SWITZERLAND –At least 650 children have been diagnosed with a mysterious and severe hepatitis infection since early April, according to the World Health Organization.
The cases, which have so far puzzled health officials, have been reported in 33 different countries.
At least 38 children have required a transplant, and nine have died, according to a Friday statement from WHO. There are also 99 cases pending classification.
European countries have reported a majority of the cases, with 222 probable cases reported in the United Kingdom and Northern Ireland. Cases were also reported in North America, Argentina, the Western Pacific, Southeast Asia and the eastern Mediterranean region.
According to data on European cases, 75 percent of the children were under the age of five. Sixty percent of the 181 cases tested positive for adenovirus.
Only 12 percent of the 188 cases tested positive for COVID-19. In addition, 84 percent of the 63 cases with data on COVID vaccination were unvaccinated.
The global health agency added that “the cases are more clinically severe and a higher proportion develop acute liver failure compared with previous reports of acute hepatitis of unknown etiology in children.”
According to UK researchers, there has been an increase in adenovirus activity, which is co-circulating with SARS-CoV-2, the virus that causes Covid-19.
While common hepatitis viruses such as hepatitis A, B, C, D, and E have been ruled out in these children, adenovirus — a common family of infections responsible for illnesses ranging from colds to eye infections — is suspected of causing the condition.
Data from the United Kingdom revealed adenovirus in 75 percent of the cases, but data from other countries is insufficient.
Common hepatitis viruses, such as hepatitis A, B, C, D, and E, have been ruled out in these children. The strongest link between the cases appears to be adenovirus 41, which is known to cause stomach upset such as diarrhea and vomiting.
“While adenovirus is a plausible hypothesis as part of the pathogenesis mechanism, further investigations are ongoing for the causative agent; adenovirus infection (which generally causes mild self-limiting gastrointestinal or respiratory infections in young children) does not fully explain the more severe clinical picture observed with these cases,” the agency stated.
Many of the affected children reported those symptoms before becoming jaundiced, when the whites of their eyes and possibly their skin developed a yellowish tinge, which is a sign of liver problems.
Experts say adenovirus 41 is unlikely to be the culprit because it has never been linked to hepatitis in children with healthy immune systems.
According to the WHO, adenovirus associated virus 2 (AAV-2) has been found in a small number of cases in the United Kingdom in liver and blood samples.
The UK Health Security Agency has launched a case-control study to see if adenovirus 41 is more prevalent in children with hepatitis than in others.
SARS-CoV-2 has been detected in a number of cases, according to WHO, though data is limited.
The cause of the outbreak remains under investigation, and the WHO classifies the global risk level as moderate.
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