The mysterious case of child hepatitis
A mystery case of hepatitis has been infecting children, mostly from Europe, since the start of the year. (Photo: Getty Images)
The US Centers of Disease Control and Prevention (CDC) continues investigating cases of acute hepatitis with unknown causes among children in the US.
So far, at least 18 cases have been found in four US states. The UK and WHO reported 74 cases in April, though symptoms among kids were around as early as January. As of Monday, nearly 200 cases have been reported in 16 countries.
Based on the CDC’s new data from Alabama, patients were from different parts of the state. They had no epidemiologic links with each other, meaning they couldn’t have gotten hepatitis from one another. The patients, three years old on average, were also healthy with no comorbidities and weakened immune systems.
Common symptoms were vomiting, diarrhea, jaundice, yellow eyes, and abdominal pain. Some experienced upper respiratory symptoms, while a handful have gotten liver transplants.
Hepatitis causes an inflamed liver. The liver processes nutrients, filters the blood, and helps fight infections. So if anything bad happens to it, it would be bad news for the rest of the body too.
Looking into possible causes
Viral infections are commonly to blame for hepatitis, but there are other possible causes that each result in an alphabet variety. Doctors have so far found no traces of hepatitis A, B, C, D, and E and have since ruled these out. Babies are commonly vaccinated against hepatitis A and B, plus it’s unlikely a toddler—from a first world country at that, where most cases were found—would get hepatitis from drugs, alcohol or a contaminated water supply.
The CDC doesn't think SARS-CoV-2 is to blame because all nine children from Alabama tested negative for COVID, but did not say if they had antibodies that could have indicated they had it prior. UK doctors would beg to differ, citing several patients also had COVID-19. Besides, experts can’t completely rule out COVID’s effects on organs just yet.
One common thread in their investigations? Adenovirus.
Adenovirus causes flu-like symptoms in children and young adults. Hepatitis is not a common side effect of adenovirus, but it was already detected in a majority of cases. This prompted the CDC to advise healthcare providers to start testing for it in any future mystery hepatitis cases.
Additionally, adenovirus has been going around with COVID-19 lately, so co-infection could still be possible. Scientists are also looking into non-infectious causes like food poisoning, drug or metal exposure. Considering Kinder’s recent salmonella scare, there’s no such thing as “too paranoid” for the most discerning epidemiologist or parent these days.
Post-pandemic hepatitis 2.0
But maybe children have been “too protected” from diseases like hepatitis too. Scientists say a lack of exposure to viruses over the past two years of quarantine and COVID restrictions could be a factor.
Professor Deirdre Kelly, a pediatric hepatologist investigating the cases, said that the surge and pandemic were likely related. Her group cited data from 1924 on an outbreak of child hepatitis after the 1918 influenza pandemic—history repeating itself a century later, if you will.
Though more data is yet to be made publicly available to back up this historical link, one thing 1918 and 2020 definitely share is a deadly virus that has crippled health systems globally, affecting children’s health in more ways than direct.
