Public Health Canada (PHAC) has confirmed 10 cases of severe acute hepatitis in children.
The agency posted an update on its website Friday, confirming three cases in Alberta, two in Manitoba, four in Ontario, and one in Quebec.
The children, ages 1 to 13, fell ill between November 3, 2021 and April 23, 2022, according to the Primary Health Care Center.
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All diagnosed children were taken to hospital. Two of them needed a liver transplant. No deaths have been reported so far.
Hepatitis is inflammation of the liver. Depending on the cause, the agency says the disease can be sudden and progress to liver failure over a few days to weeks.
Some types of hepatitis can be treated, and most cases recover. Acute and severe hepatitis C in children is a rare condition in Canada, and in many cases, the underlying or contributing cause is not known,” the site said.
What causes acute hepatitis in children?
The health agency says the exact cause of this disease is not yet known, and investigators are still considering possible causes of acute hepatitis.
However, one potential cause being explored is adenovirus, a common virus known to cause cold, flu, or gastroenteritis in infected children.
Investigators are also looking at other potential contributing factors such as exposure to toxins or other infections.
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Could COVID-19 be the cause of hepatitis in children?
COVID-19 may be behind severe hepatitis cases in children according to a report published last Saturday on medRxiv ahead of peer review.
Children infected with COVID-19 are at significantly increased risk of developing liver impairment afterward, the report said.
But most children with acute hepatitis have not reported a previous infection with COVID-19. Instead, the majority were found to have an adenovirus called 41F, which is not known to attack the liver.
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A separate team of researchers in The Lancet Gastroenterology and Hepatology suggested that it was possible that infected children, many of whom were too young to be vaccinated, had mild or asymptomatic infection with Covid.
If true, suspended particles from the coronavirus in the digestive tract of these children could prime the immune system to overreact to adenovirus-41F with large amounts of inflammatory proteins that eventually damage the liver, the researchers hypothesized.
However, side effects of COVID-19 vaccines are not suspected because the vast majority of infected children were too young to receive COVID-19 shots, according to the World Health Organization.
The government has provided a list of symptoms that parents should look for in their children on their website.
They include yellowing of the skin or eyes, abdominal pain, nausea, vomiting, dark urine, light-colored stools, loss of appetite, fever, and fatigue.
The government also advises parents to encourage children to wash their hands frequently, to avoid people who are sick, and to avoid touching their eyes, nose or mouth.
What does Health Canada do?
PHAC says it is working with provinces and territories and international partners to investigate any reported cases of CAH in children not caused by known hepatitis viruses.
All provinces and territories are working to identify potential cases and report them to the Primary Health Care Center (PHAC). This will help further determine the national scope in Canada, and help determine whether cases in Canada are linked to other cases reported around the world,” the agency stated.
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At this time, the agency does not know if there has been a sharp rise in cases of acute hepatitis in children “not caused by known hepatitis viruses.”
We analyze Canadian hospitalization data to determine the number of cases we typically see in Canada over time. This background information will allow us to determine if we are seeing an increase in reported cases, the agency said.
The World Health Organization says at least 228 possible cases of hepatitis in children have been reported, and more are under investigation
Severe cases of hepatitis around the world
Reuters reported on May 20 that at least 600 children in at least 34 countries have had cases of sudden acute hepatitis, or acute hepatitis.
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.
7 probable cases of severe acute hepatitis in children have been reported at SickKids Hospital in Toronto
In the United States, more than 90 percent of infected children have been 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.
—With files from Reuters
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