Public health officials say they are investigating cases of severe liver disease “of unknown origin” among Canadian children as world scientists race to find out about a mysterious hepatitis epidemic that has affected nearly 200 young people worldwide.
“The Public Health Agency of Canada is aware of reports of severe acute hepatitis of unknown origin in young children in Canada,” the department said in a statement Tuesday in response to questions from CBC News.
“They are being further investigated to determine whether they are related to cases in the United Kingdom and the United States. As the investigation progresses, we will keep the public up to date. “
The latest available data the World Health Organization (WHO) shows that at least 169 cases of acute hepatitis of unknown origin have been reported in nearly a dozen countries, with the majority of reports – 114 – from the United Kingdom
On Tuesday, the European Center for Disease Prevention and Control (ECDC) published an even higher estimate of nearly 200 cases in children worldwide.
The United States has identified more than a dozen cases in several states, with unexplained hepatitis in Spain, Israel, Denmark, Ireland, Italy, Norway, France, Romania, Belgium and the Netherlands.
WHO data show that approximately 10% of affected children required liver transplants and at least one child died.
Nausea, vomiting
It is not yet clear whether the cases in Canada are the same syndrome seen elsewhere, said liver specialist Dr. Jordan Feld, a senior scientist at the Toronto General Hospital Research Institute.
Affected children usually have gastrointestinal symptoms such as nausea, vomiting and diarrhea, he said.
“But then the more serious problem is that they develop jaundice … or are found to have abnormal liver blood tests,” Feld said.
“At this stage, it would be wise if children have some of these symptoms, especially if they seem more severe, to seek medical help.
Officials have not yet provided details on the total number of cases in Canada.
Cases reported worldwide affect children from one month to 16 years.
What is confusing, scientists told CBC News, is what could be causing them.
“Certainly one viral infection is at the top of the list, but it’s definitely not proven yet,” Feld said.
A virus has been detected
Various medical conditions and medications can cause hepatitis; so can heavy alcohol use or exposure to certain chemicals or drugs. But most often inflammation or damage to the liver is caused by a virus.
However, the usual family of hepatitis viruses has not been identified in any of the cases related to the current global epidemic, the WHO said.
WATCH Mysterious liver disease strikes children:
A rare liver disease in children is a “medical mystery,” he said
The liver disease, which affects 169 children in the United States and Europe, is currently a “medical mystery,” says infectious disease specialist Dr. Isaac Bogoch, and it is premature to attribute it to a virus or cause. 5:47
Adenovirus was detected in at least 74 cases; a common group of viruses known to cause a wide range of health problems, from gastrointestinal disorders to bladder infections to the common cold.
In the UK, officials recently observed a significant increase in adenovirus infections in the community following low circulatory levels earlier in the COVID-19 pandemic.
ECDC Director Andrea Amon told reporters that a theory suggested that blocking the pandemic could have weakened children’s immunity because they were less exposed to common pathogens while in isolation.
But it is hardly definitive, given the different levels of testing for different viruses.
The virus behind COVID-19, SARS-CoV-2, was also identified in 20 of those tested, while 18 of the young hepatitis patients were infected with both viruses.
In Israel, one of the doctors involved in treating hepatitis in children suspects that it may be related to COVID-19.
“After ruling out all the different possibilities, the common denominator in all the cases we found was that they all contracted the coronavirus about three and a half months before the infection appeared,” said Dr. Jael Moser-Glasberg, head of the department. A pediatric liver transplant unit at the Schneider Children’s Medical Center in Petah Tikva reported to Israeli media Haaretz.
“It simply came to our notice then. But I don’t think it’s still possible to say that all these cases are after COVID. “
The cause may be related to adenovirus, or SARS-CoV-2, or some interaction between environmental exposure and the virus, said Dr. Isaac Bogoch, an infectious disease specialist at the University of Toronto.
“We are in the middle of a pandemic, but you can’t have what we call ‘anchored biases’ where we say it must be COVID,” he said. “It certainly can be.” But you have to be open.
Given the age of the children affected, Dr Alison McGuire said one potential cause that could be easily ruled out was vaccination against COVID-19. Most young children, she noted, still cannot be vaccinated.
Whatever the reason, scientists are on the lookout for more reports of sick children.
“Every time we see severe hepatitis, especially in young children, it’s alarming,” Feld said.
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