Disease in children: what is the cause of cases of hepatitis?


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Status: 07.05.2022 1:25 PM

Cases of mysterious hepatitis in children are increasing worldwide. Where does the disease come from? Is there a connection with the Corona pandemic? And what should parents pay attention to?

The World Health Organization has reported a global increase in cases of hepatitis of unknown origin in children under 10 years of age. Continuous examinations of blood and stool samples on behalf of the Robert Koch Institute are intended to provide information about pathogens.

Experts such as the Secretary General of the German Society of Pediatrics and Adolescents, Dr. Burkhard Roddick, suspects so-called adenoviruses as possible triggers of the disease and also speculates about possible links with the corona pandemic and the measures associated with it.

What is hepatitis and what are its symptoms?

Hepatitis is inflammation of the liver and is often preceded by a viral infection. Hepatitis A to E viruses are the most common cause of such infections. The severity, course and transmission of hepatitis depend on its type. Signs of hepatitis are elevated liver values.

However, hepatitis can also present in the form of vomiting, diarrhea, fever, malaise, and jaundice, among others. The RKI and the Standing Committee on Immunization recommend vaccination against type B virus in childhood. Hepatitis A vaccination is especially recommended for people at risk and travelers.

In which countries are there currently more cases – and how are the authorities reacting?

After Great Britain reported its first five cases in March, the World Health Organization became aware of nearly 220 new diseases in 20 other countries by May 1, 2022, according to WHO spokesman Tarik Jasarevic on May 3. In Germany, government health authorities have reported individual cases.

In a letter to associations specializing in pediatrics and on the official website, the Robert Koch Institute called for increased attention to suspected cases and indicated the corresponding reporting obligation under the Infection Protection Act. The RKI estimates that the number of cases in the UK in particular is unusually high. The development in Germany must continue to be observed. Acute, unexplained hepatitis is rare in children, but occasionally occurs in Germany.

What are the consequences of the disease on children?

The unresolved phenomenon of hepatitis in children, which is spreading throughout the world, leaves experts confused. Especially severe cycles of hepatitis occur in people under the age of five. According to the World Health Organization, nearly ten percent of affected children required a liver transplant as a result of hepatitis B infection.

At least four children have already died of hepatitis in the past few weeks. Current laboratory tests have shown that hepatitis A to E viruses are not detected in the majority of infected children.

What factors can be triggers for cases of hepatitis in modern children?

Instead of traditional pathogens, type 41 adenoviruses were detected in many of those infected. These viruses are found in 75 percent of sick children in Great Britain. As a rule, adenoviruses cause symptoms of mild colds and gastrointestinal infections, among others.

Serious complications such as hepatitis, which can lead to liver failure, are to some extent atypical in adenovirus infection. These severe consequences usually only affect people with weakened immune systems. It was not previously known that adenovirus is the cause of hepatitis in healthy children.

Could there be a link to corona or a vaccination against corona?

The World Health Organization has reported double infection in nearly 20 of the 200 reported cases. Accordingly, the infected patients appear to have been infected with adenovirus and coronavirus.

A link to corona vaccination cannot be proven because infected children were not vaccinated at the time of illness. However, the exact cause of new hepatitis B disease remains unclear. However, experts, including Rodeck, speculate that the Corona pandemic could be directly linked to serious infections.

What is the relationship of the Corona pandemic?

Roddick and other experts believe that children’s immune systems, particularly formed in the first few years of life, are weakened by their distance maintenance and other aura measures. In these important first years of life, the children were thus exposed to fewer viruses due to any contact restrictions, and thus were unable to develop the corresponding antibodies.

On the one hand, increased hygiene measures can significantly reduce the risk of infection, but on the other hand, the performance of a permanently weakened immune system steadily decreases.

This increases the risk of infection and disease more easily if you are exposed to viruses. According to Rodeck, the development of severe disease, as in cases of childhood hepatitis, can be the result of a lack of training of young and naïve immune systems.

At the same time, there is a hypothesis that, as with SARS-CoV-2 variants, a more aggressive and infectious adenovirus variant could appear.

Does contaminated food cause cases of hepatitis?

Hepatitis can also be transmitted through contaminated food or drinking water. However, Tobias Tenenbaum, MD, senior physician in pediatrics and adolescents at the SANA Klinikum Lichtenberg, rules out the possibility that cases of hepatitis observed in children were caused by food contamination. His opinion is based on the knowledge that there is no common dietary pattern in the different age groups affected.

What should parents pay attention to?

Senior Physician Tenenbaum advises parents to pay special attention to the skin and conjunctiva of children if they have a gastro-intestinal virus. If your urine becomes yellow, your urine darkens, or your stools become lighter, you should see your pediatrician. Strict hand and bathroom hygiene can also reduce the risk of infection.

How do experts assess the situation?

Even if the manageable number of reported cases of hepatitis in children seems small, health authorities around the world are on the alert because of the high health risks that could arise, according to pediatric infectious disease scientist Tenenbaum. The exact causes of mysterious cases of hepatitis in children are still being researched.

Mysterious hepatitis disease in children

Claudia Sarr, ARD Washington, May 7, 2022, 1:48 pm

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