Scientists worldwide are concerned[/B] about the increasing number of cases of hitherto unexplained severe hepatitis (inflammation of the liver) in young children, which are coming to light in several European countries (Britain, Spain, Denmark, the Netherlands) and in the USA.[THE WORLD HEALTH ORGANISATION (WHO), THE US AND EUROPEAN CENTRES FOR DISEASE CONTROL AND PREVENTION (CDC AND ECDC) AND THE UK HEALTH SECURITY AGENCY (HSA) HAVE ALREADY ISSUED NOTICES OR WARNINGS.
The situation raises concerns among experts, as the parallel occurrence of cases of severe childhood hepatitis of undetermined etiology in so many countries is considered strange. Viruses can cause hepatitis, but healthy children rarely get sick and even seriously. Although no child has so far been reported to have died from mystery hepatitis, several have developed acute liver failure and have required hospitalisation or liver transplantation.
The prevailing theory - but not a certainty - in the scientific community so far is that the cause is an adenovirus (a family of viruses commonly responsible for colds), as such a virus has been detected in many of the sick children. However, the possibility that a coronavirus may also be involved has not been ruled out.
"This is a serious phenomenon. The children were perfectly healthy until a week ago. However, most of them are recovering on their own," said paediatric hepatologist Deirdre Kelly of the British Children's Hospital Birmingham, according to Science.
"The situation must be taken seriously. The increase in cases is unexpected and common causes have been ruled out," the WHO Regional Office for Europe said in a statement.
The first case was detected on 31 March in Scotland in children aged three to five years who were admitted to hospital and diagnosed with hepatitis of unknown cause. There are a maximum of four cases of severe childhood hepatitis in Scotland each year, while this year 13 had already been diagnosed by 12 April. A total of 74 have been found across the UK (more than any other country so far), most in children aged two to five, with vomiting, abdominal pain and jaundice being the most common symptoms. Other possible symptoms include dark-coloured urine, itchy skin, joint stiffness, muscle aches, fever, lethargy, loss of appetite, etc.
Initially it was thought that a toxic substance in food, drink or toys was 'blamed', but now experts are turning their attention to a virus. But none of the children in Britain or Spain were found to be infected with hepatitis A, B, C, D or E viruses.
On the other hand, some had been infected with the SARS-CoV-2 coronavirus in the previous weeks or months, and none had received the covid-19 vaccine, so the possibility that the cases were linked to a vaccine side effect was ruled out. About half of the sick children were found to have adenovirus, a class of viruses that causes vomiting, diarrhea, conjunctivitis and cold symptoms, but rarely hepatitis.
According to the experts in Scotland and their publication in Eurosurveillance, "the dominant hypotheses focus on adenovirus: either a novel variant with a distinct clinical syndrome or a routine variant but which more severely affects younger children who have lower immune defences."
The isolation of young children during the lockdown of the pandemic may have made them more immunologically vulnerable because they were not exposed to the usual variety of viruses, including adenoviruses. "We see a spike in typical childhood viral infections as children come out of the lockdown, and a spike in adenovirus infections, but we can't be sure that one is causing the other," said clinical virologist Will Irving of Britain's University of Nottingham.
Scientists
continue to study the issue, not ruling out either the involvement of a previously unknown toxin or the possibility that it is a complication of long-standing covid-19. It is thought likely, according to epidemiologist Jim McMenamin of the Scottish Public Health Agency, that not all cases have the same cause.
In the US, where nine such cases of hepatitis in Alabama in children aged one to six years are being investigated, all have also been found to have an adenovirus, with strain 41 being the most common, but usually causing gastroenteritis rather than hepatitis. A CDC spokesperson said the Center is "working with state health departments to see if there are other cases in the U.S. and what might be causing them."
In Spain, authorities reported on April 13 the identification of three severe cases in children 2 to 13 years old in different regions (Madrid, Aragon, Castilla-La Mancha), while pediatricians in the Netherlands and Denmark have also reported similar cases of severe childhood hepatitis that also need liver transplants.
Source: Proto Thema
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