Issued on: 25/04/2022 – 17:54
Paris (AFP) – In recent weeks, an unknown severe strain of hepatitis has been identified in nearly 170 children in 11 countries, with at least one child dying from the mysterious disease, according to the World Health Organization (WHO).
Here’s what we know so far.
Where was it found?
The first five cases were marked in Scotland on March 31 by “discerning clinicians who realized they were seeing something unusual,” said Meera Chand, director of clinical and emerging infections at the UK’s Health Security Agency.
The children did not have any of the five known hepatitis A, B, C, D and E viruses, Chand said at an emergency presentation at the European Congress of Clinical Microbiology and Infectious Diseases on Monday.
Such cases are very rare – Scottish doctors usually see four to five unknown cases of hepatitis in a year, she said.
The United Kingdom has since reported a total of 114 cases, the WHO said in a weekend update.
Spain has the next highest number of cases with 13, followed by Israel with 12 and the United States with nine, while a small number are also registered in Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania and Belgium.
Who was affected?
Children between the ages of one month and 16 have had the mysterious disease, but most are under 10 – and well under five. Most of them used to be healthy.
Before the children showed signs of severe hepatitis, they had symptoms including jaundice, diarrhea, vomiting and abdominal pain.
Maria Buti, a pathologist in Barcelona and president of the European Liver Research Association (EASL), said the “main concern” was the severity of the strain.
Seventeen of the children – 10 per cent of the 169 known cases – had hepatitis so severe that they needed a liver transplant, she told AFP.
Aikaterini Mugku, an expert on antimicrobial resistance at the European Center for Disease Prevention and Control (ECDC), said the cases were “really worrying”.
It is unclear whether even more children had mild cases, as their symptoms were not traceable, she told the emergency room.
“Because we don’t know the cause, we don’t know the route of transmission and how to prevent and treat it,” Mugku said.
What is excluded?
Hepatitis is an inflammation of the liver and is usually rare in healthy children.
No common exposure seems to connect patients, experts said, and the WHO has ruled out international travel as a factor.
Chand said there was no link to paracetamol, an overdose of which could cause liver failure.
Any association with Covid vaccines is also ruled out, as most of the children were not old enough to be stabbed.
What is the leading theory?
Adenoviruses – common viruses that cause a number of diseases such as colds, bronchitis and diarrhea, but mostly do not cause serious illness – have been found in 74 of the cases, the WHO said.
Chand said the adenovirus was found in 75 percent of patients in the UK.
She said the “leading hypothesis” was a combination of normal adenovirus with another factor that made it more severe.
One possibility is that young children who have spent their “formative stages” under Covid’s measures such as blocking and wearing masks over the past two years have not developed immunity to these adenoviruses.
Adenovirus levels in the UK fell in the early stages of the pandemic, but rose well above previous levels after the measures were lifted, Chand said.
An “unexpected increase” in adenovirus cases has recently been reported in several other countries, including Ireland and the Netherlands, the WHO said.
Other possible causes for the unknown strain could be a combination of adenovirus and Covid or related to a previous Covid infection, Chand said.
Nineteen of the 169 reported cases had both Covid and adenovirus, while 20 had Covid alone.
All experts stressed that ongoing investigations require more time, but Buti said he expects results within a month.
What can you do?
Buti said that because the adenovirus is an infectious disease, Covid’s measures work well against it – especially children who clean their hands regularly.
She also urged doctors to watch out for signs of jaundice.
© 2022 AFP
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