Acute hepatitis of unknown origin in children

The past few weeks has seen the appearance of a strange outbreak of acute hepatitis in children. Over 20 cases have been reported in Spain and more than 450 worldwide. While its cause remains unknown, confirmed cases remains rare.

The Spanish Association of Paediatrics has released a reassuring statement regarding this outbreak and cautioned parents to be on the lookout for symptoms. 


What is hepatitis?

Hepatitis is an inflammation of the liver. It carries a host of complicating factors and side effects. There are a wide range of causes for hepatitis, including viral infections, heavy drinking, certain medications, and toxic substances.

Sudden and severe hepatitis in previously healthy children is uncommon, which is why these cases in multiple countries have raised concern.


What do we know about this outbreak?

This strain of hepatitis has been reported though Europe, including the UK, Spain, Portugal, Italy, Norway and Belgium. Thus far, around 10% of child patients have required a liver transplant.

While it is not yet known what is causing this type of hepatitis, the viruses known as hepatitis A, B, C, D and E have all been ruled out, as has a link to the SARS-CoV-2 vaccine.

A leading hypothesis points to an adenovirus. Adenovirus is a very common virus in childhood and may cause upper respiratory colds, gastroenteritis, conjunctivitis, and hepatitis. Some studies indicate the presence of adenovirus F41 in approximately half of cases.


What is the situation in Spain?

At the time of writing, Spain has had 8 confirmed and 15 suspected cases of this mysterious strain. Liver transplant has only been necessary on 1 patient.

In any given year, Spain’s incidence of hepatitis tends to fall between 88 and 138 cases. The rarity of new cases has not yet exceeded this range.


What are the symptoms to look out for?

The Spanish Association of Paediatrics has released a reassuring statement regarding this outbreak. Incidence remains very low for hepatitis in general and this variant in particular.

Nevertheless, parents should be on the lookout for signs and take their child to the doctor if they display symptoms.

The most common symptoms of hepatitis are:

  • – Abdominal pain
  • – Vomiting
  • – Nausea
  • – General malaise
  • – Jaundice (yellow eyes and skin)
  • – Light-coloured stools
  • – Lack of appetite
  • – Tiredness
  • – Dark-coloured urine
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