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The Mysterious Hepatitis
There have been many cases of children, especially those under the age of 10, with severe acute hepatitis of unknown origin emerging in many countries. Although there have been no cases reported in Thailand yet, parents should still be alert to the signs associated with jaundice – yellowing of skin and whites of eyes, as well as the body secretions.
Dr. Philippa Easterbrook, a senior scientist in the World Health Organization’s Global Hepatitis Program, said that, as of May 1, there are 228 probable cases linked to the outbreak in 20 countries under investigation. The US Centers for Disease Control and Prevention (CDC) is investigating more than 100 cases of severe and unexplained hepatitis in children in 25 states.
Among them, 14 per cent needed transplants, and five children died. Nearly all the children – more than 90 per cent – needed to be hospitalized. In the United Kingdom, 114 cases were reported while Japan was the first country in Asia to report the case of the disease. Dr. Jay Butler, the CDC’s deputy director of infectious diseases, stressed that the investigation is an evolving situation. Not all the hepatitis cases now may ultimately be caused by the same thing.
Although the investigation of the disease has not been able to determine the exact cause, adenovirus type 41 was detected in more than 50 per cent of the patients. The World Health Organization added that Hepatitis A, B, C, D and E were not identified as the main causes of current hepatitis outbreak and revealed that adenovirus type 41 was detected in at least 74 of the total number of patients, and 19 cases of both adenovirus type 41 and SAR-CoV-2 virus have been reported. Even so, WHO reiterated that the adenovirus is still inconclusive as the exact cause.
Adenovirus normally does not cause such severe symptoms. There have never been any records of the virus causing severe hepatitis in healthy children, to this point. A number of scientists have hypothesized that a genetic variation of the adenovirus may trigger hepatitis more easily. In the meantime, UK Health Security Agency insisted that Covid-19 vaccines shouldn’t be linked to the cause of hepatitis because many of the children diagnosed with acute hepatitis were not eligible for vaccination.
Another possibility is that the pandemic, by delaying children’s exposure to a number of different viruses including adenovirus because of reduced social mixing, may have made them more prone to a severe immune response. However, despite a family of viruses well known for attacking the liver, hepatitis can be caused by infections, toxins, alcohol and drugs, as well as autoimmune diseases.
Most of the sick children were healthy when they developed acute symptoms with elevated liver enzymes and often with symptoms of jaundice – a yellowing of the skin and whites of the eyes occurring when too much bilirubin in the bloodstream cannot be excreted from the body. Occasionally, there will be symptoms of gastrointestinal diseases such as vomiting, fatigue, loss of appetite, abdominal pain, food poisoning, diarrhea, stomachache, dark urine. and light- colored stools.
Dr. Heli Bhatt, a pediatric gastroenterologist of M Health Fairview Masonic Children’s Center in Minneapolis who has treated two children, noted that liver failure in children is “super rare.” Sometimes, common viruses like Epstein-Barr or even SARS-CoV-2 will raise a child’s liver enzymes a little, indicating “mild hepatitis,” but they typically recover showing minimized symptoms as their bodies fight off the infection.
Dr Meera Chand, the Director of the UK Health Security Agency (UKHSA), reckoned that common prevention measures for adenovirus and other common infections involve regular hand washing and respiratory hygiene. Any children with such symptoms as vomiting and diarrhea should stay home for 48 hours after the symptoms have subsided or stopped manifesting.
Source: stanfordchildrens, who, bbc
