Mysterious childhood hepatitis now found in at least 20 countries, WHO reports

The number of cases of children with sudden and severe hepatitis infections continues to rise, a spokesman for the World Health Organization (WHO) announced Tuesday.

“As of May 1, at least 228 probable cases have been reported to WHO from 20 countries,” said Tarik Jasarevic, an organization’s media officer, at a press conference in Geneva.

There are “over 50 additional cases under investigation,” he added.

The death toll from the worldwide epidemic may also have risen this week, as three children in Jakarta, Indonesia are suspected to be the latest victims of the mysterious disease. These deaths, of children between the ages of two, eight and 11, bring the total likely deaths worldwide to at least five.

The etiology of the unusual increase in childhood hepatitis cases is still unknown, although one main hypothesis puts the cause of the disease as a type of virus, known as adenovirus. In the UK, where the majority of cases have been found and the international alarm was first raised last month, more than three-quarters of children with confirmed hepatitis have tested positive for a particular adenovirus called F41.

However, if correct, this explanation raises further questions: “There are very few case reports in the global literature of hepatitis-associated adenovirus infection in immunocompetent children,” explained Will Irving, professor of virology at the University of Nottingham, UK. .

In fact, adenovirus is primarily known as a tummy bug or common cold virus, which only leads to more complicated outcomes in immunocompromised patients. All of the cases linked to the mysterious outbreak have occurred in previously healthy children, so if F41 is indeed what is behind the recent increase in hepatitis cases worldwide, “it will be necessary to explain why the natural history of infection with adenovirus has changed so much dramatically in 2022, ”Irving said.

However, others remain skeptical. With so few cases worldwide, it is not yet definitive that the “epidemic” exists: it could be that we are experiencing an increase awareness of cases of hepatitis, rather than in the number of cases themselves.

“There is still little data to define if there is an outbreak and for now the global risk is considered low,” noted Leandro Soares Sereno, consultant for the prevention and control of viral hepatitis at the Pan American Health Organization ( PAHO).

“Since there is still no certainty about the origin of the disease, it is possible that we are becoming aware of a situation that existed before but went unnoticed because there were so few cases”.

While the WHO, as well as various national and international health agencies, continue to monitor the emergence of cases, the scientists stress that parents and health professionals should not be overly concerned about the outbreak. There are “only a small number of children affected,” said Deirdre Kelly, professor of pediatric hepatology at the University of Birmingham and consultant pediatric hepatologist at Birmingham Women’s & Children’s Hospital, and most of these have recovered well.

“The most important [action for caregivers] is paying attention to symptoms, such as diarrhea or vomiting, and to color: if there are signs of jaundice – where the skin and whites of the eyes turn yellow – you need to see a doctor immediately ”, advised Sereno.

“We recommend basic hygiene measures such as washing your hands and covering your mouth when coughing or sneezing to prevent infections, which can also prevent adenovirus transmission.”

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