Health experts are investigating the probable cause of a new liver disease in children, first reported in the UK in January 2022, and whether it has anything to do with the coronavirus.
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Japan has discovered its first probable case of a mysterious liver disease that has so far affected more than 170 children, mostly in the UK, as health experts are investigating its possible links to Covid-19.
Japan’s health ministry said on Tuesday that a child had been hospitalized with an unidentified form of severe acute hepatitis – or inflammation of the liver – in what is considered to be the first reported case in Asia.
As of April 23, at least 169 cases of the disease had been detected in 11 countries worldwide, according to the World Health Organization. Most of them are in the United Kingdom (114), followed by Spain (13), Israel (12) and the United States (9). The addition of Japan marks the 12th country to identify a case.
Of those infected, one child died and 17 needed a liver transplant.
The WHO said it was “very likely that more cases will be found before the cause is confirmed”.
Health experts are investigating the relationship with Covid
Children aged five or younger have so far been most affected by the disease, although cases have been found in children aged one month to 16 years.
Common symptoms, including gastroenteritis – diarrhea and nausea – followed by jaundice or yellowing of the skin and eyes.
Health experts are now investigating the probable cause of the outbreak, which was first reported in the United Kingdom in January 2022, and whether it has anything to do with the coronavirus.
In particular, they investigated whether the lack of previous exposure to common viruses known as adenoviruses during coronavirus restrictions, or previous Covid-19 infection, could be related. Alternatively, the genetic makeup of hepatitis may have mutated, making it easier to trigger inflammation of the liver.
Most importantly, experts say there is no known link to the Covid-19 vaccine.
Usually children get exposure – and immunity – to adenoviruses and other common diseases in their early childhood. However, pandemic restrictions have largely limited this early exposure.
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A strain of adenovirus called F41 appears to be the most likely cause so far, according to the UK Health Security Agency.
“The information gathered from our research increasingly suggests that this increase in sudden hepatitis in children is linked to adenovirus infection. However, we are thoroughly investigating other potential causes,” said Meera Chand, director of clinical and emerging infections at UKHSA.
Adenovirus is the most common pathogen found in 40 of 53 (75%) of confirmed cases tested in the United Kingdom. Globally, this number is 74.
Covid (SARS-CoV-2) has been identified in 20 cases tested worldwide. Co-infection of adenovirus and Covid-19 was found in 19 cases.
The new case from Japan is negative for adenovirus and coronavirus, although officials have not revealed other details.
What are the symptoms and how much should we worry?
Usually children get exposure – and immunity – to adenoviruses and other common diseases in their early childhood. However, pandemic restrictions greatly limit this early exposure, leading to more severe immune reactions in some.
Adenoviruses that have cold-like symptoms such as fever and sore throat are usually mild. However, some strains may show liver tropism or liver tissue favoring, which can lead to more serious consequences such as liver damage.
How serious this latest outbreak will be is still unclear and will depend largely on how it spreads in the coming months, according to Dr. Amy Edwards, a pediatric assistant at the Case Western Reserve School of Medicine.
“Adenovirus is a ubiquitous virus and is not seasonal. If it is a more severe form of adenovirus that causes liver disease in children, it is very worrying. But it is currently isolated and few cases so as not to jump to conclusions.” she told CNBC.
Edwards said health authorities were on alert and would monitor the situation.
Meanwhile, parents and guardians should be alert to common signs of hepatitis, including jaundice, dark urine, itchy skin, and stomach pain, and contact a healthcare professional if they are concerned.
“Normal hygiene measures such as thorough hand washing (including observation of children) and good thorough respiratory hygiene help reduce the spread of many common infections, including adenovirus,” said Chand of UKHSA.
“Children who experience symptoms of a gastrointestinal infection, including vomiting and diarrhea, should stay home and not return to school or kindergarten until 48 hours after the symptoms have stopped,” she added.
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