The Toronto Children’s Hospital says it has identified seven possible cases of severe acute hepatitis of unknown origin.
The research and pediatric hospital, also known as SickKids, says the mysterious cases were identified between October 1, 2021 and April 30, 2022, and were reported to Public Health Ontario.
Dr Upton Allen, head of the hospital’s infectious disease department, said on Tuesday that large children’s hospitals like his regularly visit children with severe hepatitis and that the overall figures “seem to be quite in line with what we have seen before”.
“But we’re really looking at these numbers in great detail,” Alan added.
World Health Organization officials said last week they had reports of nearly 300 possible cases in 20 countries. More than 100 possible cases have occurred among children in the United States, including five deaths.
Alan could not say whether the seven cases cited by SickKids were different from what they would have seen in previous years.
“What we can say is that we have cases that meet the definition of the World Health Organization case. But we still can’t say for sure that these cases are really a new signal, “he said.
SickKids said infectious disease specialists are looking for young people with symptoms of liver disease, which may include a new appearance of dark urine, pale stools and / or jaundice, which can turn the whites of the eyes into a distinctive yellow color.
They also recommended a lower threshold for referral to specialized care.
Allen said concerns about his privacy did not allow him to reveal details of the seven cases, but that the children had previously been healthy and were less than a year to 12 years old.
He declined to give details of their medical condition or whether they needed a liver transplant.
“But what I can say is that severe hepatitis in general will inevitably end in some children who need a transplant if the hepatitis is particularly severe,” he said.
The Ottawa Pediatric Health Center CHEO said Tuesday it has no suspicions of hospitalized cases of acute pediatric hepatitis. The only suspected case since December counts in the issue published by SickKids, a CHEO spokesman said in an email.
Vancouver BC Children’s Hospital also said there were no cases, while an Alberta Health spokesman said the province was “in the early days of gathering information.”
Canada’s chief public health official said federal officials were working with the country’s 17 pediatric centers to better understand what was happening.
Even before the pandemic, about half of all cases of hepatitis in children who are severe would have no known cause, Dr. Theresa Tam said Friday.
“We are still under investigation to try to find out if any of these cases are related at all. “There has always been hepatitis and some severe cases of hepatitis in children before a pandemic, and it can be expected after a pandemic,” she said.
There he said that the cases that occur in Canada are called “probable” because there is no confirmation of the specific cause. She said experts in the United Kingdom and the United States had found cases involving type 41 adenovirus, “but this may or may not be the cause or the only factor leading to hepatitis in children.”
Canada’s deputy chief public health officer added that federal officials are also working closely with the provinces and territories to launch a broad monitoring network.
“We anticipate that there may be situations or cases that meet this broad definition of the case,” Dr. Howard Nju said on Friday.
There are dozens of adenoviruses, many of which are associated with symptoms such as colds, fevers, sore throats and pink eyes.
But some versions can cause other problems, including inflammation of the stomach and intestines. Officials are investigating a link to a specific version, which is usually associated with inflammation of the intestines.
“The verdict is not yet whether the real culprit is the adenovirus or not,” Allen said of the SickKids case.
“Adenoviruses belong to a family of viruses that can stay in our bodies in certain cells for a long time. And it’s not uncommon for us to be able to detect adenovirus in some people if we get seriously ill and are in the hospital for a reason completely unrelated to adenovirus.
A case of severe hepatitis in a child would manifest itself as a very obvious disease and is rare, Alan said.
“If your child is excluded, you should be included in your family doctor anyway, right?” But I don’t want people to line up (emergencies) because the child started vomiting once or something, “Alan said.
In addition to jaundice, dark urine and pale stools, there are several other key symptoms to watch out for, SickKids notes.
These include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain and joint pain.
– With files from Laura Osman in Ottawa and the Associated Press.
This report from The Canadian Press was first published on May 10, 2022.
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