Kids At Risk: WHO Warns of Acute Hepatitis Affecting Liver. CDC Asks Docs To Report Cases

The World Health Organisation (WHO) is keeping a close watch on the rising cases of the illness that is causing serious liver issues among children. The illness is largely being reported in children between 1-16 years old and were largely healthy.

New Delhi: Even as the world is battling coronavirus pandemic, the World Health Organisation (WHO) has warned of a mysterious illness which is causing serious liver issues among children. The disease was largely being reported in young children among one month to 16 years old. Amid rise in the acute hepatitis of unknown origin which is affecting liver among children, the WHO has urged parents or guardians to closely observe their kids if they report any of the symptoms. So far, at least 169 cases of acute hepatitis of unknown origin were reported among children across 12 countries. Out of the 169 cases, one children had died from the mystery strain of severe hepatitis.

The UN body said that it is aware of 169 rare cases of acute hepatitis, an inflammation of the liver, in young children. Of these, 17 became so sick they needed liver transplants, reports The Guardian. While mild pediatric hepatitis is not unheard of, severe hepatitis in previously healthy children is rare, the report said.

Symptoms to watch out for

The WHO has urged parents or guardians to keep a close eye on children and inform health centres if their kids report any of the gastrointestinal symptoms including abdominal pain, diarrhea and vomiting “preceding presentation with severe acute hepatitis, and increased levels of liver enzymes (aspartate transaminase (AST) or alanine aminotransaminase (ALT) greater the 500 IU/L) and jaundice”. Most children who reported the acute hepatitis cases did not have fever, the WHO said.

According to the US’ Centers for Disease Control and Prevention (CDC), the symptoms of hepatitis, or inflammation of the liver, include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice and can be caused by viruses. Adenoviruses spread from person-to-person and most commonly cause respiratory illness, but depending on the type, can also cause other illnesses such as gastroenteritis (inflammation of the stomach or intestines), conjunctivitis (pink eye), and cystitis (bladder infection). Adenovirus type 41 typically presents as diarrhea, vomiting and fever, often accompanied by respiratory symptoms.

• Abdominal pain
• Diarrhea
• Vomiting
• Nausea
• Joint pain
• Fever
• Fatigue
• Loss of appetite
• Light-colored stools
• Dark urine
• Jaundice

Where were cases of severe hepatitis reported

At least 114 infections are in the UK, followed by Spain, which has recorded 13 cases, and Israel with 12. The outbreak has also spread to the US, Denmark, Ireland, the Netherlands, Italy, France, Norway, Romania and Belgium.

About the mystery illness

Health authorities have been investigating the mystery illness, which has affected young people ranging from one month to 16 years old since a cluster of cases have been identified in Scotland between January and mid-April.

There have been continuing further reports of cases of acute hepatitis of unknown origin among young children. It is not yet clear if there has been an increase in hepatitis cases, or an increase in awareness of hepatitis cases that occur at the expected rate but go undetected. While adenovirus is a possible hypothesis, investigations are ongoing for the causative agent, the WHO said.

The clinical syndrome among identified cases is acute hepatitis (liver inflammation) with markedly elevated liver enzymes. Many cases reported gastrointestinal symptoms including abdominal pain, diarrhoea and vomiting preceding presentation with severe acute hepatitis, and increased levels of liver enzymes (aspartate transaminase (AST) or alanine aminotransaminase (ALT) greater the 500 IU/L) and jaundice. Most cases did not have a fever. The common viruses that cause acute viral hepatitis (hepatitis viruses A, B, C, D and E) have not been detected in any of these cases.  International travel or links to other countries based on the currently available information have not been identified as factors.

What CDC said on the severe hepatitis cases

The Centers for Disease Control and Prevention (CDC) in US issued a nationwide health alert to notify clinicians and public health authorities about a cluster of children identified with hepatitis and adenovirus infection – and to ask all physicians to be on the lookout for symptoms and to report any suspected cases of hepatitis of unknown origin to their local and state health departments.

The CDC is currently working with the Alabama Department of Public Health to investigate a cluster of nine cases of hepatitis of unknown origin in children ranging in age from 1 to 6 years old, all of whom were previously healthy. None of these children were at the hospital because of a current SARS-CoV-2 infection. The first US cases were identified in October 2021 at a children’s hospital in Alabama that admitted five children with significant liver injury (including some with acute liver failure) without known cause, who also tested positive for adenovirus. Hepatitis A, hepatitis B, and hepatitis C viruses were ruled out.

“Upon investigation, a review of hospital records identified four additional cases, all of whom had liver injury and adenovirus infection; laboratory tests identified that some of these children had adenovirus type 41, which more commonly causes pediatric acute gastroenteritis,” the CDC said.