COPENHAGEN: A mysterious hepatitis is spreading among children. No one can explain the reason. Experts suspect that a particular intestinal virus may play a role. Or could it be due to the coronavirus?

Health experts and researchers around the world are facing some explanation for a possible outbreak of infectious hepatitis. Worldwide, according to the European Center for Disease Prevention and Control (ECDC), at least 493 cases of acute hepatitis have been detected during April and May.

Most infected children are under the age of five, and have not tested positive for any of the known hepatitis types A, B, C, D and E. So far, 12 children have died. Many have been treated for liver failure and a small proportion have had liver transplants.

Outbreaks in the United Kingdom

It was at the beginning of last month in the World Health Organization (WHO) was made aware of a rapid increase in unexplained cases of hepatitis in the UK, especially in the UK, and since then has many cases. The same is the number of countries that have registered cases of disease.

In Europe, at least 293 cases have been registered. In Scandinavia, there have been 7 cases in Denmark. Two of the Danish children have had liver failure, according to the Statens Serum Institut in Copenhagen. Among other EU countries, most cases are in Italy and Spain.

Outside Europe, there have been at least 181 cases so far. Of these, more than 100 are in the United States. However, this is also the case in Argentina, Brazil, Costa Rica, Panama, Canada, Israel, Palestine, Indonesia, Singapore, Japan and South Korea.

– It is very likely that more cases will be discovered before the cause can be confirmed. We develop consequences closely, says WHO. The 12 deaths have been five in Indonesia, five in the United States, one in Palestine and one in Ireland.

– If you look at the numbers, it is most reminiscent of an outbreak in the UK, where there have been 176 cases and where 11 children have had a liver transplant, says chief physician in infection epidemiology and prevention, Anders Koch.

– It is not uncommon for a few cases of unexplained hepatitis in children each year. But what is unusual is that it – at least in England and Scotland – is an accumulation of it, he says.

Fun of intestinal virus

– This is a serious phenomenon. The sick children were completely healthy just a week ago, says Deirdre Kelly who is a hepatologist at Birmingham Children’s Hospital in England, to The scientist.

Health experts are looking at several possible explanations. Adenovirus type 41, which is a relatively common and mild intestinal virus that causes stomach symptoms, has been found in many of the liver-sick children in England, the United States and other countries. And the most common hypothesis the researchers work from is therefore that it plays a key role.

But there is a lot of brooding over the context. Adenovirus type 41 is not known to cause hepatitis. On the other hand, there are other types of adenovirus – and then only in rare cases – and usually in children who already have a weak immune system. Several things astonish researchers.

Is it due to the corona?

The WHO states that researchers are investigating whether adenovirus type 41 can change so that it attacks the body in a new way. Another hypothesis is that many of the children who have suffered from the unexplained hepatitis will have fewer colds and other infections in recent years, due to special hygiene rules associated with the corona pandemic. It may have made them more prone to developing serious illness later.

– One wonders if it is because the children have been isolated so much that they have not received their usual boost from everything that goes on, such as. adenovirus, and whether that may be why it strikes in this way, says Professor Jan Gerstoft from Rigshospitalet in Copenhagen.

Researchers have ruled out coronary vaccines playing a role, as only a small number of children with the infectious hepatitis have been vaccinated – age group taken into account. On the other hand, it can not be ruled out that the hepatitis may be due to a long-term effect of corona, since many of the sick children have had corona, writes New scientist.

In Europe, the British health authorities have taken the lead in research work. The European Center for Disease Prevention and Control, ECDC, is also working hard to find the cause of the mysterious hepatitis.