Another 71 cases of mysterious hepatitis are being investigated in the United States, the Centers for Disease Control and Prevention said Wednesday.
No more deaths have been reported in the past two weeks, but the CDC previously said it was investigating five deaths at the outbreak, one in Wisconsin.
Another child needs a liver transplant, bringing the national number of patients in need of this procedure to 16.
A total of 180 cases of mysterious hepatitis have already been linked to the outbreak in 35 states, with all patients under the age of 10.
This is the highest of any nation in the world with the United Kingdom, which opened the outbreak for the first time, with the second largest total of 163 cases.
The CDC said the “vast majority” of these patients were retrospective and had come to hospitals before May, but had just been diagnosed with the mysterious disease.
Researchers are puzzled by what the epidemic is causing, but CDC officials say adenoviruses – which can cause the common cold – remain a “strong lead”, with nearly half of patients testing positive for them.
Other theories suggest that previous Covid infection, mutation in adenoviruses, or even exposure to domestic dogs may trigger the disease.
All normal causes of the disease – hepatitis A, B, C, D and E viruses – are excluded.
The CDC said today that another 71 cases of mysterious hepatitis have been reported in the United States, with a total of 180. They are in 35 states (shown above)
At least 12 children have already died from the mysterious hepatitis worldwide, with five deaths also reported in Indonesia and one each in Ireland and Palestine.
Today’s US report shows the global number of at least 520 cases in 21 countries, mostly among children under 10 years of age.
CDC officials said they were continuing to investigate all possible causes of the mysterious hepatitis epidemic.
Questions and Answers: What is the mysterious global hepatitis epidemic and what is behind it?
What is hepatitis?
Hepatitis is an inflammation of the liver that is usually caused by a viral infection or damage to the liver from drinking alcohol.
Some cases resolve on their own without ongoing problems, but some can be fatal, forcing patients to need liver transplants to survive.
What are the symptoms?
People who have hepatitis usually have fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light stools, and joint pain.
They can also suffer from jaundice – when the skin and whites of the eyes turn yellow.
Why are experts concerned?
Hepatitis is usually rare in children, but experts have already noticed more cases in the current epidemic than they usually expect in a year.
The cases are of “unknown origin” and are also serious, according to the World Health Organization.
What are the best theories?
Co-infection
Experts say the cases may be related to an adenovirus, often associated with colds, but further research is underway.
This, in combination with Covid infections, can cause a jump in cases.
About three quarters of British cases tested positive for the virus.
Weakened immunity
British experts tasked with investigating a series of diseases believe that the endless cycle of blocking may have played a role.
Restrictions may have weakened children’s immunity due to reduced social mixing, which leaves them at increased risk of adenovirus.
This means that even “normal” adenovirus can cause severe results because children do not respond to it as they have in the past.
Adenoviral mutation
Other scientists have said it may be an adenovirus that has acquired “unusual mutations.”
This would mean that it may be more portable or more able to bypass children’s natural immunity.
A new version of Covid
UKHSA staff included a “new version of SARS-CoV-2” in their working hypotheses.
Covid causes inflammation of the liver in very rare cases during the pandemic, although they were at all ages and not isolated in children.
Ecological triggers
The CDC noted that environmental causes are still being investigated as possible causes of disease.
These may include contamination or exposure to certain drugs or toxins.
They revealed that 11 more states have discovered cases of mysterious hepatitis in the last two weeks.
These were: Arkansas, Hawaii, Kentucky, Maryland, Massachusetts, Nevada, New Jersey, Oklahoma, Rhode Island, South Dakota and Virginia.
Earlier, a total of 24 states discovered the virus, which are: Alabama, Arizona, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Michigan, Minnesota, Missouri, North Carolina, North Dakota, York, Nebraska , Ohio, Pennsylvania, Tennessee, Texas, Washington and Wisconsin.
It was also reported at the time that Puerto Rico had at least one case of the disease.
The CDC added: “It is important to note that severe hepatitis in children remains rare.
“However, we encourage parents and caregivers to be aware of the symptoms of hepatitis – especially jaundice, which is yellowing of the skin or eyes – and to contact their child’s healthcare provider with any concerns.
The outbreak of mysterious hepatitis in America began in October last year, when nine cases were reported in Alabama.
CDC officials initially dismissed this as an isolated incident, but took another look after the UK raised alarm about a fire on its shores.
Since then, U.S. health officials have issued two signals urging doctors and nurses to watch out for patients with the disease.
Last week, a leading scientist warned that the epidemic would continue “all summer” and that many cases remained undiagnosed.
Dr Matthew Biniker, director of clinical virology at the Mayo Clinic in Minnesota, told DailyMail.com that cases would continue to occur because the transmission of adenoviruses – the main suspect – was usually “not seasonal”.
He warned that schools and day care centers – where children mix – are major centers for the spread of the virus.
Adenoviruses can be transmitted by touching surfaces contaminated with feces.
Speaking exclusively to DailyMail.com, Dr Biniker said: “I would not be comfortable saying that this outbreak has reached its peak.
“I would say that the cases will continue to appear during the summer, because we will continue to see children in day care, where there is a higher transmission.
“This type of adenovirus, which we are reluctant to think of as seasonal, will continue to see cases throughout the year.”
Children with adenovirus with mysterious hepatitis are more likely to test positive for type 41.
This infects the stomach system, causing symptoms including diarrhea and vomiting.
It is spread by faecal-oral route or when someone touches a surface contaminated with feces and later touches their own mouth.
Asked if many more cases would be seen in the United States last week, Biniker warned that they would most likely still be diagnosed because they were milder.
“Hepatitis can occur on a sliding scale, leading to hospitalization of the individual to the other end, where it is much milder,” he said.
“Inside.” [the mild] cases, may not cause parents to take their child to an investigation or hospital.
“Many of these children will experience symptoms of gastroenteritis such as vomiting, diarrhea and nausea, and some also face upper respiratory disease, such as a cough or sore throat that precedes hepatitis.
“Those who then develop hepatitis will see changes in skin color, so some develop symptoms of jaundice or yellowing of the skin … ranging from very, very noticeable to very, very subtle changes.
“Yellowing of the white of the eye is also something that is very obvious and parents are sometimes shocked, but other times it is very, very fine and may not be noticeable.”
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