Hepatitis outbreak in children in US and Europe may be linked to adenovirus

United Kingdom (April 28, 2022)—Mysterious cases of serious liver damage or hepatitis in kids have been reported in a dozen countries, including the U.S., the U.K., Japan, and Canada.

  • Health officials say there have been nearly 200 cases, 17 liver transplants, and one death.
  • Health officials report that the outbreak may be linked to adenovirus, a common cold virus.
  • Any child showing signs of jaundice, a symptom of hepatitis, should be evaluated by a medical professional as soon as possible.

This is a developing story. We will provide updates as more information becomes available.

Health officials are searching for clues as a puzzling outbreak of serious liver disease impacts young children in Europe, North America, and Asia.

Worldwide, there have been nearly 200 cases, 17 liver transplants, and one death linked to “acute hepatitis of unknown origin,” according to the World Health OrganizationTrusted Source and the European Centre for Disease Prevention and Control (ECDC). The WHO did not say where the death was reported.

The cases were first recorded in the United Kingdom where a majority of the cases have been identified. The outbreak has since spread to at least 12 countries, including the United States, Canada, and Japan.

In the U.S., cases have been identified in several states, including Alabama, North Carolina, Illinois, and Wisconsin.

The children’s ages range from 1 month to 16 years old.

So far, none tested positive for known hepatitis viruses A, B, C, D, or E, suggesting novel pathogenesis.

Hepatitis is indicated by excessively high liver enzyme levels. Medical experts are scrambling to identify the cause of the outbreak. While not confirmed, there is evidence that a common virus, adenovirus, may be involved, the U.K.’s Health Security Agency (UKHSA) said in a technical briefing Monday.

According to the WHO, a strain of adenovirus known as F type 41 was detected in more than 70 cases.

“While adenovirus is a possible hypothesis, investigations are ongoing for the causative agent,” the agency said in a statement.

“While adenovirus is a possible hypothesis, investigations are ongoing for the causative agent,” the agency said in a statement.

As the medical community is on the lookout for new cases, the number of affected children is expected to rise as more cases have been reported in Ireland, Spain, Israel, and other countries.

 
A growing outbreak

On April 21, the Centers for Disease Control (CDC) issued a Health Alert Network Health Advisory notifying clinicians and public health authorities about a cluster of unexplained child hepatitis cases in Alabama. In November 2021, a large hospital informed the CDC that they had seen five children with significant, unexplained liver injury. Three of them experienced acute liver failure. By February, the hospital had identified another four patientsTrusted Source. All had adenovirus type 41 infections.

Health officials in the U.K. had already notified the World Health OrganizationTrusted Source on April 5, of 10 cases of severe acute hepatitis in central Scotland. One case occurred in January of this year, and the remainder were reported by March. By April 8, the number of cases had risen to 74. Some of these, children, too, had the adenovirus.

There has been no consistent link to SARS-CoV-2, though some children tested positive for it.

Hepatitis symptoms

According to the CDC, standard symptoms of hepatitis include “fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.”

Dr. Anupama Kalaskar, a pediatric infectious diseases specialist at Children’s Minnesota Hospital in Minneapolis, told Medical News Today:

​“We are learning more about the cases of acute hepatitis in children and trying to understand any similarities in cases that could help us to identify them sooner. Some common symptoms that have been reported in known cases are the presence of diarrhea and jaundice in the absence of fever. Diarrhea is a quite common symptom in children and can be seen with a number of infectious causes, including many kinds of viruses, as well as non-infectious causes.”

“Jaundice, however, especially in the age group in which the hepatitis cases have been more common, is a more rare symptom,” said Dr. Kalaskar. “Any child with diarrhea and jaundice should be seen for evaluation.”

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Source: Medical News Today wrote the original article.  Written by Angela Chao and Robby Berman on April 28, 2022 

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