Disease in children: what is behind the cases of hepatitis?


Status: 07.05.2022 13:25

The mysterious cases of hepatitis in children are on the rise worldwide. Where does the disease come from? Is there a connection to the corona pandemic? And what should parents be aware of?

The WHO has reported a worldwide increase in hepatitis infections of unknown origin in children under ten years of age. Ongoing studies of blood and stool samples on behalf of the Robert Koch Institute aim to provide information on the causative pathogens.

Experts such as the Secretary General of the German Society for Pediatrics and Adolescent Medicine Burkhard Rodeck, suspects so-called adenoviruses as possible triggers of the disease and also speculates on possible links to the corona pandemic and the associated measures.

What is hepatitis and what are the symptoms?

Hepatitis is an inflammation of the liver that often precedes a viral infection. Hepatitis viruses A to E are the most well-known triggers of such infections. The severity, course, and transmission of hepatitis depend on its type. Signs of hepatitis are elevated liver values.

However, hepatitis can also manifest itself in the form of, among other things, vomiting, diarrhea, fever, malaise and jaundice. RKI and the Standing Vaccination Committee recommend vaccination against type B virus in infants. Hepatitis A vaccination is especially recommended for people at risk and travelers.

In which countries are there currently more cases – and how do the authorities react?

After Britain reported the first five cases in March, the WHO became aware of nearly 220 new diseases in 20 other countries by May 1, 2022, according to WHO spokesman Tarik Jasarevic on May 3. In Germany, a few cases have been reported by the state health authorities.

In a letter to specialist associations in pediatrics and on the official website, the Robert Koch Institute called for increased attention to suspected cases and referred to the corresponding reporting obligation under the Infection Control Act. RKI estimates that the number of cases in the UK in particular is unusually high. Developments in Germany must continue to be followed. Acute hepatitis diseases of unclear cause are rare in children, but they also occur occasionally in Germany.

What are the consequences of the disease in children?

The still unresolved phenomenon of hepatitis in children, which is spreading all over the world, leaves experts amazed. Particularly severe hepatitis cases occur especially in those affected under five years. According to the World Health Organization, nearly ten percent of affected children required a liver transplant due to hepatitis infection.

At least four children have already died of hepatitis within the past few weeks. Current laboratory studies showed that no type A to E hepatitis virus could be detected in the majority of the affected children.

What can trigger recent cases of hepatitis in childhood?

Instead of the classic pathogens, type 41 adenoviruses were detected in many of those affected. These viruses were found in 75 per cent of sick children in the UK. Adenoviruses usually trigger mild cold symptoms and gastrointestinal infections, among others.

Serious complications such as hepatitis, which can lead to liver failure, are quite atypical in adenovirus infections. Such serious consequences usually affect only people with particularly weak immune systems. Adenovirus was not previously known to be the cause of hepatitis in healthy children.

Could there be a link with Corona or a Corona vaccination?

The WHO reports double infection in almost 20 of the 200 reported cases. Consequently, the affected patients appear to have been infected with both adenovirus and coronavirus.

No association with corona vaccination can be demonstrated because the affected children were not vaccinated at the time of disease. However, the exact cause of the new hepatitis diseases is still unclear. However, experts, including Rodeck, speculate that the corona pandemic may be directly related to the serious infections.

What is the connection to the corona pandemic?

Rodeck and other experts suspect that children’s immune systems, which are particularly shaped in the first few years of life, have been weakened by distance and other corona measures. During these important first years of life, children were therefore exposed to fewer viruses due to possible contact restrictions and were therefore unable to develop similar antibodies.

On the one hand, the markedly increased hygiene measures can reduce the risk of infection, but on the other hand, the performance of a permanently under-challenged immune system is steadily declining.

It increases the risk of becoming infected and getting sick more easily if you come in contact with viruses. According to Rodeck, severe disease progressions, such as in the case of childhood hepatitis, can be the result of a lack of training of young, naive immune systems.

At the same time, there is the hypothesis that, as with the SARS-CoV-2 variants, a more aggressive and contagious adenovirus variant could have emerged.

Can hepatitis cases be caused by contaminated food?

Hepatitis can also be transmitted through contaminated food or drinking water. However, Tobias Tenenbaum, chief physician for pediatric and adolescent medicine at Sana Klinikum Lichtenberg, rules out that the cases of hepatitis observed in children are due to contamination of food. His opinion is based on the knowledge that there is no common nutritional pattern in the differently affected age groups.

What should parents take care of?

Chief physician Tenenbaum advises parents to pay special attention to their children’s skin and conjunctiva if they are infected with a gastrointestinal virus. If these turn yellow, the urine becomes darker, or the stool becomes lighter, you should contact your pediatrician. Strict hand and bathroom hygiene can also reduce the risk of infection.

How do experts assess the situation?

Although the manageable number of reported hepatitis cases in children seems low, health authorities worldwide are on alert due to the high health risk that can occur, according to pediatric infection doctor Tenenbaum. The exact causes of the mysterious cases of hepatitis in children are still being researched.

Mysterious hepatitis disease in children

Claudia Sarre, ARD Washington, May 7, 2022 at. 13.48

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