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“As of May 17, 2022, 33 probable cases of acute hepatitis of unknown origin have been reported in children in seven countries in the Americas. No country has reported to PAHO mortality or the performance of transplants in children for this cause,” said a PAHO spokeswoman.

“By ‘probable case’ is meant a case in which infection with hepatitis A, B, C and E viruses has been ruled out, and other conditions are met,” he explained.

PAHO, the regional office of the World Health Organization (WHO), did not specify which American countries reported cases of this rare disease that affects young children.

But two North American countries have reported in recent days that they are investigating suspected cases of this type: Mexico said on Tuesday it was analyzing 21 cases, and the United States said on Friday it was studying 109 cases, including five deaths.

The WHO was first informed on April 5 of a dozen unexplained cases of hepatitis in Scotland, detected in children under 10 years of age.

As of May 15, the WHO had a record of 429 probable cases of this type in 22 countries around the world, nine of them in Europe. Six children have died so far in the world from this disease and 26 require transplants, he said.

Many cases reported jaundice and gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting.

“It may take some time before we can really establish the mechanisms of causality,” Enrique Pérez, PAHO’s head of Information on Health Emergencies and Risk Assessment, said at a press conference on Wednesday.

Pérez said that PAHO works with the countries in the region “to focus its efforts on investigating suspected cases,” for which he proposed a standardized form to guide investigations.

One of the main hypotheses of the WHO is the link between the coronavirus and adenovirus type 41, a common cause of diarrhea in children around the world.

Experts estimate that a covid-19 infection may have remained in the children’s intestines and a subsequent adenovirus infection would have triggered an immune response and caused inflammation.

Until now the coronavirus has been associated with hepatitis in adults, but not in children.

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