Acute hepatitis outbreak

2022 - 5 - 4

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Image courtesy of "Economic Times"

Hepatitis outbreak in children: explainer on adenovirus type 41, the ... (Economic Times)

What has been very concerning for health professionals reporting on these cases is the severity of the disease in these young, otherwise healthy children.

Because of the number of cases and the severity of the disease in children, scientists are urgently investigating the cause of the outbreak. Sampling the population (both adults and children) to get an idea of how prevalent adenovirus 41 is in these reporting areas versus other areas of low to no incidence would help firm up the link. Early in the outbreak, epidemiologists sought to identify contact links with these cases and, of course, to identify what the cause of the viral hepatitis was. It will be crucial to understand the immune response in these cases versus other mild adenovirus infections. However, none of the cases reported in the UK had received a COVID vaccine and the COVID vaccines that do use adenoviruses use an unrelated virus that cannot multiply. Because of the number of cases and the severity of the disease in children, scientists are urgently investigating the cause of the outbreak. Subtype 41 belongs to the adenovirus clustering that is typically associated with mild-to-moderate gastroenteritis; essentially a stomach bug with symptoms of diarrhoea, vomiting and abdominal pain. Early in the outbreak, epidemiologists sought to identify contact links with these cases and, of course, to identify what the cause of the viral hepatitis was. Sampling the population (both adults and children) to get an idea of how prevalent adenovirus 41 is in these reporting areas versus other areas of low to no incidence would help firm up the link. In the meantime, parents should be vigilant for hepatitis symptoms in their children, including yellowing of the eyes and skin (jaundice), dark urine, pale poo, itchy skin, feeling tired and tummy pain. It will be crucial to understand the immune response in these cases versus other mild adenovirus infections. Subtype 41 belongs to the adenovirus clustering that is typically associated with mild-to-moderate gastroenteritis; essentially a stomach bug with symptoms of diarrhoea, vomiting and abdominal pain.

Hepatitis Outbreak in Children: What to Know (WebMD)

While severe hepatitis with acute liver failure is rare in healthy children and the odds are greatly in your child's favor should they get hepatitis, ...

Even now, most doctors are only testing for adenovirus if a child is sick enough to be in the hospital. Instead, doctors have found one type of adenovirus, type 41, in about half of the worldwide cases. In some cases of severe hepatitis, we never find a cause.” The most common usually cause respiratory illnesses, but some also cause symptoms in the gut, which has been a theme in the cases leading to severe hepatitis. Of the worldwide cases, 17 have required a liver transplant. In addition, all children were previously healthy.”

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Image courtesy of "CBS News"

Mystery liver disease kills three more children after "unexpected ... (CBS News)

This severe strain of acute hepatitis has been identified in nearly 170 children across 11 countries in recent weeks.

"CDC is working with state health departments to see if there are additional U.S. cases, and what may be causing these cases," the CDC said in the alert. The pathogen is known to cause gastroenteritis in children, but "it is not usually known as a cause of hepatitis in otherwise healthy children," the agency had said. Three children in Indonesia have died from a mysterious liver disease, the country's health ministry said, raising to at least four the global death toll of a fatal ailment puzzling doctors from the U.S. to Asia.

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Image courtesy of "The Guardian"

Three children in Indonesia die from unidentified form of hepatitis (The Guardian)

Health ministry says symptoms match those of acute liver disease of 'unknown origin' found in almost 170 children worldwide.

The pathogen is known to cause gastroenteritis in children, but “it is not usually known as a cause of hepatitis in otherwise healthy children”, the agency said. Indonesia’s health ministry said three children had died in hospitals last month in the capital, Jakarta, after displaying some of the symptoms. Three children in Indonesia have died from a mysterious liver disease, the country’s health ministry has said, raising the global death toll to at least four.

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Image courtesy of "Pan American Health Organization"

Q&A - Acute severe hepatitis in children - PAHO/WHO | Pan ... (Pan American Health Organization)

On 15 April 2022, the World Health Organization (WHO) published an alert on severe acute hepatitis cases of unknown origin in children in the United Kingdom ...

At this time, the recommendation to countries is to stay informed and to monitor for cases. Treatment recommendations can be refined once the origin of infection is determined. We cannot speak of confirmed cases at this point because the specific cause is still unknown and under investigation. For now, PAHO/WHO is providing information to countries about criteria and definitions to assist in monitoring. In general, the infection with such viruses is of limited duration and does not evolve into more serious conditions. The most frequently implicated infectious agents are the viruses responsible for hepatitis A, B, C, D and E.

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Image courtesy of "Popular Science"

We still don't know what's behind the global hepatitis outbreak in kids (Popular Science)

Jaundice, diarrhea, and abdominal pain, in addition to liver inflammation, are among commonly reported symptoms of this hepatitis.

The WHO and CDC advise doctors to be on alert for any potential pediatric acute hepatitis cases. The COVID-19 pandemic also may have helped to prime children for these infections. Five of them tested positive for the same strain of virus: adenovirus 41.

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Image courtesy of "UPI.com"

Mysterious global outbreak of hepatitis kills three children in Indonesia (UPI.com)

A serious liver disease that's struck hundreds of young children worldwide has caused the deaths of three children in Indonesia, bringing the global death ...

"CDC is working with state health departments to see if there are additional U.S. cases, and what may be causing these cases," the alert stated. However, the Wisconsin Department of Health Services reported last week that four pediatric cases of acute hepatitis had occurred in that state. None of the affected children in Alabama died.

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Image courtesy of "CNA"

Acute hepatitis: What is the mysterious liver disease hurting children? (CNA)

An outbreak of acute hepatitis - an inflammation of the liver - in children has killed at least four and required liver transplants in more than a dozen ...

There are more than 50 types that can infect humans. In 18 of those, a specific strain has been identified: F type 41. Most of the children didn’t have a fever. As of Apr 21, 169 cases had been detected, the WHO said. Early this year, 10 cases were identified in Scotland. Advertisement

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Image courtesy of "The New York Times"

What Scientists Know About the Unusual Hepatitis Cases in Children (The New York Times)

Hepatitis is an inflammation of the liver and can have a wide range of causes. Viral infections can cause the condition; the viruses known as hepatitis A, B, C, ...

Not all of the children have tested positive for an adenovirus, and while the viruses can cause liver inflammation, that symptom is most common in people who are immunocompromised. “The likelihood of your child developing hepatitis is extremely low,” Dr. Meera Chand, the director of clinical and emerging infections at the U.K. Health Security Agency, said in a statement. Of the 169 cases included in a recent W.H.O. report, at least 74 had an adenovirus infection, the organization said. That, in turn, might have made them more susceptible now, according to one of the U.K. Health Security Agency’s working hypotheses. In early April, Britain became the first country to notify the W.H.O. of a cluster of unexplained hepatitis cases in children. In many of the cases, children developed gastrointestinal symptoms, including vomiting, diarrhea and abdominal pain, followed by a yellowing of the skin or eyes, known as jaundice. Hepatitis is an inflammation of the liver and can have a wide range of causes. Or the adenovirus infections could be a red herring. Gastrointestinal symptoms are common in children and should not, in isolation, be cause for alarm, Dr. Shiau said. The cases were unusual because they occurred over a short period of time in otherwise healthy children, and because clinicians quickly ruled out any of the common hepatitis viruses as the cause. All of the children either recovered or are recovering, the agency noted. The cause remains unknown, but scientists are exploring the possibility that an adenovirus may be responsible.

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