Experts now suspect that the culprit is an adenovirus. So far, 77% of cases in the UK have tested positive for active adenovirus infection, plus five out of nine in Alabama.
These infections are incredibly common – especially among children – but usually cause cold symptoms, sometimes pneumonia. Only in rare cases have immunocompromised patients been known to cause hepatitis.
“This raises the possibility that this is an unusual or mutated adenovirus,” said Professor Kelly. “Although it doesn’t look unusual so far.”
Another related theory is that the effect of the virus is enhanced by the lack of exposure to common adenoviruses during blockade.
But this is not a stalemate. In Denmark, where four cases have been confirmed, no child has tested positive, said Prof. Anders Koch, an infectious disease specialist at the Danish Statens Serum Institut.
“We haven’t seen the same signal with the adenovirus, but we’ve looked at it,” he told The Daily Telegraph. “So what you see in England may be different from what you see in Denmark.
According to the European Center for Disease Prevention and Control (ECDC), only seven of the 30 cases found on the continent tested positive for adenovirus, while three children had Covid. Several have also tested positive for other viruses such as rotavirus and influenza.
“The situation across the EU has developed since Easter,” said Erika Duffel, chief expert on hepatitis at ECDC. “We update our information every hour.” But experts have warned that we are still in the “fog of war” – the numbers are murky, as patients may not be tested for all viruses in the same way.
Some believe that another, as yet unidentified infection may be to blame. “One possibility is to have a completely new infectious agent that we haven’t met before,” said Professor Will Irving, a professor of virology at the University of Nottingham.
Or, Professor Kelly suggested, “we may find that there is more than one virus behind it.”
“It is extremely important to have an open mind that adenovirus may not be the only factor here,” she said. “It may be too obvious – I hate to say it, but there may be more to it.”
A side effect of coronavirus vaccines has also been ruled out, as none of the children affected in the UK have been hit. Although the definition of the case applies to children under the age of 10, most in the UK are actually under the age of five, so they are not yet eligible for the vaccine.
“Countless symptoms”
Meanwhile, pediatricians are focused on treating children who end up in a hospital ward.
Doctors emphasize that most cases are relatively mild and resolve on their own. They suspect that many cases have gone unnoticed, with children recovering without medical intervention. But although no one has died yet, for some the prognosis is serious.
Dr. Thassos Gramatikopoulos, a consultant in pediatric hepatology, works at King’s College Hospital in London, one of the three specialist liver departments in England, along with Birmingham and Leeds. Since January, he has been treating a handful of patients with hepatitis.
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