The mysterious Hepatitis outbreak

Source: By Sanskriti Falor: The Indian Express

A series of unexplained cases of Hepatitis B in children has taken over the world. Many countries including the US and UK reported mysterious cases of a few children being diagnosed with Hepatitis B.

From January till now, several cases of Hepatitis B positive children have come forward and the doctors are constantly being urged to identify the reason behind this outbreak.

What is Hepatitis B?

Hepatitis B is an infection in the liver which happens because of the Hepatitis B virus or HBV. The virus usually spreads through blood, semen or other body fluids.

It can be prevented or protected against through vaccination. When it is acute, the virus lasts a small time and doesn’t always necessarily need treatments although it can get serious and lead to life-threatening diseases like organ scarring, liver failure and even cancer.

The most common symptoms of Hepatitis B are jaundice, fever, fatigue that lasts for weeks or even months, vomiting, loss of appetite, and pain in joints or belly.

There is a fair chance that the symptoms are not visible for one to six months since you catch the virus.

What do we know so far?

The World Health Organization (WHO) said the extent of the outbreak is such that at least 169 cases were recorded of children being diagnosed with Hepatitis B. “Cases have been reported in the United Kingdom of Great Britain and Northern Ireland (114), Spain (13), Israel (12), the United States of America (9), Denmark (6), Ireland (<5), The Netherlands (4), Italy (4), Norway (2), France (2), Romania (1), and Belgium (1).”

Most of these cases were found in children as young as one month and up to 16-year-olds. While 17 children required a liver transplant, at least one child had died of the disease, the WHO report said.

Most of these cases were of acute hepatitis, which causes liver inflammation. The WHO report stated that most of the cases reported symptoms like “abdominal pain, diarrhoea and vomiting preceding presentation with severe acute hepatitis, and increased levels of liver enzymes… and jaundice”.

One concern that the doctors face is that the viruses found in affected children were not any of the usual viruses that are linked to Hepatitis A, B, C, D, E. Instead, Adenovirus, which is a family of viruses that usually cause cold among other symptoms, has been found in at least 74 cases worldwide.

The WHO report also stated, “The United Kingdom, where the majority of cases have been reported to date, has recently observed a significant increase in adenovirus infections in the community (particularly detected in faecal samples in children) following low levels of circulation earlier in the COVID-19 pandemic. The Netherlands also reported concurrent increasing community adenovirus circulation.”

Public Health Scotland’s director Jim McMenamin told Reuters that 77 per cent of children in Britain had tested positive for the adenovirus.

Amidst rising cases in the US, health officials have been directed to be on the lookout for symptoms of hepatitis in children and conduct tests for adenovirus when they come across such symptoms, especially those linked to a cold virus. The doctors have also been urged to report any suspected cases of Hepatitis B in children to the state as well as the health department.

The United States Centers for Disease Control and Prevention (CDC) has said that it was working with the UK to understand the cause of the disease among children.

What is adenovirus and how is it leading to Hepatitis B in children?

Adenovirus is a group of viruses that commonly cause cold or flu-like symptoms, fever, sore throat, acute bronchitis, pneumonia, conjunctivitis, acute inflammation of the stomach, diarrhoea, vomiting, nausea and stomach pain.

Adenovirus is known to spread from one person to another through close contact, coughing, sneezing and even by touching an object containing adenovirus and then further touching the mouth, nose or eyes.

Type 41 adenovirus is suspected of causing Hepatitis B in children. While there are more than 50 types of adenoviruses, it is type 41 that causes diarrhoea, vomiting and fever along with respiratory problems.

In a statement, WHO said: “Adenoviruses are common pathogens that usually cause self-limited infections. They spread from person-to-person and most commonly cause respiratory illness, but depending on the type, can also cause other illnesses such as gastroenteritis (inflammation of the stomach or intestines), conjunctivitis (pink eye), and cystitis (bladder infection).

WHO added, “While there have been case reports of hepatitis in immunocompromised children with adenovirus infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children.”