'Acute Hepatitis' Outbreak in Children May Be Due to COVID-19 Lockdown Measures - UK Health Experts
13:20 GMT 26.04.2022 (Updated: 15:19 GMT 28.05.2023)
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The World Health Organisation (WHO) earlier revealed that as of 21 April 2022, at least 169 cases of acute hepatitis of unknown origin among minor patients aged one month to 16 years had been detected in 12 countries, including the US, UK, Netherlands, Denmark, and Spain. The WHO advised member countries to investigate and report each case.
An outbreak of children's hepatitis in at least 12 countries, including the US, Ireland, and Spain, has affected around 170 minor patients, with one child dying so far. It may have been triggered by COVID-19 lockdown measures clamping down on social mixing, UK health officials have been cited by media outlets as saying.
The restrictive measures imposed during the pandemic to curb the spread of the respiratory disease may have resulted in children’s immunity systems becoming more susceptible to the adenovirus causing the disease.
New @WHO update notes „169 cases of acute hepatitis of unknown origin have been reported“ from Europe and US.
— Kai Kupferschmidt (@kakape) April 23, 2022
17 children have required liver transplantation; at least one death has been reported. https://t.co/OyJA2WlWJV pic.twitter.com/dIbtptCegO
Younger children were getting infected as they had not been exposed to it “during the formative stages that they've gone through during the pandemic”, according to Dr Meera Chand, director of clinical and emerging infections at the UK Health Security Agency (UKHSA), as she spoke at an emergency session of the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Lisbon on Monday.
Being exposed to adenovirus for the first time at a later point in their lives could result in a "more vigorous" immune response in some children.
"Adenovirus virtually disappeared during the COVID-19 outbreak when there was reduced mixing and it has come back in a surge now", said Professor Calum Semple, an expert in infectious diseases at Liverpool University.
The UK Health Security Agency believes a strain of adenovirus called F41 is the most probable cause of the current outbreak. None of the cases have been caused by any of the five typical strains of the virus — hepatitis A, B, C, D, and E. Adenovirus was found in 75 percent of the sick children tested for it.
Experts have also acknowledged that the pathogen responsible for hepatitis may have undergone a change in its genetic make-up, triggering liver inflammation more easily.
"Information gathered through our investigations increasingly suggests that this rise in sudden onset hepatitis in children is linked to adenovirus infection. However, we are thoroughly investigating other potential causes", said Chand.
A total of 114 cases of “acute hepatitis of unknown origin” have been reported in the UK in the last four weeks, with 10 youngsters undergoing critical liver transplant procedures, according to the UKHSA.
Hit with diarrhoea and nausea before later getting jaundice — the yellowing of the skin/eyes — children have been aged one month to 16 years old, with a majority in the under-5s. The first were spotted in Scotland less than a month ago.
Health officials raised the alarm as they revealed that they had detected as many cases in three months as they would typically anticipate in a year.
Other possible symptoms include dark-colour urine, grey-coloured faeces, itchy skin, muscle pain, fever, lethargy, loss of appetite, and stomach pains. Health experts have warned parents to look out for symptoms of a gastrointestinal infection, keeping their youngsters at home for 48 hours after the symptoms have stopped.
It was added that normal hygiene measures such as handwashing and respiratory hygiene help reduce the spread of infections such as adenovirus.
Health officials added that there is currently no link established to the coronavirus vaccine, as none of the confirmed cases in under-10-year-olds in the UK are known to have been jabbed. Cases have been registered all across England, Scotland, Wales, and Northern Ireland.
Hepatologists cited by the Daily Mail warned that the official numbers may be the “tip of the iceberg” due to some parents overlooking the early warning signs.
Professor Simon Taylor-Robinson, a hepatologist from Imperial College London, was quoted as saying:
“I'd imagine there are more cases than have been reported — but they are likely to be less severe", adding that in “99 per cent” of cases the liver is able to regenerate and chances of needing a transplant or dying are low.
