What you need to know about severe hepatitis reported in children

Last month, the US Centers for Disease Control and Prevention reported a population of nine infants in Alabama. All of these were previously healthy, had no underlying illness, and caused severe liver inflammation, also known as hepatitis.

Two of the nine patients needed a liver transplant, and three even developed liver failure. Since then, all children have recovered or are recovering, but the cause of their mysterious infection is struggling to identify the cause, while more potential cases have been reported. It remains a mystery to the medical community.

Brandon Dionne is a clinical professor of pharmacy and health systems science at the Bouvé College of Health Sciences at Northeastern University. Photo courtesy of Matthew Modoono / Northeastern University

As of last week, more than 100 cases of unexplained severe hepatitis in infants in the United States were being investigated by the CDC. More infectious diseases have been reported abroad. In response to the news that the number of cases may increase, infectious disease specialists, including experts at Tohoku University, have parents and guardians take some of the daily precautions taken during the coronavirus pandemic. Recommended to take: wash hands, do not touch eyes, mouth or nose, and stay home if you feel sick.

“This is still relatively new, but I’m worried because it can cause quite serious illnesses in children,” said a clinical professor at the Faculty of Pharmaceutical Sciences and Health Systems Science at Bouvet Health Science University at Northeastern University. One Brandon Dionne says. .. “It is important for parents and guardians to be aware of the symptoms of hepatitis in their children and act swiftly.”

A common theme for many pediatric hepatitis patients in the United States and around the world is that they are also usually diagnosed with adenovirus, a common virus that causes colds, flu-like symptoms, and stomach problems. It is usually not associated with severe liver inflammation in otherwise healthy children. This is a concern, says Dionne.

Dionne, a clinical pharmacist specializing in the management of antibiotics and the treatment and prevention of infectious diseases, works primarily with adult patients at Brigham and Women’s Hospital in Boston. The professor says he saw many cases of adenovirus, primarily among adults experiencing mild respiratory symptoms.

“Usually, it’s the seasonal respiratory illness that causes cold-like symptoms,” explains Dionne.

According to Dionne, a particular strain of adenovirus recently identified in many cases of childhood hepatitis is adenovirus type 41, which was previously associated only with hepatitis in immunocompromised patients. But still, it’s still incredibly rare.

“This is the first time I’ve seen it in an immunocompetent patient,” he explains. “That’s certainly something we have to be careful about.”

so Media briefing On May 6, Dr. Jay Butler, Deputy Director of Infectious Diseases at the CDC, said he was investigating 109 children with acute hepatitis in 25 states and territories reported in the last seven months. Over 90% of patients were hospitalized. About 14% received liver transplants and more than half confirmed adenovirus infection.

The updated number of cases and deaths came after the federal government issued a national health warning requiring doctors to monitor and report cases of suspected liver inflammation of unknown cause.

Butler said the CDC is also aware of recently discovered cases of unexplained childhood hepatitis in other countries.

“We work closely with public health authorities around the world to understand what they are learning,” he said, based on early research, hepatitis A and hepatitis B. , Pointed out some of the common causes of viral hepatitis such as hepatitis C, delta hepatitis, hepatitis E. — Examined and tested, but not found in any of the reported patients.

At this time, the CDC states that it believes that adenovirus may be the cause of some of these cases, but other potential environmental and circumstantial factors are under investigation. Adenovirus 41 is usually not known to cause such severe liver problems in children without weakened immunity, and no known epidemiological association has been found among these patients. Is not …

Butler emphasized that the coronavirus vaccine was not the cause, as rumors spread online about the potential causes of severe childhood hepatitis cases. Nine children in Alabama had never been infected with COVID-19 while hospitalized for hepatitis and had no recorded history of coronavirus. In addition, no one was vaccinated with the COVID-19 vaccine before going to the hospital.

Beyond the mysteries surrounding the causes of these hepatitis cases, Dionne recognizes another major problem. “Why does hepatitis suddenly occur if the actual cause is adenovirus 41?”

“That’s the hardest part here. Even if we identify this as a complication of adenovirus 41, we don’t know if there are any new mutants causing it,” he says. “If this is a new variant, it would be more worrisome, because it’s likely that these cases will be more common. I don’t know yet.”

As these cases are under investigation, the CDC states that it is important to remember that severe hepatitis in children is rare, even though the number of cases published last week may increase. Nevertheless, the agency and Dionne recommend that parents and caregivers be aware of the symptoms of hepatitis (vomiting, dark urine, light-colored skin, yellowing of the skin, also known as jaundice).

“If your child is experiencing symptoms such as respiratory illness, pay attention to them and be aware of more serious complications. But in most cases it will be like a common cold. “Dionne says. “The more serious symptoms are the direct reason to bring them in for treatment.”

The CDC also recommends that children stay up to date on all vaccinations and prevent many infectious diseases, including frequent hand washing by infant parents and caregivers. We encourage you to take the same routine actions. People who are ill and cover their coughs and sneezes to avoid touching their hands, eyes and mouth.

In addition, if you feel sick, stay home, says Dionne. He says that some of the current infections with adenovirus are likely due to people who come to school or work when they are ill.

“As much as possible, if your child feels sick, try to keep them at home or in day care,” says Dionne. “Don’t let them go to school.”

For media inquiriesPlease contact us at [email protected].