine as a possible cause, because none of the sick British children were vaccinated due to their young age.
*With information from UOL and O Globo