Outbreaks of severe hepatitis in healthy children, which have caused liver failure in some children, may be linked to adenoviral infection rather than hepatitis, as originally thought, although further investigation is needed, World Health Organization officials said Thursday. .
Eleven countries, including the United States, have reported at least 169 cases of severe acute hepatitis in children aged 1 month to 16 years with the largest outbreak in the United Kingdom, according to the latest WHO report. At least 17 children needed a liver transplant and one patient died.
Hepatitis is an inflammation of the liver, most commonly caused by viruses, but drugs and toxins can also cause the disease.
“What is particularly unusual is that most of these children were previously healthy,” said Dr. Philippa Easterbrook, a WHO hepatitis observer, during a question-and-answer session. live on social media from the World Health Agency on Thursday.
At least 74 of the children tested positive for adenovirus, according to the WHO. Adenoviruses are common and usually cause respiratory illness, but can also cause stomach pain, pink eyes, and bladder infections. The severe epidemic of hepatitis in children has coincided with increased transmission of adenovirus in countries such as the United Kingdom, according to the WHO.
“At this stage, this does not prove that there is a causal link to these cases, but it is a promising interesting early warning that is being considered in more detail,” Easterbrook said.
In rare cases, the adenovirus has been linked to hepatitis in children with weak immune systems, according to Dr. Richard Peabody, who heads the WHO team on high-risk pathogens in Europe. However, adenovirus is not a known cause of hepatitis in healthy children, according to the WHO.
“This is an unusual phenomenon that we see, and that’s why we are somehow warning parents and public health authorities about it,” Peabody said.
At least 20 of the children had Covid, and 19 of them tested positive for the virus as well as for the adenovirus, according to the WHO. Peabody said Covid may also play a role in the outbreak of hepatitis, although it is unclear and more investigation is needed.
The United Kingdom first notified the WHO of an outbreak of severe acute hepatitis in children earlier this month. The most common symptoms are inflammation of the liver, stomach pain, diarrhea, vomiting and jaundice, according to the WHO.
The Centers for Disease Control and Prevention issued a national health alert last week after finding nine cases of hepatitis in children aged 1 to 6 in Alabama. All nine children had liver damage with some liver failure, according to the CDC. The CDC also believes the cause may be adenovirus, although the Public Health Agency said investigations are ongoing.
Easterbrook said health officials have largely ruled out hepatitis A, B, C, D and E viruses as a possible cause. Hepatitis viruses were not detected in any of the reported cases, according to the WHO. Other viruses such as CMV and Epstein Barr also do not appear to be the cause of the outbreak, Easterbrook said. The parents of the children have so far not reported frequent exposure to drugs, toxins, food or a travel destination, she said.
The WHO has also largely ruled out Covid-19 vaccination as a possible cause, as most children have not received the vaccine, Easterbrook said.
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