United Kingdom: Mysterious hepatitis in children

A wave of mysterious hepatitis outbreaks in children is spreading worldwide. In the UK, a potential cause to these cases is being considered by scientists.

Great Britain is on the trail of the hepatitis outbreka in children

In the UK, the national Health Security Agency has been thoroughly investigating the mysterious cases of the disease in young children. Since January 2022, new cases of hepatitis have continued to appear in children under the age of 10. The total number of confirmed sudden-onset hepatitis cases in the UK has now risen to 263. The majority of affected children are younger than 5 years old. In most cases, the illness began in previously healthy children with gastroenteritis, presenting the typical symptoms of diarrhoea and nausea. This was followed by jaundice with yellowing of the sclera of the eyes, skin and mucous membranes. In some cases, the disease escalated to such an extent that a liver transplant became necessary for the young patients. As late as 17 June 2022, the British health authorities informed the population on its website that there was no evidence of a connection with the vaccine against the coronavirus (COVID-19). Many of the children affected had been too young to have received the vaccine.1

The "Sherlock Holmes" of virology solves the mystery of childhood hepatitis

A new and extremely complex theory is circulating in scientific circles about what may have caused the puzzling cases of hepatitis in young children. Two unpublished studies from the UK theorise that the children affected by acute hepatitis may have been co-infected with two different viruses. Another complicating factor could be a genetic predisposition to an exaggerated immune response. So far, research suggests that two viruses we know and widely circulate may now have made a comeback with the relaxation of the Corona measures. With contact restrictions, homeschooling and closed daycare centres, most infants and children had little contact with each other to exchange viruses and bacteria. Now, some children's immune systems may be overwhelmed with the sudden contact and the germs that come with it. The children's immune systems also lack the training they would otherwise have received at that age in daycare centres.1,3

Lack of immunity to adenovirus in young children as a result of the pandemic

The two UK research teams were able to make an interesting observation: infants who could only be vaccinated at a later stage due to Covid restrictions missed out on early immunity against the adenovirus. And this is what may have led to the serious cases of liver inflammation in children. Co-infection with adenovirus and adeno-associated virus 2 may have led to this unusual manifestation of hepatitis. This again demonstrates the importance of training the immune system for infants and children and the potential impact of the Corona pandemic.1,3

The link between childhood hepatitis and COVID-19

Virologist William Irving of the University of Nottingham (UK) sees a strong link between the Corona pandemic and the hepatitis outbreak in children. According to Irving, the global hepatitis outbreak could also be a result of direct damage from previous SARS-CoV-2 infections. It is also conceivable that reduced viral exposure during the lockdown contributed significantly. This abnormal immune response, which culminated in a serious and life-threatening liver inflammation, could be just one of many more abnormal immune responses we can expect in children. This hypothesis is contradicted by the data from the CDC study. The CDC study researchers did not observe an increase in paediatric hepatitis cases after analysing medical records and laboratory testing of stool samples for adenoviruses.4,5

References:
  1. https://www.bbc.com/news/health-61269586
  2. https://www.gov.uk/government/news/hepatitis-liver-inflammation-cases-in-children-latest-updates
  3. https://www.statnews.com/2022/07/25/new-studies-offer-theory-on-cause-of-unusual-hepatitis-cases-in-kids/
  4. https://www.nature.com/articles/d41586-022-01706-y
  5. Kambhampati, A. K. et al. Morb. Mortal. Wkly Rep. 71, 797–802 (2022).