Public health officials in the United States and the United Kingdom are investigating a number of unusual cases of severe hepatitis in young children, the cause or causes of which are currently unknown.
Evidence from the United Kingdom and Alabama – where nine cases have been reported since last autumn – suggests the possible involvement of adenovirus. Adenoviruses usually attack the airways, causing colds. But they are associated with inflammation and infection of the bladder, and sometimes with hepatitis, although rarely in children who are not immunocompromised.
In a statement issued late Thursday, the Centers for Disease Control and Prevention said it was working with Alabama to investigate the cases and work with other state health departments to see if there were other cases elsewhere. In a report to Alabama Public Health Doctors in early February, he said he was aware of a case in another state but did not give details.
advertising
“The CDC is aware of and is working with the Alabama Department of Public Health to investigate nine cases of hepatitis in children – ages 1 to 6 – who have also tested positive for adenovirus since October 2021,” said Kristen Nordlund, spokeswoman. of the agency, said in a statement.
“The CDC is working with public health departments to see if there are additional cases in the United States and what could be causing them. At the moment, adenovirus may be the cause, but researchers are still learning more – including ruling out the more common causes of hepatitis, “she said.
advertising
Karen Landers, a district health officer at the Alabama Department of Public Health, said the cases were found in different parts of the state, and investigations have so far found no links between the children. Investigators in the United Kingdom also found no connection between the cases there.
“It’s not uncommon to see children with severe hepatitis,” Landers, a 45-year-old pediatrician, told STAT in an interview. “Seeing children with severe [hepatitis] in the absence of severe underlying health problems is very rare. That really made us stand out in Alabama. ”
There are a number of adenoviruses that can infect humans. Genetic sequencing is underway to try to identify whether one or more types of adenoviruses are involved. So far, five of the children have tested positive for type 41, Landers said.
As status information is disseminated, additional cases may be identified. El País reported on Wednesday that Spain had found three cases, all involving children between the ages of 2 and 7. One of the children needs a liver transplant, the newspaper writes.
As in the United Kingdom, children in Alabama were quite ill, said Helena Gutierrez, medical director of the Pediatric Liver Transplant Program at the University of Alabama at Birmingham. “We have seen a full range of cases from severe hepatitis to acute liver failure,” she told STAT in an email.
Nirav Shah, director of the Center for Disease Control in Maine and president of the Association of State and Territorial Health Professionals, said the organization was aware of the cases in the UK, but was not informed that there were similar cases in the country. “We have contacted the US CDC to learn more, as well as to discuss how states can monitor such cases,” he said.
In the United Kingdom, where approximately 75 cases have been reported from England and Scotland, a small number of children have had or may need liver transplants.
A number of affected children in the United Kingdom have tested positive for adenoviruses and SARS-CoV-2, the virus that causes Covid-19. But the first appears to be the prime suspect, according to a scientific article on Scottish cases published Thursday in the online journal Eurosurveillance.
However, even if the cause is an adenoviral infection, it may be related to the pandemic, the authors suggest, noting that young children – many under the age of 5 – who were not exposed to the normal set of germs during the pandemic they may have become more vulnerable when the masks were removed and social distancing measures were removed.
At the time of publication, the leading hypotheses are focused on the adenovirus – either a new variant with a clear clinical syndrome, or a routinely circulating variant that more seriously affects younger children who are immunologically naive, write the authors from Public Health Scotland, Royal Hospital for children in Glasgow and the Center for Virus Research at the University of Glasgow.
“The latter scenario could be the result of limited social mixing during the Covid-19 pandemic,” they said. Five of the 13 children described in the article tested positive for adenovirus infection.
Hepatitis – an inflammation of the liver – is a condition that can be caused by a number of factors, although viral infections are often the cause. A number of hepatitis viruses – A, B, C, D and E – are common causes of hepatitis, but in these cases they are excluded.
The European Center for Disease Prevention and Control issued a signal on Tuesday, urging doctors to monitor and report cases of acute hepatitis in children aged 16 and under when testing rules out infection with hepatitis A, B, C, D or E.
Add Comment