At least 108 mysterious cases of acute hepatitis in children

The first cases were detected in the UK. Dozens of children were exposed to cases of acute hepatitis, a very serious inflammation of the liver, the source of which has not been identified so far. The patients, aged between 22 months and 13 years, now number 108 in the UK alone, according to Britain’s Health Security Agency, which has opened a health investigation. The first infections date back to the beginning of April, in Scotland, then cases were announced across the United Kingdom, then in Spain, Denmark, the Netherlands, and finally in Alabama, in the United States.

These inexplicable cases have hitherto been called into question in the scientific community. Especially since cases are extremely rare. Six children benefited from liver transplantation to survive. “It is a very rare disease in children and liver deficiency is also unusual.‘, comments Professor Alistair Sutcliffe, of the Department of Pediatrics at University College London, contact him science and the future. Liver transplantation remains very rare in children and at this stage the number of cases is alarming. “There is no doubt that the reported cases are much higher than in previous years‘, estimates Professor John Irving, a specialist in microbiology and infectious diseases at the University of Nottingham with science and the future.

No cause has been identified at this time

Hepatitis can be caused by a virus or by consuming alcohol, drugs, a plant, or a chemical product. There are several types of viral hepatitis, characterized by several viruses (A, B, C, D, E). There are several ways of contamination. Hepatitis A and E are transmitted through food. Hepatitis B, C, and D are transmitted through blood (such as sharing used medical equipment) and sexual relations. However, none of these indications appear to be dangerous for the cases identified in children in the spring of 2022. Young patients have developed classic symptoms, such as diarrhea, yellowing of the skin or eyes, and stomach pain. Most of them did not have a fever.

Detailed information collected through the case questionnaire regarding food, drink and personal habits did not identify any common exposures“, emphasize European Center for Disease Prevention and Control. None of the main suspects – the viruses that cause hepatitis A to E – were found in young patients. SARS-CoV-2, the virus responsible for Covid-19, must also be ruled out. Covid-19 has not been detected in all sick children, making this lead unlikelyAlistair Sutcliffe explains. “It is also unlikely that this is a hitherto unknown symptom of Covid-19, given the high number of infections and the small number of hepatitis. Finally, children who have not been vaccinated against SARS-CoV-2, this pathway is not maintained either.

On the other hand, epidemiological living conditions could have played a role in the emergence of these mysterious cases. “The affected children, ages 3 to 6, had just spent two years in severe isolation and were therefore not exposed to the usual range of child infections, and abrupt release from confinement led to an increase in infection“, supports William Irving. Social distancing and confinement would have ensured that their immune systems were not armed against this virus. But the specialist stresses that, if known, this path may not be possible either. Just a coincidence.

Impact of adenovirus AD-41

The last track reported by observers: a virus called AD-41. “AD-41 is a virus from the group of adenoviruses. Viruses of this class can cause mild illnesses such as the common cold or the traditional flu, but other viruses of this type can lead to more persistent illnesses and cause complications.“There are more than 80 adenoviruses known to infect humans. But AD-41 is already known in children,” Alistair Sutcliffe explains.In them, it usually causes a disease similar to gastroenteritis, that is, vomiting and diarrhea. It is not known to cause hepatitis. However, it is possible that there could be something a little different about this virus in 2022, or something different in the way the immune system handled the virus in these children.”, supposes William Irving. Again, this hypothesis should be taken with caution, inasmuch as adenovirus has not been found in all sick children.

In France, two cases of unknown origin, children aged 3 to 7 years, were treated at Lyon University Hospital. But they have nothing to do with the epidemic in the UK. “One was of hepatitis of viral origin, the other of metabolic/genetic origin, tests are still being analyzed‘, he pointed to CHU to Lyon News. At the moment, Public Health France has not noticed any excess cases in the country.

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