CASES of severe hepatitis of unknown origin in children are rising, and causes remain mired in mystery.
In recent days, cases in the UK exceeded 250, an increase of 11 from the previous update by the Health Security Agency on June 9.
In Europe, the World Health Organisation regional office reported 48 cases during the period.
Guidelines offered by the Pan American Health Organisation (PAHO) this week included a laboratory algorithm created to rule out the most frequent viral hepatitis (A, B, C, D and E) and other diseases that were present in the region. Such diseases that could cause liver damage included malaria, yellow fever and leptospirosis.
At least 869 probable cases of acute hepatitis of unknown aetiology had been reported in healthy children below the ages of 16 in 33 countries worldwide between 1 October 2020 and 16 June this year.
Of these cases, 368 were in seven countries of the Americas, the vast majority (290) in the USA.
At least 38 children have required transplants while no less than nine died.
“We have to continue to monitor the situation and investigate probable cases,” said Rubén Mayorga, head of HIV, tuberculosis, hepatitis, and sexually transmitted infections at PAHO.
Toxicological/drug, food, immunological, environmental and infectious factors had been thought to be the causes, but none of the hypotheses had been proven so far.
“It may be multi-factorial; something that is triggered in conjunction with other infectious, toxic or metabolic causes, but we do not know yet,” said Jairo Méndez, PAHO advisor on viral diseases.
In the USA, the centres for Disease Control and Prevention (CDC) were investigating 290 cases, which were children 10 years and below.
“While rare, children can still have serious hepatitis, and we don’t always know the cause. That’s why investigators continue to look at possible causes and investigate,” said the CDC.
WHO reported that Covid-19 was detected in a number of cases, although the data reported were incomplete.
The UK recently observed an increase in adenovirus activity, that was co-circulating with the pandemic but the role of these viruses in the pathogenesis was not yet clear.
Coincidentally, the UK and USA were the epicentres of Covid-19, with over 22,5 million and more than 88 million cases respectively as of the time of publishing this article.
A school of thought linked the hepatitis outbreak to weakened Covid-19 restrictions in both regions. – CAJ News
