KUALA LUMPUR, May 12 – The United States’ Centers for Disease Control and Prevention (CDC) issued a health alert last week to educate parents on symptoms of hepatitis in kids as unexplained paediatric hepatitis cases rise in the US.
The CDC wrote that parents should be aware of the symptoms associated with liver inflammation, including fever, fatigue, loss of appetite, nausea, abdominal pain, joint pain, and jaundice (yellowing of the skin).
“Hearing about severe liver disease in children can be concerning. If you have any questions about your child’s health, call your child’s healthcare provider,” the CDC said.
Hepatitis, or swelling of the liver, can be caused by infections, autoimmune diseases, drugs and toxins.
The public health agency said it is working with state and local health departments on what may be causing these illnesses, though it noted that laboratory tests identified that some of the children had adenovirus type 41, a common virus which is more likely to cause intestinal symptoms like vomiting and diarrhoea in children.
“At this time, we believe adenovirus could be the cause of some of these reported illnesses, but investigators are still learning more – including ruling out other possible causes and identifying other possible contributing factors,” the CDC said.
It added that while there have been previous reports of hepatitis in children with suppressed immune systems who were infected with adenovirus, adenovirus type 41 is not a common cause of hepatitis in otherwise healthy children.
Other common causes of viral hepatitis, such as infection with hepatitis A, B, C, D, and E viruses were considered, but evidence for these infections were not found in any of the patients, the CDC said.
The CDC said last Friday it is investigating 109 cases of severe and unexplained hepatitis in children in 25 states and territories. Over 90 per cent of the children were hospitalised and 14 per cent required liver transplant.
The rise in severe and mysterious hepatitis cases in children has led the CDC to issue a health advisory to clinicians so that health care providers can be on the lookout and report cases accordingly.
The CDC reported in late April a cluster of severe hepatitis cases among nine children in Alabama identified between October 2021 to February 2022.
All patients from geographically distinct parts of the state, with no epidemiologic links identified among the nine children. The median age at admission was 2 years, 11 months and seven patients were female. All patients had no significant medical comorbidities.
The report stated that all patients received negative test results for hepatitis viruses A, B, and C, and several other causes of paediatric hepatitis and infections were ruled out including autoimmune hepatitis, Wilson disease, bacteremia, urinary tract infections, and Covid-19. None of the children had documented history of previous SARS-CoV-2 infection.
In contrast, the World Health Organization (WHO) did not discount the potential link of the outbreak to Covid as yet.
According to the WHO, there were 169 cases of acute hepatitis of unknown origin reported, as of April 21, 2022, where SARS-CoV-2 was identified in 20 cases. Additionally, 19 were detected with a SARS-CoV-2 and adenovirus co-infection.
The WHO said adenovirus was detected in at least 74 cases, and of the number of cases with information on molecular testing, 18 have been identified as F type 41.
The United Kingdom first reported an unexpected significant increase in cases of severe acute hepatitis of unknown origin in young, generally previously healthy children. An unexpected increase of such cases has now been reported by several other countries.