Explainer-Scientists investigate hepatitis outbreak in children in
Europe, US
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[April 22, 2022]
By Jennifer Rigby and Natalie Grover
LONDON (Reuters) - Health authorities
around the world are investigating a mysterious increase in severe cases
of hepatitis - inflammation of the liver – in young children.
Below is a summary of what is known about the outbreak.
WHAT'S HAPPENED?
More than 130 cases have been identified, with the majority in Britain,
which has reported 108 cases since January.
Other countries including the United States, Israel, Denmark, Ireland,
the Netherlands and Spain have also reported smaller numbers of cases.
WHY IS IT CAUSING CONCERN?
Mild paediatric hepatitis is not unheard of, but the cases first raised
the alarm in Scotland, on April 6, because children were very sick.
Several have even needed liver transplants.
The other concern was that the cases were not linked to the typical
viruses usually linked to the condition – hepatitis A, B, C, D and E.
![](http://archives.lincolndailynews.com/2022/Apr/22/images/ads/current/goodman_sda_SFARM_2022.png)
"This is still a very low number of cases, but they are children, that
is the main concern, and the other thing is the severity," said Maria
Buti, a hepatology professor from Barcelona and chair of the European
Association of the Study of the Liver's public health committee, who has
been following the outbreak closely with the European Centre for Disease
Control (ECDC).
WHAT IS CAUSING IT?
The leading theory is viral infection, probably with an adenovirus – a
common family of viruses that can cause the common cold, among other
conditions.
One kind of adenovirus commonly causes acute gastroenteritis, and there
have been reports of it causing hepatitis in immunocompromised children,
but never previously in healthy children.
Public Health Scotland's director, Jim McMenamin, said work was underway
to establish if the adenovirus involved had mutated to cause more severe
disease, or if it could be causing the problems "in tandem" with another
virus, including possibly SARS-CoV-2, the virus that causes COVID-19.
He said 77% of the children in Britain had tested positive for
adenovirus.
It is also possible that a novel pathogen may be involved, or exposure
to a toxin, but the geographic spread of cases suggested infection was a
more likely explanation, scientists said.
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![](../images/042222PIX/news_f55.jpg)
People walk into the Children's Hospital of Georgia in Augusta,
Georgia, U.S., January 14, 2022. REUTERS/Hannah Beier
![](http://archives.lincolndailynews.com/2022/Apr/22/images/ads/current/graue_21BLAZER_081621.png) Any link to COVID-19 vaccines has
been ruled out, as the children in Britain, where the majority of
cases have been found, were not vaccinated.
Other scientists said lowered immunity as a result of reduced social
mixing during the pandemic could be an explanation.
"This may be an over-response to stimulation to the immune system
that is not used to such insult … that's a good theory," said Simon
Taylor-Robinson, a consultant hepatologist and professor of
translational medicine at Imperial College London.
Others cautioned that the adenovirus infections could be
coincidental, because they are widely circulating at this time of
year. Investigations are going on.
WHAT ARE PUBLIC HEALTH AUTHORITIES ADVISING?
Public health alerts in the United States and Europe have asked
doctors to be on the lookout for the condition, and to test children
for adenovirus if they suspect hepatitis.
Symptoms include dark urine, yellowing of the eyes and skin
(jaundice), sickness, fatigue, fever, loss of appetite, nausea,
vomiting, abdominal pain, light-coloured stools, joint pain.
There is no specific treatment for hepatitis but drugs like steroids
can help, as well as medicines to treat the symptoms.
Parents are being told to watch out for symptoms and to contact a
healthcare professional if they are concerned.
To prevent further spread, the British Health Security Agency urged
handwashing and "good thorough respiratory hygiene", such as
catching coughs and sneezes in a tissue.
![](http://archives.lincolndailynews.com/2022/Apr/22/images/ads/current/charrons_bch_2022.png)
Experts said that the rise in case numbers had been relatively slow
but cautioned that more cases were expected.
"If you pay attention to a thing, you see more of it," said Buti.
(Reporting by Jennifer Rigby and Natalie Grover in London; Editing
by Josephine Mason, Robert Birsel)
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