One possible cause under investigation
#16,703
Two weeks ago (Apr 6th) the UK Health Security Agency announced their preliminary investigation into an unusual cluster of acute hepatitis (including liver failure) among young children in both England and Scotland. At the time roughly 70 children had been identified with this non A-E hepatitis of unknown origin.
While some on the internet were quick to blame the COVID vaccine, we learned pretty quickly that none of the confirmed cases (mostly under the age of 5) had been vaccinated.
Although all potential causes - including toxic exposures - are still on the table, investigators are most tightly focused on the possibility of a viral cause. COVID - which has been linked to some liver dysfunctions - is on that list, but one would expect more cases given its prevalence.
Adenoviruses - of which there are dozens - are a common cause of (generally mild) respiratory or gastrointestinal illnesses in both adults and children. Serious illness can sometimes occur however, particularly in immunocompromised or medically fragile individuals.Another group of viruses that often infects young children are adenoviruses, and they increasingly are being looked at as a potential cause.
Last Thursday, the Journal Eurosurveillance carried a report from Scottish Public Health on their findings, which included the mention of cases in the United States. Two days later the Alabama Department of Health released details on their Investigation Into 9 Young Children with Hepatitis/Adenovirus.
It is not clear how long cases have been flying under the radar, but some of those cases occurred last fall. According to the Alabama DOH release, the CDC is involved in the investigation, and is expected to release a HAN advisory to alert clinicians across the country.
Yesterday the ECDC released a brief update on their investigation into cases (see Update: Hepatitis of unknown origin in children), where they indicated they were aware of additional reports from Denmark, Ireland, the Netherlands, and Spain, although the number of cases was not provided.
Overnight Israel has become the latest country to announce cases, with the disclosure that they are tracking 12 children diagnosed with acute hepatitis of unknown origin over the past 2 months.
Brought to the attention of the Ministry of Health about 12 cases of children with acute hepatitis for an unknown reason
Date published
19.04.2022
The reports were received following a request from the Ministry of Health from the directors of the health funds and hospitals to report cases of children with acute hepatitis for an unknown reason, in light of the World Health Organization's announcement on the subject.
Following the World Health Organization's announcement of cases of acute hepatitis from an unknown source and an examination by the Ministry of Health with the Association of Pediatricians and the Association of Pediatric Infectious Diseases, an official directive was issued on Tuesday (19.4.22) by the Ministry of HMOs and hospitals .
Following the request, in the evening (19.4.22), 12 cases of children were brought to the attention of the Ministry of Health in recent months in two hospitals, Shaare Zedek and Schneider, and may be suitable for defining the case.
The reports are currently under investigation.
This report was follow-up with:
The Ministry of Health has asked HMO and hospital directors to report hepatitis
Date published
20.04.2022
It is quite likely, that as the word spreads to be on the lookout for these types of cases, that we will begin to see a lot more cases reported from around the globe. The Israeli MOH is asking clinicians to look back as far as early January for suspected cases.Following the Ministry of Health's request to report cases in children with acute hepatitis for an unknown reason, 12 cases were brought to the attention of the Ministry of Health this evening.
And in this case, it appears that many of these hepatitis cases have gone largely unnoticed for months.
I'm sure the concurrent demands of dealing our ongoing pandemic haven't helped matters. Hopefully, now that the alert has gone out, we'll see progress on determining the cause.
But this should also remind us how easily a new infectious disease threat can fly under the radar - sometimes for months - without triggering an alarm.
And that doesn't bode well for when the next global health crisis emerges.
