Hepatitis in children is usually very rare – but recently in Europe and the United States, there have been increasing reports of hepatitis in children up to 10 years of age. What is behind it?
So far there have been nearly 190 cases of hepatitis B infection (as of April 27). So far, one case has been reported in Germany, but the child was already ill in January. No other cases have been reported since then.
By far, most children suffer in Great Britain. Children under the age of five are particularly affected. Many had a mild course, but others also required a liver transplant, and one child died. What could be behind this?
Hepatitis (inflammation of the liver) can have different triggers
Hepatitis means inflammation of the liver – and there are a number of potential triggers for this. The most common are the specific hepatitis viruses – but those are not exactly found in infected children.
In addition, alcohol, drugs, toxins or even spoiled food can lead to hepatitis. None of that seems to play a role here. In addition to hepatitis viruses, other viruses can cause hepatitis.
Viruses can also cause hepatitis
British experts currently consider adenoviruses as the most likely cause, particularly adenovirus F41. It is found in about three-quarters of the children tested for it. This type of virus is usually pretty harmless—young children often get it, leading to cold symptoms, mild diarrhea, and vomiting.
It is unclear why a common pathogen can suddenly cause hepatitis: is there suddenly a new, more virulent variant in circulation? It is also possible that a previously unknown virus is present.
Children’s immune systems can be stressed
Many experts have another suspicion: over the past two years, the strict preventive measures imposed by the Corona epidemic have resulted in young children being exposed to far fewer pathogens than usual. Now they are exposed to a large number of viruses and bacteria in a single exposure – this can overwhelm the immune system of some children.
The effect of previous diseases is still under investigation
At least, it is quite clear that there is no link to vaccination against corona – none of the affected children have been vaccinated. There have been severe covid infections, but not many. Whether or not an ancient disease plays a role is still being investigated.
The Robert Koch Institute notified the Pediatric Specialty Societies at the beginning of April and asked physicians to report suspected hepatitis. So far, the authorities in this country know only one case, the disease was three months ago. 111 cases have been reported in Great Britain since January, which is in fact an unusually high number from an RKI point of view.
On the other hand, in cases in the rest of Europe, it is still not clear whether there are actually more diseases than usual. Renowned British pediatrician Professor Alistair Sutcliffe reassures anxious parents and sees no reason to panic: most sick children are already improving and the risk of liver failure is very low.
These are the warning signs of hepatitis
The most obvious warning sign of hepatitis is yellowing of the skin – when the whites of the eyes turn yellow, this is a clear warning signal. In addition, some affected children complained of abdominal pain, diarrhea, and vomiting. On the other hand, fever was rare. Other possible symptoms of hepatitis include dark urine, itchy skin, frequent bruising, and extreme tiredness.