This childhood disease, of unknown origin, is spreading around the world and has already infected at least 450 children
It appeared in the UK in April and has continued to infect children ever since. It was even fatal for a dozen of them.
But above all, it remains of unknown origin.
Scientists trying to trace its origins, despite the lack of retrospect, have made some progress in just a few weeks.
A viral origin
Most patients had gastrointestinal symptoms before progressing to jaundice to acute liver failure. No general environmental exposures were found and an infectious agent remains the most plausible cause.
This severe acute hepatitis in children would be of viral origin, but would not involve the known hepatitis viruses, neither A, nor B, nor C… to E.
The viral trail is virtually certain, but it has yet to be identified.
It would be an adenovirus type 41. In any case, this adenovirus was detected in most small patients.
But researchers aren’t sure, because this virus doesn’t normally cause liver damage in healthy underage patients, which is the case with this hepatitis.
Also read – Hepatitis of unknown origin in children: cases in France, what to look out for?
Research focused on Covid
Another hypothesis is currently under investigation: the Covid. Indeed, most patients with this hepatitis have tested positive for Covid at the time of the illness or some time before.
And according to English and American researchers who published an article in The Lancet on May 14, this is a trail to study without rejecting the adenovirus trail.
For them, this severe acute hepatitis could be the result of an adenovirus infection, but it can develop after a Covid infection.
Because “the viral persistence of Covid in the gastrointestinal tract can lead to the repeated release of viral proteins from the intestinal epithelium, leading to immune activation. This superantigen-mediated activation of immune cells has been proposed as a causal mechanism of the syndrome. Inflammatory disease in children”, as reported by Petter Brodin and Moshe Arditi, the authors of the publication.
Which means the possibility of Covid persisting in children needs further investigation and when they are then infected with the adenovirus they have a more vulnerable ground leading to this hepatitis.
In mice, the mechanism of this “double” infection promotes hepatitis and leads to the death of the animal.
The authors of the publication urge: “We suggest that children with acute hepatitis be examined for the persistence of Covid in the stool, particularly as this could provide evidence for a mechanism associated with Covid in a host that sensitized to adenovirus type 41.”
If this were the case, appropriate treatment could be given to the children and thus save their lives.
In numbers: a hundred cases in a row in Europe
As specified by the European Center for Disease Prevention and Control, the number of cases listed as of May 10 was over 100:
35 in Italy, 22 in Spain, 9 in Sweden, 8 in Portugal, 6 in the Netherlands, 6 in Denmark, about 5 in Ireland, 4 in Norway, 3 in Belgium, 2 in France, 2 in Cyprus, 2 in Austria and a in Poland.
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