The World Health Organisation has announced that 169 cases of “acute hepatitis” of “unknown origin” have been reported amongst young children across 11 countries in recent weeks.
One child has died, while 17 have required liver transplants as treatment.
There has already been a range of theories proposed as to what exactly is causing the outbreak, but, so far, scientists are not entirely sure about any of them.
Here’s what we know.
What is Hepatitis?
Hepatitis means inflammation of the liver, which can lead to liver failure and death. Symptoms of hepatitis include fever, fatigue, loss of appetite, nausea, abdominal pain, joint pain, and jaundice.
Hepatitis can be caused by a number of different things, including, commonly, viruses. Hepatitis viruses are named A through E and these are the ones you’d probably think of as the main cause of the illness. Parasites and bacterial infections are also common causes of hepatitis.
You can catch viral hepatitis by not washing your hands after using the bathroom, drinking unclean water, injecting drugs like heroin, or having unprotected sex with someone who has the virus.
The condition can also be brought on by heavy alcohol use, poisoning, and the use of some medications like paracetamol.
What is Causing This Outbreak?
The current outbreak, which is described by the WHO as “unexpected and significant,” is mainly being seen in the UK, where 114 of the cases have been detected, Spain, where 13 cases have been detected, and Israel, where 12 cases have been detected. The US has also seen 11 cases, Denmark six, and The Netherlands four. No cases have so far been detected in Australia.
The cases have all been in children aged one month to 16 years old, however, most of them are in children under 10. The vast majority of these children were previously healthy.
So far, we can rule out viral hepatitis in all of these cases, as hepatitis A through E have not been found in any of the confirmed cases.
Drug-induced hepatitis also seems to be off the cards, with no link to paracetamol usage having been found.
The WHO has also ruled out international travel to places where hepatitis is prevalent as a cause since the children do not have this in common.
Online, COVID sceptics have been quick to identify the COVID vaccines as a cause, the WHO have said this is not the case, given that most of the children have not been vaccinated.
Adenoviruses, which are common viruses that cause things like the cold, bronchitis, and diarrhoea but are not often severe, have been detected in 74 of the 169 cases and scientists suspect that viral infection could be triggering the outbreak. In the UK, 75% of hepatitis cases had adenovirus infections.
However, the WHO has said that “while adenovirus is currently one hypothesis as the underlying cause, it does not fully explain the severity of the clinical picture”.
Infection by adenoviruses has not previously been linked to severe hepatitis, so, while the WHO is looking at this possibility, they are also keeping an open mind on what else could be causing it.
Is COVID Causing Hepatitis?
The link between COVID and hepatitis is at least plausible. Thirty-nine of the hepatitis cases tested positive for SARS-COV-2, however, COVID alone is unlikely to be causing the issue, as it’s not previously been linked to hepatitis, except in extreme cases.
Conor Meehan, a senior lecturer in Microbiology at Nottingham Trent University, appears to dismiss the suggestion, writing that “isolated cases of hepatitis have been reported in COVID patients, but this is even rarer than autoimmune hepatitis, and has mostly been observed in adults with severe COVID”.
Meehan suggests that hepatitis could be “a new symptom resulting from interaction between viruses (perhaps adenovirus and coronavirus both infecting the same child, for example)”.
“Alternatively, it could be caused by a totally different virus that hasn’t been detected yet”.
While the WHO has not ruled out the possibility, they have recommended against travel restrictions to areas where these infections have been occurring.
What the WHO has said, however, is that due to COVID health measures, which have been successful in stopping the circulation of not just COVID but all manner of air-borne viruses, young people who have not previously been exposed to common adenoviruses may now be getting hit hard by them.
The global health monitoring organisation has said that they expect to see more cases of hepatitis in children and are urging local health providers to monitor closely for symptoms.