‘Very unusual’ increase in cases of liver damage seen in children in the UK, US and Europe

An unusual rise in cases of liver damage in children has been seen in the UK, US and Europe, prompting the World Health Organization (WHO) to closely monitor the situation.

On April 5, the WHO was informed of 10 cases of severe acute hepatitis (inflammation of the liver) in children under the age of 10 in Scotland. Three days later, he received reports of 74 cases across the UK. Typically in Scotland, there are around 7-8 cases in a year in patients with no underlying conditions. Similar cases have been reported in Alabama, and some cases have also been reported in Ireland and Spain.

“Mild hepatitis is very common in children after a variety of viral infections, but what is being seen at the moment is quite different,” Professor Graham Cooke, NIHR professor of infectious diseases research, said in a statement. Imperial CollegeLondon. “Children are experiencing more severe inflammation, which in some cases causes the liver to fail and require a transplant.”

In a case report based on patients first seen in Scotland, the doctors note that the severity of the disease seen in the children was “unfortunately remarkable”. They report that the children had no significant medical history prior to their admission to the hospital, where all remained for at least six days, with three children requiring a liver transplant. The symptoms in the cases were similar.

“For two children, close contact in a home or other setting was reported with two other cases. Reported symptoms include jaundice (eight of nine cases), abdominal pain (seven of nine cases), and nausea and malaise (six of nine cases). ) before admission,” says the report, published in Eurosurveillance. “Almost all reported gastrointestinal symptoms including diarrhea or vomiting and lethargy, but no fever, in the weeks prior to admission.”

So far, the cause of the increase in cases is unknown. Hepatitis A, B, C, E, and D viruses were ruled out by laboratory tests, while SARS-CoV-2 (the virus that causes COVID-19) and/or adenoviruses were detected in several cases, and The WHO noted that there has been an increase in adenovirus activity in the UK. Experts are divided as to the cause of the illness, with not enough data to go on, although it seems likely that it is a virus of some description.

“When there is a cluster of cases like this, I think there is likely to be a viral cause,” said Professor Simon Taylor-Robinson, a hepatologist at Imperial College London, who was not involved in the study. “A large number of viruses can cause hepatitis: Hepatitis A to E are well known, and Epstein Barr virus (which causes glandular fever) may be another cause.”

To complicate matters, several viruses, including adenoviruses, which can rarely cause inflammation of the liver, are currently circulating.

“It’s not uncommon to have adenoviruses in the spring. And there are other viruses, too: COVID-19 has been associated with inflammation of many other organs in the body,” Taylor-Robinson continued. “At the moment we don’t know what the cause is or if any of these viruses are involved. It’s also difficult to determine cause and effect because viruses can be common anyway, so they can be present but not necessarily the cause.” “.

Although worrying, experts highlight the fact that the liver is very good at regenerating itself over time. Parents and caregivers should contact a health care provider if they notice any symptoms of hepatitis in their children. Meanwhile, the health authorities and the WHO will continue to investigate.

“Hepatitis is unusual in children. In relation to viral hepatitis, infection in childhood rarely causes clinical illness (this is true of most viral infections; the illness is usually much worse if contracted in adulthood),” said Professor Will Irving, professor of virology at the University of Nottingham Science Media Centre.

“The current crop of hepatitis cases in children under 10 years of age is therefore highly unusual. At present, no specific cause has been identified, but research is ongoing to try to find the cause. These include looking for toxins in patient samples (toxicology) and also trying to identify any viruses that may be responsible.”

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