Hepatitis in childhood: What is the latest theory?

By Jim Reed and Philippa Roxby
Health reporters

Image source, Getty Images

Health authorities continue to investigate a sudden increase in cases of hepatitis or hepatitis among young children.

Even if children get adenovirus, the chances of developing the liver condition are extremely low, says the British Health Safety Agency.

What is hepatitis?

Hepatitis is the collective term to describe inflammation of the liver tissue.

It is often caused by a viral infection – but also by exposure to certain chemicals, alcohol, drugs and certain genetic disorders.

How were these cases discovered?

It triggered a study by the UK Health Security Agency (UKHSA), which has now looked back at hospital admissions in England, Wales and Northern Ireland since January.

It is now investigating at least 111 cases in children under the age of 10, with the majority children under the age of five.

They had initial symptoms of vomiting and diarrhea followed by yellowing of the skin or the whites of the eyes, called jaundice.

Of the confirmed cases, 81 live in England, 14 in Scotland, 11 in Wales and 5 in Northern Ireland.

Most have a mild form of the condition, although 10 have needed a liver transplant.

Cases in children have also been detected in several other countries around the world – 169 at the latest census.

What could be the reason for this?

There are many different types of adenovirus. A specific adenovirus called F41 was detected in about three-quarters of the children with confirmed hepatitis who were tested.

Health authorities believe it is likely to come back after virtually disappearing during the first year of the pandemic due to reduced social mix.

Its impact on young children who did not come into contact with any of the normal viruses during lockdown when they were infants could be behind the current increase.

Laboratory data from the NHS show that common viruses are now circulating in children, especially those under the age of five, at a higher level than in previous years.

What else has been found?

About 16% of cases were positive for coronavirus (SARS-CoV-2) when they were hospitalized, but because there was plenty of Covid at the time, health officials say this is not unexpected.

The most common forms of hepatitis – known as A to E – are caused by specific viral infections. However, these viruses have not been detected in these childhood cases.

The large geographical spread of cases means that there is no obvious link between the children involved, which excludes, for example, contaminated food.

Dr. Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said: “Information gathered through our studies increasingly suggests that this increase in sudden onset hepatitis in children is associated with adenovirus infection.

“But we are investigating other potential causes thoroughly.”

Could it have something to do with Covid vaccinations?

No – none of the children had been vaccinated.

Covid vaccines are only available from the age of five in the UK, meaning many of the children diagnosed with hepatitis would not have been eligible.

How about a Covid infection in itself?

UKHSA says it is looking at previous Covid infections in the affected children, as well as the emergence of a new variant of adenovirus, as possible causes.

It says it continues to investigate a wide range of other infections and causes.

Studies suggest that a small number of babies and children infected with Covid have needed treatment for hepatitis in other countries, such as the United States as well as Brazil and also India. In most of these cases, patients came quickly and were discharged in a few days.

What should parents take care of?

Parents, GPs and other healthcare professionals have been asked to keep an eye on the symptoms of jaundice, a yellow tinge on the skin and other parts of the body that are most easily seen in the whites of the eyes.

Other symptoms of hepatitis in children include:

  • dark urine
  • pale, gray stools
  • itchy skin
  • muscle and joint pain
  • a high temperature
  • to feel and be ill
  • feeling unusually tired all the time
  • lost appetite
  • abdominal pains

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