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International authorities are investigating the increase in acute hepatitis cases of unknown cause in children and adolescents up to 16 years of age. Originally reported by April 8 in the United Kingdom where more than a hundred cases are still concentrated the reports are already reaching other European countries alongside the United States and Israel.
As of Friday 22nd, there have been at least 169 cases in at least thirteen countries, according to the latest bulletin published this Saturday 23rd by the World Health Organization (WHO). At least one death was reported, but details of the victim’s history are not available.
In addition to the United Kingdom and Northern Ireland (114), cases have been reported in Spain (13), Israel (12), the United States (9), Denmark (6), Ireland (less than 5), the Netherlands (4), Italy (4th ), Norway (2), France (2), Romania (1) and Belgium (1). So far, seventeen children need a liver transplant.
According to WHO, hepatitis is an inflammation affecting the liver caused by various infectious viruses (viral hepatitis) and noninfectious pathogens. The infection can lead to a number of health problems that can be fatal. The usual viruses that cause acute viral hepatitis (hepatitis A, B, C, D and E viruses) were not detected in any of these cases.
Although the syndrome affects patients up to 16 years of age, most cases occur in the 2 to 5yearold range. The picture of European children is one of acute infection. Many have jaundice, which is sometimes preceded by gastrointestinal symptoms—including abdominal pain, diarrhea, and vomiting—particularly in children up to the age of 10. Most cases did not have a fever.
Although adenovirus is currently suspected as the underlying cause, this does not fully explain the severity of the disease. Infection with adenovirus type 41, the adenovirus type involved, has not previously been associated with such a clinical presentation.
“Adenovirus was detected in at least 74 cases, and of the number of cases with molecular testing information, 18 were identified as FType 41. SARSCoV2 was identified in 20 cases of those tested. Also, 19 were detected.” . with a SARSCoV2 and adenovirus coinfection,” he said in a statement.
Adenoviruses are common pathogens organisms capable of causing disease in a host that usually cause selflimiting infections. They spread from person to person and most commonly cause respiratory illnesses, but depending on the species, they can also cause other conditions such as gastroenteritis (inflammation of the stomach or intestines), conjunctivitis (red eyes), and cystitis (inflammation of the bladder).
According to the WHO, there are more than 50 immunologically distinct types of adenoviruses that can cause infections in humans. Adenovirus type 41 usually presents with diarrhea, vomiting and fever, often accompanied by respiratory symptoms.
new adenovirus
The possible emergence of a new adenovirus as well as coinfection with Covid19 needs further investigation. The hypotheses on the side effects of vaccines against the new coronavirus are currently not considered, since the vast majority of affected children are not of the appropriate age for vaccination. Other infectious and noninfectious explanations must be ruled out to fully assess and manage risk according to WHO.
In case of suspicion, blood tests (with initial experience that whole blood is more sensitive than serum), serum, urine, stool and respiratory specimens, and liver biopsy specimens (if available) with further characterization of the virus, including sequencing, are recommended.
It should be emphasized that simple preventive measures for adenovirus and other common infections include regular hand washing and respiratory hygiene.
In addition to the WHO, countries that have registered cases are also monitoring the situation. The priority is to identify the root cause of these cases in order to further refine the control and prevention measures.
According to the entity, it is still unclear whether there has been an increase in hepatitis cases or an increase in awareness of reports. Although adenovirus is a possible hypothesis, investigations are ongoing to discover the source of the infection.
There is currently no guidance to restrict travel to countries with cases of illness.