Explanation: What do you know about cases of severe occult hepatitis in children

Explanation: What do you know about cases of severe occult hepatitis in children

People walk into Children’s Hospital of Georgia in Augusta, Georgia, US, January 14, 2022. REUTERS/Hannah Beer

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NEW YORK (Reuters) – At least 600 children in at least 34 countries have contracted cases of sudden acute hepatitis, or acute hepatitis, for which there is no explanation for doctors.

Here’s what health officials know so far:

Several cases have been detected in the United States and the United Kingdom

As of May 18, at least 175 children in the UK and 180 in the US have fallen ill since October 2021, most of them under the age of five.

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By way of comparison, doctors typically see 20 children with acute hepatitis of unknown origin each year in three specialist pediatric hepatology units in the UK, Dr Deirdre Kelly, a pediatric hepatologist at the University of Birmingham, told reporters on Thursday. “That’s a lot more,” she said.

How serious are these cases?

In the United States, more than 90% of infected children are hospitalized. Most have recovered, but at least five have died, according to the US Centers for Disease Control and Prevention. Worldwide, more than twenty children have required liver transplants.

Most cases have been reported since April. Typical signs are dark urine, light stools, vomiting, and jaundice.

The reason is the mystery

Acute hepatitis is unusual in young children. No common environmental exposures, such as unsafe water or food, were found. Doctors believe the virus is to blame, but none of the children had viruses known to cause hepatitis.

Nearly half of the children tested positive for adenovirus, a common childhood virus, including some with a type called adenovirus-41F. Adenovirus-41 is known to cause gastrointestinal symptoms such as diarrhea, vomiting, and fever. It has not been previously linked to this type of acute liver injury in healthy children, said Dr. Rima Fawaz, a pediatric hepatologist at Yale University School of Medicine.

The UK’s Health Security Agency said possible explanations include an exceptionally large wave of natural adenovirus infection that causes unusual complications that often appear, a new variant of adenovirus, a novel variant of SARS-CoV-2, or a new variant of SARS-CoV-2. contagious previously unknown. The researchers raised the possibility that some past infections may have caused children’s immune systems to overreact to pathogens that are usually relatively benign.

Is there a link to COVID-19?

Disease experts have ruled out a link between hepatitis cases and COVID vaccines, because most infected children were too young to receive injections.

Most children do not currently have COVID-19, and previous SARS-CoV-2 infection has not been identified for many cases, said Dr. Jason Kendracchuk, an infectious disease researcher at the University of Manitoba, Canada.

However, some may have a mild or asymptomatic COVID infection that no one has noticed. Coronavirus particles stuck in the GI tract may be a primer for the immune system to overreact to a mild adenovirus that contains large amounts of inflammatory proteins that eventually lead to liver damage.

Other experts also believe that due to social distancing and other measures used to curb the epidemic, younger children were less exposed to adenoviruses that would help them build immunity. As a result, their immune systems may be overreacting to the infection now.

“More research will be needed to confirm either theory,” Fawaz said.

Discovery data may conflict with estimates

There is also the possibility that rates of acute hepatitis in young children may not be as high as they seem. Pediatricians may test for the condition more often in children with gastrointestinal symptoms, which leads to more frequent diagnoses of conditions that may have gone undetected in the past.

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(Reporting by Nancy Lapid and Jennifer Rigby) Editing by Michael Gershberg and Bill Bercrot

Our Standards: Thomson Reuters Trust Principles.

2022-05-20 17:05:00

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