WHO: Mysterious Hepatitis Outbreak Has Led To One Child Dying, 17 Needing Liver Transplants

Its cause may still be unknown. But the potential dangers of this ongoing mysterious acute hepatitis outbreak have been clear. One child has already died, and at least 17 children have required liver transplants. All in all, at least 169 children, ranging from one month to 16 years of age, have come down with hepatitis across at least 12 countries, according to a new World Health Organization (WHO) report released on April 23. These children in general tended to be healthy prior to developing hepatitis. And before you start blaming the Covid-19 vaccine, keep in mind that the majority of these affected children did not even get vaccinated against Covid-19.

Here’s a WHO, what, when, and how many tweet from Maria Van Kerkhove, PhD, an infectious disease epidemiologist at the WHO:

Judy Stone, MD, first reported on this outbreak for Forbes on April 16. Back then the case count was still under 100. Since then, though, cases have continued to balloon with now at least 114 in the United Kingdom, at least 13 in Spain, at least 12 in Israel, at least nine in the U.S., at least six in Denmark, at least four in The Netherlands, at least four in Italy, at least two in Norway, at least two in France, at least one in Romania, at least one in Belgium, and somewhere between one and four in Ireland.

That’s at least 14 “at least’s,” because reported cases can only be a fraction of actual cases. After all, hepatitis ain’t like wearing socks with sandals, where it’s obvious that something’s wrong. Instead, not everyone may know that they have hepatitis. “Hepatitis” is a fairly generic term for some kind of inflammation of the liver because “hepa” stands for liver and “itis” means inflammation. “Acute” doesn’t mean a single cute thing but instead refers to something that appears or happens rather suddenly. You shouldn’t be able to see you liver in the mirror or on a selfie unless something has gone horribly wrong. And the early symptoms of hepatitis (if you even have symptoms) such as abdominal pain, diarrhea, and vomiting can be quite non-specific and readily mistaken for something else, such as having a bad batch of hot dogs for lunch. Certainly there can be more obvious signs such as yellowing of the eyes or skin, otherwise known as jaundice. But diagnosis of hepatitis often comes only when blood tests reveal elevated levels of liver enzymes, such as aspartate transaminase or alanine aminotransaminase being greater than 500 IU/L.

The major concern with hepatitis is the potential for liver damage and even liver failure. Now, liver failure isn’t something that you just walk off or treat with some extra Nutella. It’s a life-threatening condition because you kind of need your liver. It serves as a combination sewage treatment plant and factory for your body. Your liver helps filter waste material out of your blood, detoxify chemicals, break down drugs, secrete bile into your intestines which helps with your digestion, and manufacture proteins such as those used for blood clotting. So a poorly functioning liver can lead to a lot of uh-oh’s.

Of course, there are various hepatitis viruses that can cause hepatitis such as the hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E viruses. But this has been more like hepatitis, eh? Testing has not found any of usual hepatitis virus suspects. The culprit may be an “I don’t know” virus or something that’s not a virus.

Now, “I don’t know” virus does sound somewhat like adenovirus, which is currently the leading suspect right now. That’s because testing has found adenoviruses in at least 74 of the cases. Not all of these cases have undergone more extensive molecular testing. However, of the ones that have, adenovirus type 41 has been in 18 of the cases. Twenty of the cases had active severe acute respiratory syndrome coronavirus (SARS-CoV-2) infections and 19 had the not-so-dynamic duo of both SARS-CoV-2 and adenovirus infections at the same time. Of note, the U.K. has been experiencing an upswing in adenovirus infections in general. So has The Netherlands.

But before you say that you know that it is adenovirus, keep in mind that such severe acute hepatitis would not be a typical presentation for adenovirus type 41. There are over 50 different types of adenoviruses. Usually adenoviruses will cause respiratory symptoms, as I have covered previously for Forbes. Certain types can cause gastroenteritis, conjunctivitis (otherwise known not so affectionately as pink eye), or cystitis, which is inflammation of your bladder. The most common symptoms from adenovirus type 41 are diarrhea, vomiting, fever, and respiratory symptoms. While there have been case reports of hepatitis in immunocompromised children with adenovirus infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children.

So why might this be happening? Could it be because young children haven’t been used to seeing adenovirus over the past two years? After all, adenovirus activity has been lower during the pandemic due potentially to Covid-19 precautions such as face mask use and social distancing. Perhaps. Could this be a new funky type of adenovirus with “funky” not being an official medical term? Could the SARS-CoV-2 and adenovirus be double teaming to wreak greater havoc? All of these remain possibilities until further research sheds more light on what’s really happening.

For now this hepatitis outbreak remains a bit of a mystery wrapped in an enigma, sprinkled with some WTH. Until more is known about the cause, it’s difficult to know what to do to contain this outbreak. For now, be aware of the possible symptoms of hepatitis and seek medical care when you have any suspicion of liver issues. This may be a hepatitis outbreak of unknown origin. But the potential bad consequences are becoming quite well known.


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