Mysterious hepatitis in children: The clues experts have found

Where was the mysterious hepatitis discovered?

Ms. Meera Chand, Clinical and Emerging Infectious Diseases Director at the UK Health Security Agency, said, 5 cases Hepatitis The first mystery was recorded in Scotland on March 31. “Astute clinicians realized they were seeing something unusual,” she said.

Such cases of hepatitis are rare – Scottish doctors typically see four to five cases of unexplained hepatitis a year, she notes.

Since then, the UK has reported a total of 114 cases of mysterious hepatitis, the WHO said in an update over the weekend.

Spain has the highest number of mysterious hepatitis cases in children after the UK, with 13 cases, followed by Israel with 12 cases and the US with 9 cases. Smaller numbers of mysterious hepatitis cases were also reported in Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania and Belgium.

General characteristics of mysterious hepatitis cases

Children between the ages of 1 month and 16 have contracted the mysterious illness, but most cases are under the age of 10 – and many are under 5. Most children with previously mysterious hepatitis are healthy.

Before children show signs of severe hepatitis, symptoms include jaundice, diarrhea, vomiting, and abdominal pain.

Maria Buti, a pathologist in Barcelona and president of the European Association for the Study of the Liver (EASL), said the “main concern” was the severity of the disease.

She told AFP that 17 children – 10% of the 169 known cases – had hepatitis so severe that they needed a liver transplant.

Aikaterini Mougkou, an antimicrobial expert at the European Center for Disease Prevention and Control (ECDC), said the cases were “really worrying”.

She said it was not clear if more children had this mysterious hepatitis but in a milder form because their symptoms could not be tracked.

“Because we don’t know the cause, we don’t know the route of transmission and how to prevent and treat it,” Mougkou said.

What causes have been ruled out?

Hepatitis is rare in otherwise healthy children. There appears to be no common exposure linking the patients, experts say, and WHO has ruled out international travel as a causative factor.

Dr Chand said there was no link with paracetamol – an ingredient in overdose that can cause liver failure.

Any link to the COVID-19 vaccine has also been ruled out because most of the children in the mysterious hepatitis cases were found to be ineligible to be vaccinated.

What is the leading hypothesis about the cause of hepatitis?

Adenovirus – the common virus that causes a range of illnesses such as colds, bronchitis and diarrhea but most do not lead to serious illness – has been detected in 74 cases, the WHO pointed out.

Ms Chand said adenovirus was found in 75% of patients in the UK. The “leading hypothesis” is that a combination of a normal adenovirus and another factor makes the virus more deadly, she said.

One possibility is that young children who spent 2 years on COVID-19 prevention measures such as blockade and mask wearing did not develop immunity to these adenoviruses.

The rate of adenovirus in the UK fell during the early stages of the pandemic but is much higher than previous levels since COVID-19 measures were lifted, Ms Chand said.

According to the WHO, an “unexpected increase” in adenovirus cases has recently been reported in several other countries, including Ireland and the Netherlands.

Other possible causes of the unknown virus strain could be a combination of adenovirus and COVID-19 or related to previous COVID-19 infection, according to British experts.

There are 19 of the 169 recorded cases with both COVID-19 and adenovirus, while 20 have only COVID-19.

All experts stress that the ongoing investigation needs more time, but Buti expects results within a month.

What should be done to prevent mysterious hepatitis?

Expert Buti said that since adenovirus is contagious, hygiene measures to prevent COVID-19 effective against this virus, especially children who wash their hands frequently. She also urged doctors to look for signs of jaundice.