WHO says outbreak of hepatitis in children may be linked to adenovirus

An outbreak of severe hepatitis in healthy children that has caused liver failure in some children may be related to adenovirus infection rather than hepatitis as originally thought, although further investigation is needed, World Health Organization officials said on Thursday.

Eleven countries, including the US, have reported at least 169 cases of severe acute hepatitis in children aged 1 month to 16 years, with the largest outbreak in the UK. according to the latest WHO report. At least 17 children required a liver transplant, and one patient died.

Hepatitis is an inflammation of the liver, most commonly caused by viruses, but drugs and toxins can also cause it.

“What is particularly unusual is that most of these children were previously healthy,” said Dr Philippa Easterbrook, a WHO spokesperson for hepatitis monitoring, during a Q&A session broadcast live on social media by the global health agency. on Thursday.

At least 74 children have tested positive for adenovirus. According to WHO. Adenoviruses are widespread and usually cause respiratory problems, but can also cause abdominal pain, conjunctivitis, and bladder infections. The outbreak of severe hepatitis in children has coincided with an increase in adenovirus transmission in countries such as the UK, according to the WHO.

“At this stage, this does not prove that there is a causal relationship between these cases, but it is a promising and interesting early signal that is being studied in more detail,” Easterbrook said.

Adenovirus has rarely been associated with hepatitis in children with weak immune systems, according to Dr Richard Peabody, head of the WHO Highly Concern Pathogens Group. However, according to the WHO, adenovirus is not a known cause of hepatitis in healthy children.

“This is kind of an unusual phenomenon that we are seeing, and so we are sort of alerting parents and health authorities about this,” Peabody said.

At least 20 children have had Covid, with 19 of them testing positive for the virus as well as adenovirus, according to the WHO. Peabody said it’s possible that Covid also plays a role in the hepatitis outbreak, although this is unclear and more research is needed.

The UK first notified the WHO of an outbreak of severe acute hepatitis in children earlier this month. According to the WHO, the most common symptoms were liver inflammation, abdominal pain, diarrhea, vomiting, and jaundice.

Centers for Disease Control and Prevention last week nationwide health alert issued following the discovery of nine cases of hepatitis in children aged 1 to 6 in Alabama. All nine children had liver damage and some had liver failure, according to the CDC. The CDC also believes an adenovirus may be the cause, although the public health agency said the investigation is ongoing.

Easterbrook said health officials have largely ruled out hepatitis A, B, C, D and E viruses as a possible cause. According to the WHO, hepatitis viruses were not detected in any of the reported cases. Other viruses, such as CMV and Epstein-Barr, are also not the cause of the outbreak, Easterbrook said. So far, the parents of the children have not reported any shared exposure to drugs, toxins, food, or the place of travel, she said.

The WHO has also largely ruled out Covid-19 vaccination as a possible cause, Easterbrook said, as most children have not been vaccinated.