After a mysterious liver disease was detected in children in countries including the United States and the United Kingdom, health officials, doctors and scientists have started investigating the cases. Since November last year, the Alabama Department of Public Health (ADPH), along with pediatric healthcare providers including hospitals that treat children and the Centers for Disease Control and Prevention (CDC), has been investigating an increase in hepatitis in young children. According to reports, the children showed symptoms of a gastrointestinal illness and varying degrees of liver injury including liver failure. According to the examinations of the public health experts, there is a possible association of this hepatitis with Adenovirus 41.
On Friday, the World Health Organization (WHO) said that the experts in the United Kingdom have been investigating at least 74 cases in which children came down with hepatitis, or liver inflammation. The global health agency also stated that three similar cases in Spain and a few in Ireland are also being investigated.
“Given the increase in cases reported over the past one month and enhanced case search activities, more cases are likely to be reported in the coming days,” WHO officials said in a statement. In the United States, health officials are examining nine cases that were reported in Alabama, however, they are suspecting if there are more cases in other parts of the country.
Where has the cases of mysterious liver disease been reported so far?
Till now, cases of this mysterious liver disease have been reported in Spain, Denmark, and the Netherlands, besides the US and UK. However, no deaths have been reported yet. On April 6, the UK’s Health Security Agency (UKHSA) stated that doctors and scientists were investigating about 74 cases of hepatitis (liver inflammation) in children since January this year. According to the WHO, all hepatitis viruses (A, B, C, D, and E) have been excluded as causes of the disease. The global health agency, however, also added that adenoviruses and SARS-CoV-2 were detected in some of these cases.
In the US, Alabama has reported cases among nine children between the ages of 1 and 6 years since October last year. The WHO has stated that some of these children were required to transfer to specialist units and six underwent liver transplants.
“While some cases tested positive for SARS-CoV-2 and/or adenovirus, genetic characterization of viruses should be undertaken to determine any potential associations between cases,” WHO advised.
What are the possible causes of this outbreak?
As a matter of fact, in all these cases of the mysterious live disease, the usual viruses that cause infectious hepatitis (hepatitis A and E) were not detected. The UKHSA also stated that one of the potential causes of the mysterious disease could be a group of viruses called adenoviruses, which cause common respiratory illnesses such as the common cold. According to doctors, the majority of the people infected with an adenovirus recover from the illness without any major complications. However, sometimes, hepatitis can be a rare complication resulting from the virus. Adenoviruses can spread from human to human by touching contaminated surfaces and through the respiratory route.
A condition that affects the liver, Hepatitis, can be caused due to a number of reasons and can be life-threatening if not treated on time. Some of its symptoms include dark urine, pale and grey-colored stool, itchy skin, yellowing of the eyes and skin, high temperature, muscle and joint pain, and loss of appetite among others.
Is something like this possible in India?
As the public health officials and experts are investigating in the mysterious liver disease outbreak in the affected countries, in India adenovirus infection is common, as per doctors. The ailment typically manifests as respiratory illness.
“The so-called ‘mystery illness’ is affecting children aged under 10 years who develop a fever with cough and cold followed by jaundice. The clustering of children affected in the US, UK, and other parts of Europe suggests an infectious cause. There are several viruses that have an affinity for the liver and these are called Hepatotropic viruses. While Hepatitis A, B, C, and E are common knowledge, we do rarely see a ‘hepatitis illness’ with viruses like Herpes Simplex Virus, Epstein-Barr virus, Yellow fever, or even COVID-19 infection,” Dr (Colonel) Avnish Seth, Head, Gastroenterology & Hepatology, Manipal Hospital, New Delhi told Financial Express.com.
He pointed out that the initial investigations in these countries suggest Adenovirus as the likely cause. Dr. Seth also said that while most children recover spontaneously, some develop liver failure, at times requiring liver transplantation.
“In India, Adenovirus infection is common. There are several strains of this virus and some can also cause conjunctivitis and brain fever. The current virus could be the result of a mutant strain that licks the respiratory tract and bites the liver,” he said.
He also warned that the spread of viral infections is unpredictable and it shouldn’t be surprising if in the near future similar patients are reported from other parts of the world, including India.
