Hepatitis disease in children: to find the cause

Since the beginning of April 2022, health authorities in many countries have been dealing with unusual cases of hepatitis in children. According to the World Health Organization (WHO), a total of 228 diseases in 20 countries were reported on 1 May. In late April, the Robert Koch Institute (RKI) also reported a suspected case in Germany. Four children are said to have died as a result of the disease. What is behind the disease? Two experts’ assessment.

Cases of hepatitis in children: the actual number of those affected is unclear

Despite the increasing number of reported cases of hepatitis, the actual number of children affected is currently unclear. Burkhard Rodeck, pediatric hepatologist and general secretary of the German Society for Pediatric and Adolescent Medicine in Berlin, is therefore in favor of establishing a so-called “reporting system” to estimate the number of children affected – including the number of those with a serious illness. The course of the disease would take, as the doctor says in the BR interview. Due to the frequent occurrence of cases, he advises caution, but warns against panicking. “Yes, we need to be careful, but we do not have to be afraid that our children will all suddenly get hepatitis.”

Liver disease: why the situation is worrying experts

It is usually extremely rare for children to develop hepatitis. Experts are so far unclear why there is currently an increase in hepatitis cases, especially in children between three and five years of age. The WHO and the European Center for Disease Prevention and Control (ECDC) are talking about a worrying event.

In order to obtain a reliable database and thus a better assessment, the European Reference Network for Rare Liver Diseases has organized a European study, which will be published over the next few days. So far, however, the results of the study have not been very meaningful: Only eleven centers out of 33 pediatric specialty centers reported that they could have a small increase in the number of cases, explains Ansgar Lohse, professor at the University Hospital in Hamburg-Eppendorf (UKE) and leader of the network. There may be various reasons for this, says Lohse: It may be that the disease is a local phenomenon, or that the disease is only gradually spreading in Europe. He therefore advises, like his colleague Rodeck, “on guard [zu] stay and keep an eye on the numbers [zu] To keep”.

Adenovirus a possible cause of hepatitis

Experts are still groping in the dark, not only with the numbers, but also with the causes of hepatitis. For none of the sick children have been infected by a classic hepatitis virus. Infection is possible due to adenovirus. The first research results from the UK, which have been published recently, suggest this.

Adenoviruses are widespread, they can cause respiratory infections or gastrointestinal problems. So far, however, there has been no clear evidence that they are the cause of the common liver diseases. According to Dr. Lohse, a previous adenovirus infection was only detectable in two-thirds of the children who later developed hepatitis. However, according to the liver specialist, it may be that “the evidence simply did not succeed”, but it may also be the case that there are some other viruses, “the doctor points out. Herpes virus can also be loud, for example may also be the cause.

Why the pandemic could also be a cause

However, the expert can not see that the increase in hepatitis cases in children is related to Covid disease, as it has been widely discussed. “We’ve been in the pandemic for two years now and also have a lot of experience with children who are affected, and now suddenly acute cases of hepatitis associated with Covid 19 infections, that would be very unusual. It should have been noticed before. ” , he says in BR.

And yet, the pandemic may indirectly be the cause of the many cases of hepatitis in children. The children’s untrained immune system due to the closure of day care centers and schools may be to blame for the many liver diseases. The untrained immune system, which in turn has to deal with many viruses after relaxation of corona protection measures, can react too strongly, which can lead to hepatitis. But even that is nothing but a hypothesis. The researchers only expect more findings in the coming weeks and months.

Where cases of hepatitis increased in children

The first and so far most cases of hepatitis in children were reported in the UK. The number continues to rise there. But there have also been mysterious cases of hepatitis in children in the last few weeks in the US, in other European countries – including the presumed case in Germany – as well as in Israel and Japan.

How do I recognize hepatitis in my child?

According to current knowledge, most of the children now suffering from hepatitis were previously healthy. The first symptoms of a disease were abdominal pain, diarrhea, vomiting and jaundice.

Experts advise parents to see a doctor if they notice any of the following:

  • with yellowing of the eyes,
  • when the urine becomes dark and the stools gray.

In addition, fatigue and decreased exercise capacity may be symptoms of possible liver damage. Other signs of liver damage can be frequent bruising and vague itching. If these symptoms occur, parents should also take their child to the doctor.

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