Among the cases of acute hepatitis, at least one child has died and 17 children have needed a liver transplant, the WHO said in a press release.
“It is not yet clear whether there is an increase in hepatitis cases or an increase in awareness of hepatitis cases, which occur at the expected rate but remain undetected,” the WHO said in a statement. “As long as the adenovirus is a possible hypothesis, investigations into the cause are ongoing.”
The clinical syndrome “among the identified cases is acute hepatitis (inflammation of the liver) with significantly elevated liver enzymes,” the statement said. Many cases have reported gastrointestinal symptoms such as abdominal pain, diarrhea and vomiting “prior to severe acute hepatitis”, as well as elevated levels of liver enzymes or alanine aminotransaminase and jaundice.
Most reported cases had no fever, the WHO said, and common viruses that cause acute viral hepatitis – such as hepatitis A, B, C, D and E – have not been detected in any of these cases.
Hepatitis is an inflammation of the liver, a vital organ that processes nutrients, filters the blood and helps fight infections. When the liver is inflamed or damaged, its function may be affected.
Hepatitis is most often caused by a virus, and adenoviruses are a common type of virus transmitted from person to person that can cause a number of mild to severe illnesses. But these viruses are rarely reported as a cause of severe hepatitis in healthy people.
The WHO said the investigation into the cause should focus on factors such as “increased susceptibility in young children after lower levels of adenovirus circulation during the COVID-19 pandemic, the potential for new adenovirus, and SARS-CoV-2.” coinfection. “
The majority of cases – 114 – have been reported in the United Kingdom. There are 13 cases in Spain, 12 in Israel, nine in the United States and fewer cases have been confirmed in Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania and Belgium, according to the WHO.
On Thursday, the U.S. Centers for Disease Control and Prevention (CDC) issued a health council that warned health care providers and public health agencies to investigate acute cases of hepatitis for unknown reasons.
CDC-recommended providers are considering testing for adenovirus in children with hepatitis when the cause is unknown, adding that blood tests in general – not just blood plasma – may be more sensitive.
Jacqueline Howard and CNN’s Jen Christensen contributed to this report.
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