May 18, 2022
NBC News reports the European Center for Disease Prevention and Control announced the worldwide number of mysterious pediatric hepatitis cases has reached 450 in total from 25 different countries. The number is double what the agency noted two weeks ago and far exceeds the WHO’s count of 348.
The U.K. (160) and the U.S. (110) have reported the majority of cases of liver inflammation, mostly in children under the age of five. The cause of the cases remains unknown, though hypotheses are emerging.
The prevailing theory is adenovirus type 41. More than half of U.S. cases tested positive for adenovirus, along with 72% of U.K. cases and 60% across Europe. The timing of the discovery has opened questions as to the role COVID-19 may play in cases. No evidence links directly to hepatitis in children yet the WHO is looking into whether prior COVID infection could have prompted immune systems react abnormally to normally harmless adenoviruses.
The unexplained case pattern in the U.S. were first identified by a team at the University of Alabama at Birmingham that featured a PIDS fellow. The team recognized children presented with signs of jaundice, and a majority also had nausea, vomiting, profound fatigue and loss of appetite. Other symptoms included fever, stomach pain, dark urine and light-colored stool.
In the U.S., 90% have been hospitalized so that doctors could monitor and test the patients. The illnesses have been mostly mild. However, 14% have received liver transplants, and the CDC is investigating five possibly related pediatric deaths.
PIDS Fellow Markus Buchfellner was part of the team that made the initial identification. He is quoted in the story on the possible role, if any, of COVID-19 and called it “one of the biggest unanswered questions.” On the patients he observed, “The big symptom that made all of these kids different was that they all showed signs of jaundice,” however, “All nine of our kids are doing fine, even those who needed transplants.”