Hepatitis of unknown origin: children affected, multiplication of cases… why the phenomenon worries scientists

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Nearly 170 cases of acute hepatitis have been detected worldwide, particularly in children under 10 years old. The scientific community still cannot identify the phenomenon. La Dépêche du Midi takes stock.

A dozen countries affected, one victim, and dozens of cases listed… The phenomenon of acute childhood hepatitis extends from European countries to the United States. The World Health Organization (WHO), which has spoken on numerous occasions since the detection of the first cases of liver inflammation at the beginning of April, has expressed its concern about this. The Midi Dispatch comes back in detail on this epidemic of a new kind.

A growing epidemic

According to the latest information from the WHO, 169 people have been struck by this hepatitis of unknown origin. In a point made just 10 days ago, the WHO had registered a total of 74 cases: this “increasing increase in the number of children with sudden hepatitis is unusual and worrying”, commented Zania Stamataki, from the center Liver and Gastrointestinal Research Center at the University of Birmingham, with the British Science Media Center.

Several dozen countries are affected: the United Kingdom first (114 cases), Spain (13 cases), Denmark (6), Ireland (less than 5), the Netherlands (4), Italy (4), Norway (2), Romania (1), Belgium (1). France has detected two cases on its territory: according to Santé Publique France, these are at the Lyon University Hospital (Rhône). Israel (12 cases) and the United States (at least 9 cases) are also concerned. “What is atypical is that we have grouped cases, which occur frequently and close in time, comments Professor Jacques Izopet, head of the virology department at the Toulouse University Hospital (Haute-Garonne). There seems to be a clinical and epidemiological signal.”

Mainly affected children

Children seem to be the first to be struck by these inflammations of the liver. People affected by these forms of hepatitis range in age from one month to 16 years, and a large majority of them are under 10 years old. Last weekend, the WHO announced that a child had been killed by the disease. At least ten affected children required liver transplantation.

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Among the cases detected, patients described “signs of jaundice”: “Some of the cases reported gastrointestinal symptoms, including abdominal pain, diarrhea and vomiting in the previous weeks”, described the European center infectious diseases (ECDC).

Unusual clinical cases

Three tracks are mentioned by the WHO to explain these cases of inflammation of the liver. Experts are looking into the trail of “adenoviruses”, a family of DNA viruses and a very common human viral infection, especially in children. According to Professor Izopet, we are witnessing an atypical phenomenon: this type of virus usually tends to strike the respiratory system in young people, but in the cases that have been detected, it is the liver that is struck. This would explain the second track mentioned by the health authorities: the emergence of a new virus.

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However, of the 169 cases that were detected, 74 were infected with an adenovirus. Some children have also been infected with SARS-CoV-2: this is the last track mentioned by the authorities to explain this hepatitis. “Contamination with SARS-CoV-2 can lead to liver damage and therefore to an elevation of what are called transaminases”, proteins which are mainly found in liver cells. This is a key indicator, which can be a sign of viral infectious hepatitis”, explains the professor to The Midi Dispatch.

For the time being, it is therefore a question of not ruling out anything: “Today there is acute hepatitis which can have a viral cause, but also toxicological, even medicinal”, indicates Professor Izopet.

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