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Over 200 children worldwide have contracted hepatitis of unknown origin. According to experts, panic is not appropriate.
Unexplained hepatitis cases in children continue to increase worldwide. “At least 228 probable cases” were reported to the World Health Organization by May 1, WHO spokesman Tarik Jasarevic said in Geneva at the beginning of the week. More than 50 other suspected cases would still be checked. So far, no case has been reported in Switzerland, but individual suspected cases are being investigated.
“It’s important not to stir up panic, but at the same time to keep your eyes open,” says Patrick Meyer Sauteur, Senior Physician for Infectious Diseases and Hospital Hygiene at the Zurich Children’s Hospital. The priority is to uncover cases and get to the bottom of the cause.
Why is? In recent weeks there have been a number of cases of severe hepatitis in children in several countries. The cause of these cases is not known, which means that the previously known hepatitis pathogens are not responsible for the infection (see box). At least one child died from it, and several others had to have a new liver transplant.
Where has the disease appeared so far? In Switzerland – as of May 4th – no case has been described as yet Pediatrics Switzerland writes. According to Patrick Meyer Sauteur, only very few suspected cases are known throughout Switzerland. According to the WHO, most cases of hepatitis in children in which the causative agents of hepatitis A, B, C, D and E have been ruled out occurred in Europe. The first cases were observed in Great Britain, there were others in France, Germany and Italy, but also in Israel and Japan.
Which children are affected? The diseases occurred in children aged one month to 16 years. Children under the age of ten were particularly affected, and children under the age of five were most affected. The vast majority were healthy before the illness.
Why is this outbreak making people sit up and take notice? Severe acute hepatitis is uncommon in young children. In addition, the usual viruses that cause acute viral hepatitis could not be detected in these patients. According to the WHO, international travel or connections to other countries are also not important factors according to the information currently available.
What could be the cause? Various options are being explored. One of the most important hypotheses is the adenovirus; a group of common viruses that are transmitted from person to person and sometimes cause respiratory symptoms, vomiting and diarrhea in children. “For most people who become infected with an adenovirus, there are no complications,” writes the Robert Koch Institute in a bulletin on the subject. Although adenoviruses do not usually cause hepatitis, it is a known rare complication that mostly occurs in immunocompromised individuals. At best, a new adenovirus variant could also be circulating in the current hepatitis cases.
“There have always been cases of hepatitis for which we did not know the cause. The accumulation and possible connection with adenoviruses is exceptional,” says Patrick Meyer Sauteur.
What can parents do? “Particular concern is not appropriate given the rarity of these unclear cases of hepatitis and the fact that no such cases have been reported in Switzerland to date,” writes Pediatrics Switzerland on request. According to the WHO, parents should still be aware of the symptoms of hepatitis in younger children: acute diarrhoea, vomiting, abdominal pain and yellowing of the skin or the whites of the eyes (jaundice). According to the WHO, most children did not have a fever. “While abdominal pain, vomiting and diarrhea are very common and mostly have other causes, jaundice is a strong indication of possible hepatitis,” differentiates Pediatrics Switzerland. In case of suspicion or uncertainty, a doctor should be consulted.