While the world is still coming to terms with the devastating effects of the SARS-CoV- 2 virus, the World Health Organisation and the Centre for Disease Control and Prevention, USA are now warning citizens about a mysterious hepatitis like virus affecting children between the ages of 0-16 after it confirmed that one child died due to this infection.
This liver inflammation has been detected in over 170 children across 12 countries but the WHO has not shared any information about the child who died. The acute hepatitis and liver inflammation causing virus is a different strain which has led to over 17 children undergoing liver transplants.
The WHO reported that the first cases of the inflammation were reported from United Kingdom on April 15, 2022 but the cases most likely emerged earlier. The CDC reported that the US first reported similar cases in October and November of 2021. All the samples that were tested showed the presence of adenovirus, a family of viruses normally related which could likely be the causative agent, the WHO says, but there is no established link between adenoviruses causing hepatitis or viral inflammation.
With the highest number of cases (close to 115), UK is leading in the number of cases being detected. Other countries that have reported children suffering from acute hepatitis are mostly from the European belt. These include Spain, Israel, the United States of America, Denmark, Ireland, The Netherlands, Italy, Norway, France, Romania, and Belgium. The WHO last updated cases on April 23, and confirmed the death. STAT news reported that there were newer cases detected in North Carolina and Alabama.
What Has The WHO Found So Far?
According to the WHO, the clinical identification is acute hepatitis or liver inflammation among the children. Many children were also seen to suffer from abdominal pain, diarrhoea, and vomiting before the onset of inflammation followed by an increase in the levels of two liver enzymes and also jaundice
Following the conventional norms of testing for hepatitis when children exhibit these symptoms, the health agencies and laboratories across countries found that the samples did not have any of the common hepatitis causing viruses (A, B, C, D, E). None of the children had any international travel history, thus ruling out the possibility of the virus having originated in a different country.
Surprisingly, they detected adenovirus which is a respiratory virus in about 74 of the cases and 18 of which were of F41 type. According to the WHO, the UK has recently observed a significant increase in adenovirus infections in the community, particularly in faecal samples in children, where earlier there was lesser detection and circulation during the COVID-19 pandemic. At the same time, The Netherlands also reported a concurrent increase in the circulation of adenovirus within the community adenovirus.
The laboratories also found that SARS-CoV-2 was identified in 20 cases of those that were tested. Furthermore, 19 were detected with a SARS-CoV-2 and adenovirus co-infection.
To completely understand the aetiology of the virus, further investigations are ongoing in other countries to include detailed clinical and exposure histories of the children along with environmental and food toxicity testing, and other microbiological tests.
Does The WHO Think Adenovirus IsThe Causative Agent?
Although adenovirus has been detected in the samples and is hypothetically the underlying cause behind the rise in cases of unknown origin of acute hepatitis, the WHO states that it does not fully bode with the scientific explanations. Infection with the type 41, the adenovirus detected in the samples, has never been previously linked to causing hepatitis-like symptoms.
As mentioned earlier, adenovirus is a family of viruses that are normally associated with respiratory illnesses. However, depending on their type, they can also cause inflammation of the stomach or intestines, conjunctivitis, and bladder infections. Type 41 that has been detected in children normally leads to people suffering from diarrhoea, vomiting, and fever.
The WHO mentions that there have been scattered cases of hepatitis in immunocompromised children suffering from adenovirus infections. In the current spate of cases, the children, the WHO has noted, were all healthy before presenting hepatitis-like symptoms. The link between type 41 and liver inflammation needs to be studied and established.
The UN health body also warns that due to extensive case searching, it is possible that there would be a surge in detections before the causative agent can be ascertained and confirmed. They have also suggested investigating the potential emergence of a novel adenovirus as well as a co-infection with SARS-CoV-2.
For testing, WHO recommends that testing of blood, serum, urine, stool, and respiratory samples, as well as liver biopsy samples (when available) along with further virus characterization including sequencing should be actively undertaken.
Is The COVID Vaccine Linked To This Acute Hepatitis Infection?
After it emerged that the possible causative agent could be an adenovirus, questions were raised on whether the emergence of the mysterious hepatitis causing agent could be due to the COVID vaccines currently in use.
Both the Oxford- AstraZeneca vaccine and the Sputnik vaccine, the only two viral vector vaccines, have used adenoviruses as the viral vector for growing the vaccines.
The WHO, however, has quashed these rumours. "Hypotheses related to side effects from the COVID-19 vaccines are currently not supported as the vast majority of affected children did not receive COVID-19 vaccines," read the statement by the WHO.