A micrograph of hepatitis, this time caused by the Lhasa virus, using toluidine-blue azure II … [+] spot, enlarged 315X, 1972. Image courtesy of CDC / Dr. W. Win. (Photo from Smith Collection / Gado / Getty Images).
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The World Health Organization on Friday announced an outbreak of hepatitis (inflammation of the liver) in children under 10 out of 74 children so far in the United Kingdom.
Such inflammation can be caused by various infections and toxins. Hepatitis A, B, C, E and D viruses are excluded in the United Kingdom. Symptoms in children date back to January and include jaundice (yellowing of the skin and eyes), abdominal pain, vomiting and diarrhea. In testing, they had significantly elevated liver enzymes. Some of the children needed to be hospitalized, and six have undergone liver transplants so far.
Several cases have also been reported in Scotland and Spain. Science reports cases in Denmark and the Netherlands. Also on April 15, the United States reported cases in Alabama.
Virus testing has shown SARS-CoV-2 (which causes Covid) in some children; others had adenoviral infection, and some showed evidence of both viruses in testing.
The Alabama Department of Public Health reported 9 children with acute hepatitis. Adenovirus-41 was found in all these children. Two needed a liver transplant. No epidemiological links have been found between the cases.
The CDC is developing a national health council – this will be sent to all states, alerting them to the problem and requiring the reporting of additional suspicious cases.
Whenever there is a jump in unusual cases beyond expectations, public health experts take action by conducting epidemiological tests and analyzes. They form the definition of a case.
Researchers will test this initial hypothesis and take a detailed history of case exposure, as well as conduct extensive laboratory tests. All this will be standardized to capture the same information.
One hypothesis put forward by Scottish researchers is that the disease may be more severe because it infects “immunologically naive” children who were sheltered during the Covid pandemic.
It is not known how many children have had previous Covid infections. None of the Scottish children has been vaccinated. Other reports do not mention this detail in their cases.
Adenovirus usually causes respiratory symptoms or conjunctivitis (pink eye) and is quite easily transmitted. Others have caused outbreaks in the army. Additional manifestations include inflammation of the bladder or neurological disease. According to one review, type 41 usually causes gastroenteritis in children, although usually in those under 2 years of age. Benjamin Lee et al. Also noted that gastroenteritis with adenovirus 41 is a major cause of diarrhea in low- and middle-income countries, second only to rotavirus. This is a common reason for hospitalization.
There is no specific treatment for adenovirus. The treatment is supportive, with fluids to prevent dehydration.
Again, we do not know that adenovirus is the cause of all these infections; this is the leading candidate at the moment. It is not known how this fits into the recent wave of Covid Omicron B2 infections. A distinctive feature so far is the severity of hepatitis infection in these children and the number who needed a transplant. Further monitoring and research is needed. Stay on the line.
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