On 5 April, the United Kingdom reported an unexpected and significant increase in cases of severe, acute hepatitis of unknown origin in young, previously healthy children, all under the age of 10.
Since then, the World Health Organization (WHO) has reported an increase in cases from 11 other countries, including Ireland, the United States, Israel, the Netherlands, Romania and, on Tuesday, Japan. On Wednesday, it was reported that Canada was also investigating an undisclosed number of cases to see if they were related to the outbreak.
The affected children are between one month and 16 years old. One child died and about 10% of the cases required a liver transplant, the WHO said.
The majority of cases are in the United Kingdom (114 cases), with a total of approximately 200 cases reported. The true number may be higher if there are children affected who do not show serious symptoms and therefore have not been taken to hospital for examination.
What is hepatitis?
Hepatitis is an inflammation of the liver that can lead to a number of health problems, including cancer and liver failure, and can be fatal. The liver is crucial because it removes toxins from the blood, participates in metabolism and regulates blood clotting, among other functions.
Hepatitis has a number of causes.
The most common are viruses, with hepatitis A, B, C, D and E being the key virus strains. These viruses differ in how they are transmitted, their geographical distribution, symptoms (not everyone develops symptoms) and severity, but they all lead to hepatitis. There are vaccines against some of these virus strains.
Alcohol, certain medications and immune system disorders can also cause hepatitis.
Sometimes hepatitis has no known cause, which is the case in children reported to the WHO. However, such severe cases leading to liver failure are particularly rare in children, so when clinicians in the UK noticed an increase in such cases for no reason, they were worried. This led to a report to the WHO, and other countries were alert to the problem.
Common hepatitis viruses have not been found in any of the children affected.
Associate Professor Asha Bowen, a clinician at Perth Children’s Hospital in Australia and a researcher in infectious diseases at the Telethon Kids Institute, said: ”
“Unusually, it’s fulminant hepatitis, which essentially means that the liver has completely given up in these children,” Bowen said. “It’s extremely rare in childhood. And that put us on high alert. “
What do we know about this mysterious hepatitis?
The children were generally healthy before they became ill and diagnosed. The WHO described their hepatitis as “severe and acute”.
Many children suffered from gastrointestinal symptoms such as abdominal pain, diarrhea and vomiting just before being diagnosed. Many also had jaundice, a condition that can make the skin and eyes look yellow and can be caused by liver damage.
A number of investigations into the potential causes of the mysterious hepatitis have been conducted, but nothing has been confirmed.
Adenoviruses – which are common and lead to what people describe as colds and symptoms such as sore throats, fevers and diarrhea – have been found in more than 70 children. Covid-19 was also found in 20 cases.
But the WHO said in its latest case report that while adenovirus is currently a hypothesis as the main cause, “it does not fully explain the severity of the clinical picture.” The adenovirus strain known as type 41, seen in many children, has not previously been associated with severe hepatitis.
“While cases of hepatitis have been reported in immunocompromised children with adenoviral infection, type 41 adenovirus is not known to cause hepatitis in otherwise healthy children,” the WHO said.
Bowen, who is also co-chair of the Australian Society of Infectious Diseases, said the adenovirus theory was the most likely explanation so far, but that “whether this is the absolute cause is still a matter of uncertainty.”
Other studies are investigating whether environmental factors or other viruses or organisms may be involved.
The director of the European Center for Disease Prevention and Control, Dr Andrea Amon, told reporters during a briefing Tuesday that another hypothesis under investigation was whether the blockade could have weakened children’s immunity due to lower exposure to pathogens. .
The WHO said that “hypotheses about the side effects of Covid-19 vaccines are not currently supported” because most of the children affected did not receive the Covid-19 vaccine because they were too young.
What are the health tips in the meantime?
States have been urged to be vigilant in all cases of hepatitis in children for no apparent reason. The WHO recommends that blood, urine, faeces and respiratory samples be taken from these children, as well as liver biopsy samples.
“Other infectious and non-infectious causes need to be thoroughly investigated,” the WHO said.
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