Acute hepatitis in children, health officials around the world are looking for clues as a staggering epidemic of severe liver disease hits children in Europe, North America and Asia

According to the World Health Organisation (WHO), more than 600 cases of acute hepatitis of ‘unknown origin’ have occurred worldwide

On 27 May, the WHO confirmed that nine children had died from the disease.

Of all the cases identified worldwide, about 6%, or at least 38 children, required a liver transplant.

The cases were first recorded in the UK, where most cases were identified.

The epidemic of acute hepatitis among children has since spread to over 30 countries, including Italy, the UK, the US, Canada and Japan

In the US, cases have been identified in several states, including Alabama, North Carolina, Illinois and Wisconsin.

The age of the children ranges from 1 month to 16 years.

However, according to the WHO, more than 75% of the cases involve children under the age of 5.

So far, none have tested positive for known hepatitis A, B, C, D or E viruses, suggesting a new pathogenesis.

Hepatitis is indicated by excessively high levels of liver enzymes.

Medical experts are trying to identify the cause of the epidemic.

Although not confirmed, there is evidence that a common virus, adenovirus, may be involved, the UK Health Security Agency (UKHSA) said in a technical briefing on Monday.

According to the WHO, a strain of adenovirus known as F type 41 has been detected in most cases.

“Although adenovirus is a possible hypothesis, investigations are ongoing to identify the causative agent,” the agency said in a statement.

While the medical community is on the lookout for new cases, the number of affected children is expected to increase as more cases have been reported in Ireland, Spain, Israel and other countries.

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Paediatric acute hepatitis cases, a growing epidemic

On 21 April, the Centers for Disease Control (CDC) issued a Health Alert Network Health Advisory to inform physicians and public health authorities of a cluster of unexplained childhood hepatitis cases in Alabama.

In November 2021, a large hospital informed the CDC that it had seen five children with significant unexplained liver lesions.

Three of them had acute liver failure. By February, the hospital had identified four more patientsReliable source.

All had adenovirus type 41 infections.

On 5 April, UK health officials had already notified the World Health Organisation of 10 cases of severe acute hepatitis in central Scotland.

One case occurred in January this year and the others were reported in March.

By 8 April, the number of cases had risen to 74.

Some of these, including children, had adenovirus.

No consistent link to SARS-CoV-2 was found, although some children tested positive.

Paediatrics, acute hepatitis symptoms to watch out for

According to the CDC, standard symptoms of hepatitis include ‘fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, pale stools, joint pain, and jaundice’.

Information on adenovirus type 41

With the presence of adenovirus F type 41 reported in many affected children, the virus is currently the medical community’s best clue as to the origin of hepatitis.

To date, more than 100 adenoviruses have been identified.

They are common human pathogens that mainly affect the eyes, respiratory tract and intestines, but can also cause diseases of the liver, urinary tract and adenoid glands.

Adenovirus type 41 and adenovirus type 40 are associated with diarrhoea and diarrhoea-related mortality in children worldwide.

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