Health authorities in Scotland on Thursday published preliminary findings from an international investigation into dozens of shocking cases of severe liver inflammation in children. In some cases there has already been acute liver failure and liver transplantation.
Thursday’s report details 13 serious cases in Scotland, most of them in children between the ages of 3 and 5 and almost all of which occurred in March and April this year. Scotland typically tallies fewer than four cases of unexplained liver inflammation—aka hepatitis—in children during the entire year. One in 13 cases in Scotland this year has had a liver transplant and five are still in hospital. No death has been reported.
Meanwhile, health officials in England reported about 60 unexplained severe hepatitis cases in 2022, most in children aged 2 to 5. Some of those cases resulted in acute liver failure, and some even led to liver transplantation. Again, no deaths have been reported.
In their report, officials in Scotland noted that they have been in contact with researchers from the US Centers for Disease Control and Prevention, which is investigating their own cluster of cases of hepatitis in children. The US CDC did not immediately respond to Ars’ request for more information on the cluster, including how many children are involved and the severity of their cases. This story will be updated as more information becomes available.
Health officials are rushing to understand what is behind the serious illnesses. Of the cases described so far, the most obvious infectious culprit that causes inflammation of the liver—hepatitis (A to E) virus, has been ruled out, as children have consistently tested negative. Health investigators have not found even a common food, drink or personal care product that explains the diseases. There are no clear links between the cases, and no association with travel. Researchers have also not seen strong evidence of bacterial infection.
Some children have tested positive for infection with the adenovirus. For example, five out of 13 children in Scotland tested positive for adenovirus—two by throat swabs, two by blood tests, and one by a stool sample. And according to health officials in Scotland who have been in contact with CDC researchers, the US cluster of unexplained hepatitis cases is also linked to adenovirus infection.
Adenoviruses are a large family of viruses that are widely spread and are often associated with respiratory and eye infections. However, they can cause a variety of diseases, including gastrointestinal and disseminated infections. Adenovirus is known to cause severe hepatitis in children, but it is rare in people who are not immunized.
Some children in the UK have also tested positive for SARS-CoV-2 infection. For example, five out of 13 children in Scotland had recently tested positive. None of the children were vaccinated against the virus.
According to health officials in Scotland, the leading hypothesis is that the diseases are caused by an infectious agent – rather than toxic exposure – and that an adenovirus is the prime suspect. Officials note two possibilities if an adenovirus is behind acute cases: a new adenovirus causing severe liver injury, or an existing variant that is regularly spread among children, causing serious illness because they were previously Have not been exposed to adenovirus and are immunologically clumsy. “The latter scenario may be the result of restricted social distancing during the COVID-19 pandemic,” speculate the official.
But, there is also the possibility that the clusters are related to the infection of the omicron subvariant BA.2, which is widespread through the UK and US or even a yet-to-be-identified variant. “At this time a novel or not yet known virus also cannot be ruled out,” the officials wrote.
While researchers continue their investigation – which is still in its early stages – health officials in the UK are recommending doctors to treat children with symptoms of hepatitis, such as dark urine, pale stools, jaundice, itchy skin, nausea, vomiting and lethargy. are alerted to. ,