Canadian health officials are investigating cases of severe acute hepatitis of “unknown origin” found in children across the country.
The Public Health Agency of Canada (PHAC) told Global News on Wednesday that it was aware of reports of the disease as other regions of the world reported cases of liver disease in children of unknown cause.
“They are being further investigated to determine whether they are related to cases in the United Kingdom and the United States,” PHAC said. “As the investigation progresses, we will keep the public up to date.
Here’s what we know so far.
So far, 190 children around the world have developed sudden liver disease for unknown reasons. At least one child has died and several others have needed a liver transplant, the WHO said.
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Otherwise, healthy children develop hepatitis or inflammation of the liver, often caused by viruses. The children affected so far are from one month to 16 years old.
Most cases have occurred in Europe. The first cases in the United Kingdom were reported in January, while the United States opened its first cases in October in Alabama. The Centers for Disease Control and Prevention made the announcement last week.
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The PHAC did not say how many cases were reported in Canada or when they first appeared.
“They are in many countries around the world; most high-income countries report this, “said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital.
“We still haven’t heard from many low- and middle-income countries. The problem is probably insufficiently reported; there are probably more cases out there. “
Hepatitis is usually caused by one of several contagious hepatitis viruses, such as A and B, that have not been found in affected children.
Sometimes the disease is mild and does not require specific treatment, but severe cases require hospitalization and can lead to liver failure.
Authorities around the world are unsure of the cause of the cases.
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Nine children in the Alabama cluster tested positive for adenovirus, a family of viruses that can cause a number of diseases such as colds, fevers and sore throats, according to the CDC.
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Andrea Amon, director of the European Center for Disease Prevention and Control, told reporters at a virtual briefing this week that the researchers were also investigating whether the adenovirus involved had mutated or acted in tandem with another infection, possibly COVID-19.
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“Obviously we are in the middle of a pandemic and there are a lot of COVIDs, so this is a path that obviously requires significant investigation, be it infection or recovery from infection and some immune process,” Bogoch said.
“But again, we don’t want to have what we call anchoring bias and just focus on COVID, because you may miss other reasons.”
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The toxin may also be responsible, but this is less likely due to the geographical distribution of cases so far, Reuters reported on Tuesday. Any association with COVID-19 vaccination is excluded.
“Of our nine cohort cases, they were all positive for adenovirus,” said Dr. Helena Gutierrez, medical director of the Pediatric Liver Transplant Program at the University of Alabama at Birmingham.
“Most of these cases of adenovirus were specific types of adenovirus.”
This specific type can cause digestive problems in children, Gutierrez said. It is not known whether this virus is the cause or in any way contributes to the disease.
Symptoms of adenovirus associated with reported cases in Alabama include vomiting and diarrhea, Gutierrez said.
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“Very few have a fever and very few have respiratory symptoms,” she said.
A few days or a few weeks later, they begin to develop jaundice – a condition in which the skin and whites of the eyes turn yellow, Gutierrez added.
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These symptoms require medical attention, she added.
As it is not known exactly what causes liver disease, it is currently difficult to determine the exact symptoms, Bogoch said.
“It is premature to put a stamp on this and say that this is the ultimate reason,” he said. “There needs to be more investigations.”
Why do only children get sick?
While scientists are in the early stages of understanding the outbreak, it is unclear why only children get sick, Gutierrez said.
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One theory is that blocking COVID-19 may have weakened children’s immunity because they were less exposed to common pathogens while in isolation.
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“We are still gathering information, but that’s why this hypothesis is something that people have expressed, because adults have been exposed to the adenovirus potentially many times throughout our lives,” Gutierrez said.
“It’s a virus that causes cold symptoms, so maybe these kids have never been exposed to it before and then their bodies just have an overdose to it.
How can children stay safe?
It is important for parents to understand that children are routinely ill, Gutierrez said.
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This does not mean that they will develop acute liver failure or severe hepatitis, but it is important for parents to understand that if their child’s condition does not improve, they may need to seek medical attention.
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Practicing some of the public health measures taught for COVID-19 – such as keeping away from someone showing signs of illness – can be helpful, as can good hand washing, Gutierrez added.
“Thus, the adenovirus is transmitted only through close contact,” she said.
“If you go outside and your child touches all surfaces, make sure you wash very well before putting your hands on your face or mouth.”
– with files from Jamie Maurasher of Global News, Associated Press and Reuters
© 2022 Global News, a division of Corus Entertainment Inc.
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