A child in Ireland has died after contracting hepatitis, according to the Irish Health Service Executive (HSE). The death is believed to be linked to an increase in unexplained cases of hepatitis infections across several countries in recent weeks.
The HSE has confirmed that of the six cases of children with hepatitis, one has died as a result of the infection. Another child has reportedly required a liver transplant.
Currently, the spike in unexplained child hepatitis cases, which was first reported in the United Kingdom, has been detected in 11 other countries, including the United States, Spain, Israel, Denmark, Ireland, The Netherlands, Italy, Norway, France, Romania, and Belgium.
In the United States, the Centers for Disease Control and Prevention (CDC) has reported at least 109 active cases of hepatitis across 24 states and Puerto Rico.
The Centers for Disease Control and Prevention announced Thursday that the public health agency has begun investigating a sudden, unusual rise of hepatitis cases in children between the ages of one and six. Since January, more than 130 cases have been identified, with the majority being in Britain, which has reported 108 cases since the start of the year.
According to the press release, the agency is investigating nine cases in Alabama, all of which are said to be of “unknown origin.” Other countries named in the report include Israel, Denmark, Ireland, the Netherlands, and Spain. In the nine cases in Alabama, all of the children also tested positive for adenovirus infection, which most commonly causes respiratory illness, but depending on the type, can cause gastrointestinal infection in children.
Alerts like these are extremely important for public health and safety, but they can often cause panic, especially on social media. To better comprehend this warning, it’s important to understand what hepatitis is, why it’s rare among children, and what is being done by the CDC to control the spread.
What Is Hepatitis?
Hepatitis is a broad term for inflammation of the liver. Inflammation is swelling that occurs when tissues of the body become infected or injured. The liver is a vital organ that is responsible for processing nutrients, filtering the blood, and fighting infections. When the liver becomes damaged or inflamed, in this case by hepatitis, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus.
In the case of the recent spike in hepatitis cases among children, researchers say that it is very unusual, especially since this spike isn’t thought to be caused by the normal viruses that cause hepatitis.
How Serious Is This Alert?
While the majority of cases reported are among children in the U.K., the sudden rise in cases does mirror the observed increase in cases in other countries, like the United States, which has reported nearly a dozen cases since early January of this year.
“Do we need to panic? No. When we start to see a cluster of cases, especially cases that typically are associated with an infectious disease, we pay attention and we just we try to do the tracing to get to the bottom of it,” said Dr. Christina Johns, PM Pediatrics Senior Medical Advisor.
This is not to say that researchers are not taking this sudden rise in cases seriously, however. While mild pediatric hepatitis is not unheard of, several cases in Scotland, first reported on April 6, have raised serious concerns, as the infected children became very sick. Several of those children have needed liver transplants since then.
The other concern was that the cases were not linked to the typical viruses usually linked to the condition; those being: hepatitis A, B, C, D, and E.
“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 This Sudden Rise in Hepatitis Cases in Children?
The leading theory behind this unusual spike in hepatitis cases is a viral infection. As previously mentioned, all nine children in Alabama with hepatitis also tested positive for adenovirus. Adenoviruses are a family of viruses that can cause a range of illnesses, from the common cold to gastrointestinal issues like hepatitis.
One specific type of adenovirus is known to commonly cause acute gastroenteritis, a short-term illness triggered by the infection and inflammation of the digestive system. While there have been reports of it causing hepatitis in immunocompromised children, it has never previously been observed in otherwise 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.
McMenamin said that of the 108 cases in the U.K., nearly 77% (88) had tested positive for adenovirus.
Other theories include a novel pathogen as the potential cause or exposure to an unknown toxin, however, researchers say the geographical spread of cases suggests that infection is a more likely explanation.
Any link to the COVID-19 vaccines has been ruled out, scientists say, as the majority of children in the U.K., where most of the cases have been found, were not vaccinated.
What Should Parents Do?
The CDC recommends that children receive vaccinations for both hepatitis A and B. Currently, there is no vaccine available for hepatitis C. Aside from vaccinations, doctors say parents should look for big changes in their kids like vomiting, not behaving normally, and yellowing of the eyes.
“There are symptoms that sort of grow with time and things that you notice that you probably can ask your primary doc just to say, ‘Hey, do you think this is OK?’ Or, ‘Do you think this is alright?’ And certainly, if the child is very ill, that emergency room will get things done quickly,” said Dr. Karan Emerick, Director of Connecticut Children’s Liver Center.
According to the CDC, symptoms of hepatitis parents should look out for include:
- Loss of appetite
- Nausea or vomiting
- Abdominal pain
- Dark urine
- Light-colored stools
- Joint pain
Parents should also be aware that while cases remain relatively non-threatening, there are cases where children are getting sick. Experts recommend that if parents notice symptoms or suspect a case of hepatitis or liver inflammation, they should consult their child’s pediatrician immediately.
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