CDC Warns Doctors to Look Out for Mystery Liver Illness in Children

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The Centers for Disease Control and Prevention is warning doctors to keep an eye out for mysterious cases of hepatitis that are affecting young kids in the US and elsewhere. Two children in the US have become so sick that they’ve required a liver transplant. Officials in Europe and Israel have reported similar recent cases.

Since late last year, children have been coming down with severe hepatitis (liver inflammation) that couldn’t be explained by other well-known causes, such as the group of viruses most commonly responsible for hepatitis. Symptoms have included jaundice, fever, stomach pain, as well as discolored urine and feces, with more life-threatening cases leading to complete liver failure.

Reports have largely come from the UK so far, with now over 100 cases having been reported since January this year. But dating back to last fall, doctors at an Alabama children’s hospital have been seeing their own similarly unexplained cases of hepatitis. Between October 2021 and February 2022, they’ve documented nine such ill children. Three developed acute liver failure and two went on to need transplants, but none have died so far.

On Thursday, the CDC formally feels out a health advisory to doctors across the country, asking them to keep track of pediatric cases that could be similar to the cluster in Alabama. Specifically, they’re calling for doctors to report cases of unexplained hepatitis in children under 10.

On Friday, the European Center for Disease Prevention and Control reported that around 30 similar hepatitis cases have been documented in Belgium, Denmark, Ireland, the Netherlands, France, and Spain, with four children needing liver transplants. And following an alert from the World Health Organization last week, Israel’s Healthy Ministry announced that it’s now looking into 12 boxes that seem to fit the criteria.

The primary suspect in these cases is an adenovirus—in particular, adenovirus type 41. Type 41 is primarily known for being a common cause of gastrointestinal illness in children, but it has been implicated as a rare source of hepatitis before, though only in children with weakened immune systems. The virus has been found in many but not all cases of this mystery outbreak, both in the US and UK.

The covid-19 pandemic has ironically driven down the incidence of many other infectious diseases, thanks to pandemic-related measures and precautions people have taken to limit the spread of the highly contagious coronavirus. With these precautions fading away, it’s possible that a strong resurgence of type 41 has created a larger wave of hepatitis cases than usual, even though the actual risk of this rare complication would have remained the same. However, it’s also possible that a wide-spreading strain of type 41 has somehow mutated in a way that makes it more likely to cause hepatitis in otherwise healthy children. The possibility that other germs, including the coronavirus, could be involved isn’t completely off the table, either. There is no evidence, however, that the covid-19 vaccines are to blame, as some in the antivax movement have baselessly alleged, with many of the affected children not being vaccinated against covid-19.

With the CDC’s alert, it’s likely that more cases will be found in the US, and hopefully, a cause will be nailed down sooner than later.

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