cases of unexplained hepatitis in children in several countries

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An unusually high number of children in the UK are suffering from acute hepatitis of unknown cause. Cases are also reported in other countries.

Update for Friday, April 15, 2022: After 74 children in Britain fell ill with acute hepatitis and a hepatitis virus could not be detected, the World Health Organization (WHO) has now drawn attention to the case in a press release. The organization also says that “less than five cases (confirmed or possible)” have been reported in Ireland and are being further investigated. Three confirmed cases of acute hepatitis in children aged 22 months to 13 years have been reported in Spain. These cases are currently under investigation by the national authorities.

It is unclear whether there is a link to the Sars-CoV-2 coronavirus, which has been detected in some of the infant patients in Britain. Adenoviruses were also detected in some of the children, none of the children have been vaccinated against Corona so far.

WHO calls for vigilance: identify possible cases of hepatitis in children

In its announcement, the WHO also added additional information on the cases of hepatitis in Britain: the children’s symptoms were gastrointestinal problems and jaundice, as well as a sharp increase in liver enzymes. Six of the children in the UK are said to have needed liver transplants as a result of hepatitis. The World Health Organization is now calling on all countries to be vigilant to detect possible cases.

There is an accumulation of unexplained cases of hepatitis in children in Britain, and there are also early cases in other countries. The WHO calls for attention. (symbol picture) © Annette Riedl/dpa

Unusual rise in childhood hepatitis cases in UK

First report of Thursday, April 14, 2022: LONDON – There is currently an unusual accumulation of cases of acute hepatitis in children in Britain. Since January, 74 cases – mostly in children between the ages of two and five – have been investigated. “Hepatitis, i.e. inflammation of the liver, is actually rather rare in children and is classically caused by the well-known hepatitis viruses,” explains pediatric gastroenterologist Burkhard Rodeck, who is general secretary of the German Society for Pediatric and Adolescent Medicine (DGKJ). However, hepatitis viruses have not been found in any of the cases investigated in Britain, and the cause of liver inflammation is still unclear.

“Mild hepatitis is very common in children after a series of viral infections, but what you see now is very different. In children, the inflammation is more severe, in some cases leading to liver failure and the need for a transplant,” says Graham Cooke, an infectious disease specialist at Imperial College London.

Unusual rise in childhood hepatitis cases in UK

Besides the well-known hepatitis viruses, other viral diseases can also affect the liver – such as Epstein-Barr viruses, cytomegaloviruses or adenoviruses, Rodeck lists. “A link with Sars-CoV-2 is theoretically possible, but implausible”, underlines the doctor. The UK health authority UKHSA also rules out a corona vaccination as the cause of the hepatitis cases. “None of the currently confirmed cases in the UK have been vaccinated,” he said in a statement.

“One of the possible causes we are looking at is that it is linked to an adenovirus infection,” said Meera Chand, director of clinical and emerging infections at UKHSA. However, other possible causes are also being investigated, including corona virus, other infections, and environmental causes. “If an adenovirus is suspected, the same precautions should be taken as with other viruses, such as washing hands and using alcohol-based hand sanitizers to prevent the virus from spreading,” says hepatologist Simon Taylor -Robinson of Imperial College London.

Cases of unexplained hepatitis: children with acute liver failure and liver transplant recipients

European health agency ECDC has also issued a statement on previously unexplained cases of hepatitis in children in Britain. This shows, among other things, that some of the cases examined in children resulted in acute liver failure, which required their transfer to specialized children’s liver departments. A small number of children have had liver transplants, reports the ECDC. Some of the sick children who were taken to hospital had tested positive for corona, others for adenovirus. So far, however, there is no clear link between the reported cases and any travel connection, he said.

So far, 74 children have been affected in Britain – 49 of them live in England, 13 in Scotland, 12 in Wales or Northern Ireland, according to the British health authority. The British health authority and the ECDC are now counting on the help of paediatricians, medical staff and parents. They should help identify other sick children as early as possible so that they can be treated correctly and quickly. They also hope to discover the cause of the unusual accumulation of hepatitis infections.

Hepatitis is an inflammation of the liver, mainly caused by hepatitis viruses.
Hepatitis is an inflammation of the liver, mainly caused by hepatitis viruses. © IMAGO/Scientific photo library

Hepatitis in children: parents should watch out for symptoms of jaundice

Parents should also pay close attention to symptoms of jaundice, which can accompany hepatitis infection, Chand points out. The yellowish-colored house is easier to recognize in the whites of the eyes. Parents should contact medical staff if they have any concerns, the UK Health Agency recommends. Taylor-Robinson wants to reassure parents: “At this time this does not appear to be a cause for general concern as the numbers are low. If parents are concerned about symptoms in their children they should contact their GP.

In its communication, the European Health Agency calls on EU clinics to report cases of acute and severe hepatitis in children to national health authorities if hepatitis A to E has been ruled out. “These case numbers from Britain didn’t really worry us, but they made us aware,” says DGKJ secretary general Rodeck. “The corresponding sightings in Germany are not yet known, but we are investigating this further. We must take this seriously, ”underlines Rodeck. His organization has launched an investigation into comparable cases in Germany.

Hepatitis symptoms in children: are they related to corona virus relaxation?

The doctor has a hypothesis as to the origin of the inexplicable accumulation of hepatitis infections among children in Britain: “It is more likely that with the easing in Britain, more and more children and young people will come out of isolation in a relatively short time and will suddenly be exposed to many germs The children’s gastroenterologist warns that this scenario could also be observed in Germany with a significant relaxation.

According to Rodeck, the symptoms of hepatitis in children can be varied:

  • nausea Vomiting
  • yellowing of the skin (jaundice)
  • Diarrhea
  • stomach pain
  • exhaustion
  • Fever
  • loss of appetite

Additionally, symptoms of the viral illness that originally caused it — such as an upper respiratory infection — may also occur, Rodeck continues. (tongue)

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