An estimated 325 million people live with hepatitis globally, but rarely are children afflicted by the disease. In what experts are describing as an “unusual and worrying” occurrence, an increasing number of youngsters are undergoing liver transplants as a result of the virus. The communicable disease is usually spurred by one of five pathogens. While the driving force behind the most recent surge has yet to be confirmed, connections to adenovirus are being probed.
Cases of hepatitis have now been confirmed in several countries across the globe, intensifying efforts to identify the cause.
The prevailing hypothesis is that the adenovirus, which does not cause serious illness, is increasing the number of cases.
There is also speculation that a new variant of the virus, which is a DNA-based pathogen, could be at play.
Parents are being asked to be alert to any symptoms in their children, which encompass yellowing of the eyes and skin, muscle and joint pain, dark urine, pale-coloured faeces, itchy skin, loss of appetite, and stomach pain, and a high temperature.
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Doctor Zania Stamataki, associate professor in viral immunology at the Centre for Liver and Gastrointestinal Research, at the University of Birmingham, said: “Liver inflammation (known as hepatitis) caused by adenovirus is uncommon in the young, with the exception of immunocompromised children.
“If viral disease is suspected as the cause of liver injury, we need to establish if it is the virus or the immune system that is rapidly damaging the liver.”
The expert continued: “The rising incidence of children with sudden onset hepatitis is unusual and worrying. If an adenovirus is to blame, this could be a new variant of adenovirus that may cause liver injury in children with naïve/immature immune systems. But we need to know more to be sure.
“Alternatively, if adenovirus is the culprit for hepatitis in children that are otherwise well, we ought to look for other infections and environmental causes that could exacerbate adenoviral inflammation.”
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Professor Deirdre Kelly, Professor of Paediatric Herpetology at the University of Birmingham, stressed that a high incidence of hepatitis among children is rare.
“Nearly all recover spontaneously,” explained Doctor Kelly, adding that only a small number of cases resulted in a liver transplant.
There are five types of hepatitis, which all cause inflammation of the liver but differ in modes of transmission.
The types A and E are transmitted through contaminated water and food, while the types B, C and D are delivered through infected blood.
Hepatitis B, on the other hand, is usually passed on through intercourse or from mother to child during birth.
Some of these types are preventable through vaccination, with studies suggesting an estimated 4.5 million deaths could be avoided through inoculation.
The condition is only deemed detrimental to the health of youngsters who require a liver transplant, but very few cases are considered severe.
To date, data shows that fewer than 10 percent of confirmed cases have received a liver transplant.
Despite being relatively lower, experts have warned the figure was still “notable”.
Only 11 “super-urgent” liver transplants are expected in children in a normal year, according to Professor Sheila Bird, former programme leader at the MRC Biostatistics Unit at the University of Cambridge.
Seventy-four cases have been confirmed in England, while a further 14 have been reported in Scotland, and 15 in both Wales and Northern Ireland, bringing the total number of cases to 108.
The UKHSA has not yet reported on the age distribution of these cases, however.
