Recently, severe liver inflammation (hepatitis) has been reported in healthy children. As of 21 April, there have been 169 cases of “severe hepatitis of unknown type” in children in 12 countries, with the majority (114) in the UK. Many children suffering from the disease are under the age of ten years.
What has been of great concern to the health professionals working on these cases is the severity of the disease in these young, otherwise healthy children. Seventeen people needed a liver transplant, and one child died of liver failure.
Other infections of adenovirus are also being investigated?
The number of transplants is much higher in previous years than is typically seen in the same time period. Acute hepatitis in children is not unheard of, but these latest figures are unprecedented, and the cause is, so far, only partially clarified. A suspected cause of this is adenovirus infection.
According to the UK Health Protection Agency, adenovirus was the most common pathogen in 40 of 53 confirmed cases tested in the UK. The agency said that “investigation increasingly suggests that an increase in severe cases of hepatitis may be linked to adenovirus infection but other causes are still being actively investigated”.
Adenoviruses are a large group of viruses that can infect a wide range of animals as well as humans. They got their name from the tissue from which they were initially isolated: the adenoids (tonsils). There are at least seven different species in adenoviruses, and within those species, there are genetic variations similar to what we see with coronaviruses and other viruses. In this case, instead of variants, they are called adenovirus subtypes.
Adenoviruses cause mild illness in humans most of the time. Some species cause respiratory diseases, such as croup or laryngitis in young children and infants. Others cause conjunctivitis, and a third group causes gastroenteritis.
In how many cases this virus has been detected?
The subtype associated with current acute hepatitis outbreaks in children is called adenovirus subtype 41, with the virus being detected in at least 74 cases so far. Subtype 41 belongs to the adenovirus clustering usually associated with mild to moderate enteritis; Inevitably stomach problems with symptoms of diarrhoea, vomiting and abdominal pain.
In most children and adults with healthy immune systems, adenoviruses cause only an annoyance, resulting in an illness expected to occur within a week or two. Viral hepatitis was previously reported to be only a rare complication from infection by adenovirus.
Given the number of cases and the severity of the disease in children, scientists are urgently investigating the causes of the outbreak. Early in the outbreak, epidemiologists sought to identify contact links with these cases and, of course, to identify what caused the viral hepatitis. It soon became clear that this was not just a small, isolated cluster of cases.
What do the data from the Scottish National Health Service say?
Data from the Scottish National Health Service showed that none of these children lived in a clear geographic pattern (eg near an open water source), that the (median) age at hospitalization was four years, and No other obvious symptoms associated with the disease, such as ethnicity or gender, were found. Similar findings were reported by the US Centers for Disease Control and Prevention.
Since adenovirus was used in some of the Covid vaccines, some people on social media wondered whether vaccines were the cause of the spread of the disease. However, none of the cases reported in the UK had received a Covid vaccine and the adenovirus used in the Covid vaccine is an unrelated virus that cannot multiply.
questions that need to be answered
Researchers still need to find a direct causative link between adenovirus 41 and these cases of hepatitis. Are there any other complicating factors that contribute to serious illness, such as co-infection with another virus, such as the coronavirus?
Scientists also need to discover the genetic form of the virus. Has it changed significantly from the reference information we have? Understanding the immune response in these cases versus other mild adenovirus infections will be important and research on prevention (vaccination) and treatment options, such as antiviral medication, also needs to be initiated.
Hopefully, we’ll have some answers. In the meantime, parents should be on the lookout for symptoms of hepatitis in their children, which include yellowing of the eyes and skin (jaundice), dark urine, yellowish stools, itchy skin, feeling tired, and abdominal pain. is.
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