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Mysterious childhood hepatitis outbreak: UK study may identify prime suspect

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The Centers for Disease Control and Prevention (CDC) recently updated their original health advisory on May 11 regarding their investigation into the mysterious global outbreak of hepatitis in children. The World Health Organization (WHO) said a case-control study to be completed this week should provide more clarity on whether adenovirus or COVID-19 is causally linked to the mystery condition, according to multiple reports.

“As of May 5, 2022, the CDC and its state partners are investigating 109 children with hepatitis of unknown origin in 25 states and territories, more than half of whom have tested positive for adenovirus with more than 90% hospitalized, 14% with liver transplants, and five deaths under investigation,” the CDC said.

About 18% of cases worldwide have also actively tested positive for COVID-19, according to a report by Medical Xpress.


“The focus next week will be on serological testing for past exposures and infections with COVID,” Philippa Easterbrook, of WHO’s Global Hepatitis Programme, told reporters. conference.

Easterbrook said within a week the UK will have data from a case-control study comparing whether the rate of detection of adenovirus in children with hepatitis differs from that of other hospitalized children who do not have liver disease.

“It will really help determine if [adenovirus] is just an accidental infection that was detected or there is a probable causation or causation,” Easterbrook mentioned.

“Right now, the main hypotheses remain those involving the adenovirus – with also significant consideration of the role of COVID as well, either as a co-infection or as a past infection. »

“A fundamental question is whether there is a characteristic pattern in liver pathology in these patients. Such a pattern could be seen late when liver transplantation was performed, or earlier before severe liver damage from the unknown process may have obscured an earlier characteristic pattern,” said Dr Daniel Lucey. , Clinical Professor of Medicine at the Dartmouth Geisel School of Medicine.

“If such a pattern of liver pathology was found, it could be used to help identify the etiology of hepatitis or at least serve to provide a unifying clinicopathologic syndrome as soon as possible.” »

None of the UK liver samples “…show any of the typical features one would expect with inflammation of the liver due to adenovirus, but we await further examination of the biopsies,” Easterbrook added.

LAS VEGAS, NEVADA – MAY 14: (L-R) Illusionist Criss Angel, her son Johnny Crisstopher Sarantakos and Shaunyl Benson visit as Angel helps distribute food and other items at the Cure 4 pediatric cancer treatment center The Kids Foundation amid the spread of the coronavirus on May 14, 2020 in Las Vegas, Nevada.
(Photo by Ethan Miller/Getty Images)

Because adenoviruses are used in some of the COVID-19 vaccinations, a theory on social media has suggested a link between the vaccine and the hepatitis outbreak in the UK, where most cases have been reported, according to Reuters .

But these adenoviruses contained in the vaccines are “harmless carriers that have been modified so that they cannot replicate or cause infection”, according to the BBC. News.

“There is no evidence of a link to the coronavirus (COVID-19) vaccine. The majority of cases are under 5 years old and too young to have received the vaccine,” the UK Health Security Agency (UKHSA) said. mentioned.

The UK’s International Health Regulations National Focal Point first reported 10 cases of severe hepatitis of unknown etiology on April 5, 2022, in children aged 11 months to 5 years in Scotland, the WHO mentioned. .


“As of May 11, the European CDC reported a total of 449 probable cases in 27 countries, including Europe, the Americas (North, Central, and South), Asia, and the Middle East,” Lucey said.

“Highest number of cases to date are: UK (163), US (109), Italy (35), Spain (22), Brazil (16), Indonesia (15), Israel (12), Sweden (nine), Argentina (eight), Japan (seven) and Canada (seven). »

More than five cases have only been reported in six countries. The UK has reported the most cases worldwide, but no children have died so far in the country, according to a May 12 UKHSA report. statement.

Hepatitis, also known as inflammation of the liver, is usually caused by viruses, medications, or exposure to certain chemicals, according to Ligne Santé.

“Most of the children in the reported cases had gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain,” says Dr. Norberto Rodriguez-Baez, professor of pediatrics at the University of Texas Southwestern Medical Center.

“These symptoms were followed by the development of jaundice,” he added.

Jaundice occurs when the skin and eyes turn yellow because the liver loses its ability to properly remove bilirubin, according to Healthline.


“Interestingly, fever was not described as a common symptom in these cases. Also, all of the kids were previously healthy,” Rodriguez-Baez said.

“It is important for parents to know that the chance of their child developing hepatitis is extremely low. We continue to remind everyone to be alert for signs of hepatitis – especially jaundice, to look for a yellow tint to the whites of the eyes – and to contact your doctor. if you are worried,” said Dr Meera Chand, director of clinical and emerging infections at UKHSA.

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