Nearly 300 Cases: Global Mysterious Hepatitis Outbreak linked with COVID Infections amongst Children Spreads across 20 Countries

According to the UK Health Security Agency (UKHSA), the number of children infected with hepatitis had risen to more than 140 by May 4th. Inflammation of the liver is now most commonly reported in children under the age of five, with a small percentage of children over the age of 11 also now testing positive for hepatitis.

The first cases of this unusual hepatitis were discovered in children under the age of ten in Scotland. In the United Kingdom, more than 140 cases are currently being investigated.

Children under the age of five who get hepatitis have nausea and diarrhoea first, followed by jaundice.

There are now ten children on the liver transplant waiting list in the United Kingdom, the majority of whom were added recently. Fortunately, the UKHSA has not yet reported any deaths.

What Is Hepatitis?

Hepatitis is simply an inflammation of the liver that can result in a variety of problems, including liver failure and even cancer, both of which can be fatal. The liver is one of the most important organs in the body because it is in charge of cleaning the blood of all toxins and also plays a role in metabolism and blood clotting, among other things.

A variety of factors can contribute to hepatitis. The most common hepatitis virus strains are A, B, C, D, and E. These viruses spread in a variety of ways and vary in geographical presence, symptoms (some people may be asymptomatic), and severity, but they all cause hepatitis. Vaccines can aid in the prevention of some strains.

Hepatitis can also be caused by certain medications, auto-immune disorders, and alcohol.

In some cases, such as the case of the children, there is no known cause of hepatitis. On the plus side, liver failure caused by Hepatitis in children is unheard of. Clinicians are concerned, however, because of the sudden increase in undiagnosed hepatitis among children. Following the submission of reports to the WHO, an increasing number of countries are taking precautionary measures to protect children.

None of the children who have been diagnosed with hepatitis have been infected with the common hepatitis virus.

Tummy pain, loss of appetite, unusually tired all the time, being and feeling sick, high fever, jaundice, itchy skin, grey or pale-colored feces, and dark urine are some of the most common symptoms of hepatitis.

Rise of Cases in the UK, Asia and Canada

According to the UKHSA agency, the sudden increase in cases cannot be attributed to the common virus that infects hepatitis A-E, and the collected data increasingly point to the sudden increase in severe hepatitis cases being linked to a cluster of viruses known as adenoviruses.

In a testing sample of 53 cases, infection with a common hepatitis-causing adenovirus was responsible for approximately 75%, or 40 cases. Furthermore, Covid-19 was found in 16% of the investigated cases.

On the plus side, the agency confirmed that there is no link to the coronavirus vaccine because none of the infected children have been immunized.

Israel



The 12 cases in Israel occurred in the last four months, with five being hospitalized at Shaare Zedek Medical Center in Jerusalem and seven at Schneider Children's Medical Center in Petah Tikva. Two of the children in Schneider had liver failure, requiring doctors to perform liver transplants. The other children's conditions improved quickly after steroid treatment, and they were discharged from the hospitals.

11 of the 12 children had been infected with the coronavirus in the previous year. One hypothesis being tested is that liver inflammation is a symptom of #LONGCOVID.

Japan



Local authorities in Japan reported a case of acute hepatitis – or liver inflammation – of unknown origin on April 21 in a child.

According to the ministry, the patient in Japan tested negative for both the coronavirus and an adenovirus — common viruses that can cause common cold-like symptoms or conditions such as gastroenteritis — and has no history of having received a liver transplant.

Canada



The Public Health Agency of Canada said on Tuesday that it was looking into reports of severe acute hepatitis of unknown origin in young children. It did not specify how many cases there were or where they were located.

Severe hepatitis with an unknown etiology is not a new occurrence. Many of the cases studied by doctors did not have a clear diagnosis; however, the relative increase in cases in a short period of time necessitates more attention.

India



In addition, all pediatric hepatitis patients admitted to a hospital in India were subjected to a retrospective and follow-up observational study. During the Delta wave, researchers discovered an increase in the number of such hepatitis cases. Children and adolescents with no prior liver disease or familiar etiology of acute hepatitis developed acute hepatitis with a temporal relationship to SARS-CoV-2 infection.

Among 47 pediatric patients with hepatitis, 37 had CAH-C features, but only hepatitis symptoms, with the majority having elevated inflammatory markers and an uneventful recovery after supportive treatment. The remaining 10 MIS-C hepatitis cases had prolonged illness, multiple system involvement, required admission to critical care, and had a mortality rate of 30%.

Routine laboratory and NHS data show that common viruses circulating among children are now much higher than in previous years, and there is a significant increase in adenovirus, particularly among children aged one to four.

Adenovirus is a common virus that causes symptoms such as mild fever, diarrhoea, vomiting, and colds. Most people who contract adenovirus recover without any serious complications.

While adenoviruses do not usually cause hepatitis, it is still a highly complicated virus.

Adenoviruses are typically passed from person to person through inhaling adenoviruses in the air and touching surfaces contaminated with the virus.

There are several hypotheses that are currently being studied on why there has been an increase in the reporting of hepatitis among children who have contracted a severe adenovirus infection.

• One theory is that children are more susceptible to the virus because they have less exposure to outside air during the lockdown, while others believe it could be an environmental, toxin, or drug exposure.
  
  
• Others contend that this could be a precursor to Covid, a concurrent infection with Covid, or a completely new illness.

• Other possible explanations include the presence of a new strain of the adenovirus with or without the presence of the existing cofactors.
  
  
• And as previously stated, one hypothesis being tested in Israel is that liver inflammation is a symptom of #LONGCOVID.

The investigations have revealed a strong link between the sudden increase in hepatitis among children and adenovirus infection, and the investigation has now progressed to the causation stage.

Parents should be on the lookout for signs of hepatitis and jaundice and contact their doctors if their children exhibit mild to severe symptoms. Common preventive measures include hand washing, practicing good respiratory practices and hygiene, and monitoring children. All of this could help to reduce the spread of many recurring infections, including adenovirus.

If a child develops symptoms of a gastrointestinal infection, such as diarrhoea and vomiting, he or she is advised to stay at home and not return to nursery or school until two days after becoming asymptomatic.

Global Situation

According to the WHO, as of May 5th, close to 300 severe hepatitis of unknown origin had been reported in 20 countries. More than 14 cases have been reported in the United States, with unexplained hepatitis also being reported in the Netherlands, Belgium, Romania, France, Norway, Italy, Ireland, Denmark, Israel, and Spain. WHO have also confirmed one person's death.

Children ranging in age from one month to sixteen years are among those affected worldwide. So far, more than 17 children have required liver transplants.