Studies conducted by the University of Glasgow and the Great Ormond Street Hospital in London indicate that a recent rise in cases of acute hepatitis among children is likely linked to a common childhood virus.
Countries around the world began reporting cases of severe liver inflammation, hepatitis, caused by unknown origin in children in April 2022. At least 1,010 cases have been reported in 35 countries, according to the World Health Organization (WHO) . In total, 46 children required liver transplants and 22 died.
The studies were published as pre-prints, that is, they will still be reviewed by other scientists. Publications suggest that another common virus, an adeno-associated virus 2 (AAV2), was present in most cases, and is more likely to be involved in the rare but severe liver complications.
Research does not clarify whether the virus found in the children was indicative of a previous adenovirus infection or a cause of its own.
Scotland
According to one of the studies, in April 2022, a group of five children with jaundice and severe acute hepatitis of unknown origin was reported in Scotland. To tackle the problem, the Scottish Public Health System has convened a team of academics from the UK Health Safety Agency to investigate the problem. In July of this year, the country registered 36 children aged 10 years or younger with unexplained acute hepatitis, one of whom required a liver transplant.
The study investigated the possibility that cases of hepatitis of unknown origin may be linked to previous infection with covid-19. However, according to the scientists responsible, direct liver injury by SARS-CoV-2 “seems unlikely”, as only two of nine cases were positive for the virus.
“In addition, SARS-CoV-2 antibody positivity in hepatitis cases was within community positivity rates at that time, in children who presented to emergency departments between January and June 2022. However, it is not possible totally exclude a phenomenon related to post-covid-19 in susceptible children”, says the study.
Brazil
In Brazil, so far, six cases are considered “inconclusive”, of which three needed a transplant and one child died. Another case is treated as probable, according to report released by the Ministry of Health on the 14th of July. The folder has followed and monitored the incidence of cases of severe acute hepatitis in Brazil in children and adolescents. In all, 44 cases are still under analysis as “suspects”.
Symptoms
Symptoms include high liver enzymes, vomiting, diarrhea, abdominal pain, and jaundice (when the skin and whites of the eyes turn yellow). It manifests itself in a very severe form and has no direct relationship with the already known hepatitis viruses.
According to the ministry, severe hepatitis in this age group, leading to liver failure, is a relatively rare occurrence. “Many causes of different natures have already been associated with the condition, but it is important to emphasize that most cases of severe acute hepatitis in children and adolescents normally did not have their cause determined”, says the folder.
Causes
Among the infectious causes of hepatitis, in addition to viral hepatitis A, B, C, D and E, other viruses can cause the disease, such as herpes simplex, Epstein-Barr, cytomegalovirus, enteroviruses and even arboviruses, such as dengue. , zika, chikungunya and yellow fever. In addition, some bacterial infections may also more rarely affect the liver.
Poisoning by drugs such as paracetamol, albendazole and fluconazole are well-known causes of acute hepatitis. Many rarer autoimmune, congenital and vascular diseases can also trigger intoxication.
“Categorizing and reporting a condition as acute hepatitis with an etiology to be clarified does not necessarily mean that one expects to discover something unknown so far, but that it is necessary to refine the investigation of the causes and the general understanding of severe hepatitis in children and adolescents, not only due to the current outbreak, but also due to the historical existence of a knowledge deficit in relation to this aggravation”, explained the ministry.
Current treatment seeks to alleviate symptoms and stabilize the patient if the case is severe. Treatment recommendations should be refined once the source of the infection is determined.
Parents should be on the lookout for symptoms, such as diarrhea or vomiting, and for signs of jaundice. In such cases, medical attention should be sought immediately.
*With information from Reuters
