Rare hepatitis disease affects young children | Knowledge & Environment | DW

Health authorities in the EU, US and UK are investigating an unusual outbreak of hepatitis with children. The affected children are all younger than ten years, many even younger than five years. Some of the cases were severe enough to require liver transplants.

It is unclear what causes hepatitis. Tests for the typical hepatitis viruses – A, B, C, D or E – were negative, what Alastair SutcliffeProfessor of General Pediatrics at University College of London, described as “very unusual”.

Severe cases of hepatitis in children are generally very rare, agrees William Irving, professor of virology at the University of Nottingham. In normal years they would be hepatitis cases tends to be single digit for children in the UK. Last week, 60 cases were reported nationwide. “I have never encountered anything like this in my clinical practice,” says Irving. “It’s worrying because we do not know what’s going on there.”

A mysterious inflammation of the liver in young children

The outbreak was by UK health authorities first reported in early April. On 19 April, the European Center for Disease Prevention and Control (ECDC) reported further cases in Spain, Denmark, the Netherlands and Ireland. It also pointed to cases in the US state of Alabama.

In a rapid study in German children’s hepatological centers, according to German Society for Pediatric and Adolescent Medicine no comparable cases have been identified to date.

Adenovirus as a possible cause

Hepatitis basically just means “inflammation of the liver”. According to virologist Irving, the clinical picture can have different causes. In addition to the classic hepatitis viruses, the inflammation can also be triggered by other viruses, by toxins in alcohol or by problems such as obesity.

According to Irving, the children currently affected are suspected of being associated with a particular adenovirus. Because a staggering number of children who have been diagnosed with the mysterious disease have tested positive for a specific type of adenovirus infection: adenovirus 41.

Infections with adenovirus 41 are common in young children and usually cause only mild diarrhea and vomiting. It was with hepatitis virus previously without connection, says Irving. However, it turned out so often in the investigations of the current cases that it could be more than a coincidence – even if it was not found in all affected children. However, it must be so not clear, about absolutely all children on the supposed Adenovirus was examined.

It is also not clear why adenovirus should suddenly lead to hepatitis. According to Irving, it is possible that this is a special version of the virus. Or that the virus interacts with one or more other factors and that is how the diseases occur.

The inflammation could also be caused by an unknown, new pathogen. Or a toxin, an environmental factor, or a combination of all of these options, Irving says.

What about COVID-19?

Also whether there is a connection with COVID-19 is according to not clarified by the virologist. It is possible that some of the affected children had previously received COVID and thus had a weakened immune system. This could have meant that typical childhood viruses are harder for the body to fight.

Thirteen cases reported in Scotland for which comprehensive test results are available provide a small insight. Of these 13, three tested positive for COVID infection, five were negative, and two had received COVID-19 within the last three months virus infected. Only 11 of the 13 cases were attributed to Adenovirus tested, where five of them gave a positive result.

that hepatitis cases may also be indirectly related to the corona pandemic and the recently abolished safeguards. For while children have only come into contact with a few pathogens within the last two years, they now encounter a variety again viruses and bacteria – including adenoviruses which their immune system has not yet been able to produce antibodies against.

“There is a group of very young children who have been largely screened. So they were not on the spectrum of it. virusexposed to infections that they would normally have been exposed to, “Irving said.” We are seeing a much higher number of children this winter virusdetected infections, including adenoviruses“.

Increase in hepatitis cases is no need to panic

To the pediatrician Alastair Sutcliffe But one thing is clear: hepatitis is not caused by COVID-19 vaccines because the childrenwho are ill were not vaccinated. Probably because COVID vaccinations for children under the age of five are not yet available in most cases.

Sutcliffe recommends that parents of young children remain calm. “As far as I know, there are many who do [der an Hepatitis erkrankten Kinder] better again, which is the usual. The risk of liver failure is very low. So I do not think we should exaggerate.

Virologist Irving expects more cases in the coming weeks as health authorities recognize and track the onset of the disease. The UK, which reports the first cases, is likely due to the country’s strict reporting systems.

“I do not understand Alabama,” Irving says. “I mean why there are nine cases in one state and no cases in the other 49 states. It makes no sense. I think it’s the reporting systems. Because if it happens in Alabama, it happens elsewhere. It does just “do not know.”

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