Hepatitis outbreaks in children have been detected in the UK, Spain, Denmark, the Netherlands, and the US, in Alabama. Some cases have been serious, necessitating a liver transplant. The World Health Organization warns that the rise in childhood hepatitis cases should be taken seriously. The increase was unexpected and the usual causes have been ruled out.
Viruses are known to cause hepatitis but typically rarely cause serious illness in previously healthy children. Cases in the UK and Spain have tested negative for the typical infectious causes of hepatitis, including hepatitis A, B, C and E viruses.
Researchers and physicians suspect an adenovirus, instead, is behind the outbreak. Adenoviruses typically cause cold-like symptoms. All of the children in Alabama and up to half of those in the UK tested positive for adenovirus. Researchers think perhaps this could be a new variant of adenovirus that causes a new clinical syndrome or is a routinely circulating variant that more severely affects younger children who haven't had exposure to it before.
The outbreak was first detected on March 31 in Scotland when 3 to 5 year olds were admitted to a hospital in Glasgow earlier that same month with severe hepatitis. As of April 12, Scotland has reported 13 cases. Scotland typically sees fewer than four hepatitis cases a year in children.
Deirdre Kelly, a pediatric hepatologist at Birmingham Children's Hospital in England reports, "These [were] perfectly healthy children…up to a week ago." Fortunately, she also adds, "Most of [the children] recover on their own."
At the unit Kelly works at in England, they've seen 40 cases of childhood hepatitis since the beginning of this year where they've normally seen around seven children in the same length of time in previous years.
This hepatitis outbreak appears to affect children 2 to 5 years old and causes symptoms of jaundice and vomiting.
Interestingly, the coronavirus pandemic may indirectly play a role if these hepatitis outbreaks are caused by a routine adenovirus. Isolation during the pandemic may have contributed to an altered immune response to adenoviruses since children had less exposure to viruses in general at ages when exposure is critical to training their immune systems.
Researchers are also considering the possibility of this outbreak being directly related to long-term complications from COVID-19 infection.
Parents should not panic. Overall, the prevalence of these hepatitis cases remains low.