A new form of acute hepatitis affects very young, previously healthy children. There is no definitive explanation yet.
What are we talking about?
In early April, the United Kingdom alerted the World Health Organization to reports of an “unusual” number of cases of childhood hepatitis.
Symptoms include high fever, jaundice, discolored stool, and dark urine. Most surprisingly, this hepatitis begins with a violent digestive syndrome (nausea, diarrhea, vomiting, etc.).
But above all, it occurs especially in young children – often under ten and even under five years old – and in perfect health.
Where were these injuries detected?
These severe forms of hepatitis were first reported in the United Kingdom and Spain. And quickly, during the month of April, cases were detected in France, Ireland, the Netherlands, and even Denmark.
In France, the first two cases were reported in Lyon.
Currently, most cases of acute hepatitis have been identified in Western Europe, but the United States, Israel, and Japan have also reported several.
How many cases are we talking about?
So far, only 188 cases have been officially identified, over half (111) of them in the UK. This may not sound like much, but this number is very important for extremely rare diseases, especially in perfectly healthy children.
Additionally, the number of cases detected is likely to increase, according to medical biologist Claude-Alexandre Gustave in Liberation:
The scale of the phenomenon is still limited at the moment, but the detection of these cases is likely to increase significantly in the coming weeks.
Claude Alexandre Gustave, medical biologist
For a simple reason: reports have been made “by chance” so far, that they are being discovered. But now, “alerts issued with the establishment of diagnostic criteria, systematic biological assessment and reporting procedures for health authorities” will “make it possible to “focus data and strengthen epidemiological investigation,” explains Claude-Alexander Gustave.
The results were already severe: many of the 188 cases of severe hepatitis required hospitalization. Importantly, approximately 10% resulted in liver transplantation and one child died.
What is its origin?
The researchers are only at the hypothesis stage.
But some pathways – such as the responsibility for vaccinations – can be abandoned: Almost all patients under the age of 10 are vaccinated, and very few are. Most are even under the age of five, and they don’t even have the right to get vaccinated, as physician and writer Christian Lehmann reminds us:
The infectious hypothesis remains the main pathway, without ruling out, at this stage, toxicological or environmental causes.
Among the infectious hypotheses, the scientific community is divided: the first, widely expressed, accuses adenovirus. Others refer to Sars-Cov-2 – the virus responsible for Covid-19.
Thus, many researchers note that 30-40% of children who fall victim to these patients are positive for adenovirus. However, as Dr. Lehmann reminds us, “Not surprisingly! Adenovirus is responsible for colds and nasopharyngitis, and is very common and common in children – as in adults.”
It would be like saying that if 30% of kids have tartar on their teeth, tartar is responsible for this hepatitis: no sense!
Of the 166 European cases, 50 children tested positive for adenovirus (30%), and 13 tested positive for Sars-CoV-2 (7.8%) at the time of diagnosis.
Except we don’t know how many of these 166 children were tested, whether for adenoviruses or for Covid-19 … In France, for example, the Ministry of Health maintains its recommendation not to look for SARS-CoV-2. In children under 6 years old.
In other words, in most cases, we didn’t find a Covid-19 infection… because we didn’t look for it.
On the other hand, as biologist Claude Alexandre Gustave reminds us, among the cases identified in Israel, 90% are positive for Sars-Cov-2.
Infection with COVID in the 15 weeks preceding hepatitis is the only common denominator of the hepatitis cases that have been identified.
Therefore this hypothesis appears as ‘favorite’. Especially when suspected adenovirus (41F) causes acute hepatitis, these symptoms only affect children with severe immunodeficiency.
On Twitter, scientist Mary Pyle Normand described in detail why the adenovirus thesis was incorrect:
On a simple note: In cases where a liver biopsy was performed, no trace of adenovirus was detected in any child.
Finally, the World Health Organization does not rule out a possible joint role of Sars-CoV-2 and adenovirus, with the weakening of the immune system by Covid making children more susceptible to this hepatitis, which sometimes occurs in children.
Could confinement and masking be called into question?
The rhetoric that children are never at risk of contracting Covid-19 continues to be heard a lot. This is a serious matter, according to Dr. Lyman:
If Covid is in question, it means that all those who have reduced Covid in children, made it clear that they must build their immunity by getting infected, not wearing a mask … All these people will make a mistake, even a mistake
And adding: “This is what the French Pediatric Society, which has long distinguished itself by its denial of the role of children in the circulation of Covid disease, has called under the term ‘immune debt’ – a stupid concept that does not exist anywhere in the world. The scientific literature and clashes with epidemiological data ” , remembers the doctor.
Scientifically, it makes no sense: firstly, because adenoviruses and other rhinoviruses have spread quite naturally in recent months according to all the epidemiological data. Therefore, children’s exposure to these viruses continued during the two years of the epidemic. Then because we’re seeing an explosion in these hepatitis cases, in time and space, as Covid-19 among children has surged in recent months: countries like New Zealand or South Korea, which have opted for “zero Covid,” are doing so, recalls Christian Lehmann.
Coincidence, on a scientific level, does not translate the correlation of cause and effect, but at least it allows to give another idea in favor of the hypothesis under which Covid will be called into question.
What can we expect?
At this point, it is still too early to say for sure that Covid-19 is the cause, or at least the only cause involved. Sars-Cov-2 has yet to reveal all of its secrets – as we’ve seen with “Pims,” these harsh conditions also afflict children several weeks after they’re infected. For those, the link to Covid-19 has now been confirmed.
Regularly accused of “warning,” Dr. Lehman is pessimistic and independent:
“If in four to six weeks we confirmed that it was the Covid virus that was causing this hepatitis, I wouldn’t rub my hand saying ‘we were right.’ No, I would say to myself ‘Damn, we were right.’ At the end of the day, there is still death. for children,” he recalls. Hoping to return to respect for barrier gestures in children, to avoid such consequences in the medium term, and to amplify children’s vaccine against Covid.
* Christian Lehmann is the author of “Hold the line, Epidemic Journal”, published by L’Olivier Editions (€19).