Hepatitis cases in children: UK reports baffling rise

for acute liver failure

The UK has reported a mysterious rise in hepatitis cases in children

Friday 15 April 2022 | 18:38

Cases of acute hepatitis in children are increasing in the UK. This has been reported by the UKHSA and the European Health Agency (ECDC). 74 cases are currently being investigated – most of them children between the ages of two and five. To date, the cause of hepatitis remains unclear. According to the Occupational Health and Safety Services Authority (UKHSA), hepatitis is not caused by the common hepatitis viruses A, B, C, D and E.

Hepatitis in children is usually rare

The bewildering increase in the number of cases is also causing alarm in this country. However, no similar cases are currently known in Germany. This was reported by the German Society of Pediatric and Adolescent Medicine (DGKJ). “However, we are continuing to investigate this matter,” confirms Burkard Roddick, pediatric gastroenterologist and general secretary of the DGKJ. “Hepatitis, that is, inflammation of the liver, is actually fairly rare in children and is classically caused by known hepatitis viruses.”

In rare cases, other viral diseases with liver involvement can also lead to hepatitis. “For example, those caused by cytomegaloviruses and Epstein-Barr viruses, rarely even adenoviruses, mostly in patients with immune diseases,” explains Roddick.

Is it possible to contact Corona?

According to the NHS reports, some children infected with Sars-CoV-2 and others have tested positive for adenoviruses. None of the children had ever been vaccinated against corona. Is infection with corona a possible cause of severe liver disease?

“Link to Sars-CoV-2 is theoretically possible, but not very plausible,” Dr. Roddick explains. All children described were tested for SARS-CoV-2. This should have been a positive more often than coincidence. “These cases of hepatitis should also have been observed early in the epidemic, says Roddick. The UK Occupational Health and Safety Services (UKHSA) has also reported that there is currently no clear link between reported cases and known injuries or trips.

Doctors: Increased risk of infection due to relaxation

Roddick also rules out a link to vaccination. “It is likely that as the UK becomes increasingly lax, children and young people will come out of isolation in a relatively short time and will suddenly be exposed to many germs they have not come into contact with before due to lockdown or other measures.” Thus infection with the above pathogens could be causing an increase The number of cases of hepatitis. According to Roddick, there will also be a risk in Germany if restrictions are broadly relaxed.

How is hepatitis manifested?

In any case, the clinical picture of British patients must be taken seriously. Hepatitis is an acute acute inflammation of the liver with a significant increase in the levels of transaminases – enzymes that perform the functions of intracellular metabolism. Elevated transaminases in children up to 16 years of age are often associated with jaundice, which is sometimes accompanied by gastrointestinal symptoms such as vomiting. “Childhood acute viral hepatitis is often asymptomatic or with only slight impairment,” Roddick explains.

Clinical signs can be:

  • Vomiting and nausea
  • yellowing of the skin (jaundice, jaundice)
  • Diarrhea,
  • stomach pain
  • exhaustion
  • fever and
  • Anorexia

In addition, symptoms of the viral disease that originally caused – eg, an upper respiratory infection are added.

Isolated acute liver failure in children

As the UKHSA explains, in some cases, children developed acute liver failure, which made it necessary to transfer them to specialized pediatric liver wards. A few children have even had liver transplants.

In its letter, the European Health Agency called on clinicians across the European Union to report cases of acute and severe hepatitis in children whose hepatitis A to E infection has been ruled out to national health authorities. EU member states should share information about such suspected cases via the European Center for Disease Control and Prevention’s EpiPulse platform to facilitate systematic investigation of the causes.

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