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The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network Health Advisory regarding a possible link between a mysterious cluster of children with hepatitis, which is inflammation of the liver, and a virus known as adenovirus, according to a recent press release.
“This health advice serves to alert U.S. clinicians who may encounter pediatric patients with hepatitis of unknown etiology to consider adenovirus testing and to elicit reporting of such cases to the state public health authorities and to the CDC,” the CDC said. “Nucleic acid amplification test (NAAT, eg PCR) is preferred for adenovirus detection and can be performed on airway, stool or rectal or blood tests.”
In November 2021, a large children’s hospital in Alabama notified the agency of five previously healthy pediatric patients with significant liver damage, including three with acute liver failure who were also positive for adenovirus but none had COVID-19.
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Adenovirus most commonly causes respiratory diseases, but can cause a variety of other diseases, including conjunctivitis – also known as pink eye – acute gastroenteritis, cystitis and rarely neurological disease, but there is no treatment other than symptomatic treatment, according to the CDC.
The virus is spread by close personal contact, respiratory droplets and fomites with more than 50 different types that can cause infections in humans.
However, the virus type sequenced in the five pediatric patients, adenovirus type 41, commonly causes acute gastroenteritis, which typically manifests as diarrhea, vomiting, and fever, but may also be associated with respiratory symptoms.
“Although there have been cases of hepatitis in immunocompromised children with adenovirus type 41 infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children,” according to the health advice.
Four additional pediatric patients with hepatitis and adenovirus infection were identified at the Alabama Children’s Hospital for a total of nine inpatients from October 2021 to February 2022, with two patients in need of a liver transplant. But no patients died.
The United Kingdom Health Security Agency (UKHSA), Public Health Scotland, Public Health Wales and the Public Health Agency reported a total of 108 cases of “sudden onset hepatitis” in children under the age of 10 who tested negative for common viruses known to cause hepatitis , including hepatitis viruses A, B, C, D and E between January 2022 and 12 April 2022, according to a press release from the UK Health Security Agency.
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The UK authorities reported that approximately 77% of their cases have been tested positive for adenovirus infection.
“The United Kingdom has recently observed an increase in adenovirus activity circulating with SARS-CoV-2, although the role of these viruses in the pathogenesis (mechanism by which the disease develops) has not yet been elucidated,” the World Health Organization noted.
The release noted that 79 of the confirmed cases are in England, 14 are in Scotland and the rest are in Wales and Northern Ireland, where 8 children are having a liver transplant. However, none of the confirmed cases are known to have been vaccinated against COVID-19.
“We work with the NHS [National Health Service] and public health colleagues in Scotland, Wales and Northern Ireland to quickly investigate a wide range of possible factors that can cause children to be hospitalized with hepatitis known as hepatitis, “said Dr Meera Chand, Director of Clinical and New Infections at UKHSA. .
“Information gathered through our studies increasingly suggests that this is associated with adenovirus infection. However, we are investigating other potential causes thoroughly.”
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Spain and Denmark have also reported cases of unusual hepatitis in children, while France is investigating two suspected cases in Lyon, and Israel is investigating a dozen children with unexplained hepatitis over four months, two of whom need liver transplants, according to a State report.
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Hepatitis can be caused by viruses, alcohol, toxins, medications and other medical conditions. However, in the United States, the most common causes of viral hepatitis are hepatitis A, hepatitis B and hepatitis C virus, according to the CDC.
Signs and symptoms of hepatitis include nausea, vomiting, abdominal pain, yellow and dark urine, with treatment aimed at the underlying cause, per. the agency.