Unexplained hepatitis in children: Should parents be concerned?

This increase in difficult and enigmatic work has led the CDC to provide health advice to clinicians so that health care providers can monitor and report accordingly.

What do parents need to know about hepatitis in children? How worried should they be, and what signs should they pay attention to? Is there a link between hepatitis and Covid-19 cases?

To answer these questions, I spoke to a CNN medical analyst. Liana Wen, Ambulance Physician and Professor of Health Policy and Management at the School of Public Health, George Washington University, Milken Institute. She is also the author of Lines of Life: A Doctor’s Journey in the Struggle for Public Health and a mother of two.

CNN: Let’s start from the beginning. What is hepatitis and how common is it in children?

Dr. Liana Wen: Hepatitis is an inflammation of the liver tissue. There are a number of reasons for this. People may have heard about hepatitis A, B and C, which are liver infections caused by infectious hepatitis viruses. Excessive consumption of alcohol, certain medications and especially toxins, as well as certain medical conditions can lead to hepatitis. There is also something called autoimmune hepatitis, in which the body’s own immune system attacks the liver.

Hepatitis is less common in children, especially those that are not related to one of the hepatitis viruses. This is the reason why so many unexplained cases of hepatitis have been reported. Such cases are rare, but they are serious enough to require further investigation.

CNN: How many children have been infected with hepatitis and what do we know about them?

Wen: As of May 1, the World Health Organization reported at least 228 possible cases of pediatric hepatitis, and dozens more are being investigated. These cases have been found in more than 20 countries.
According to the CDC, twenty-five U.S. states and territories have reported crimes, 109 of which are under investigation. One week ago, a CDC report analyzed clinical data from Alabama, which has been monitoring cases of hepatitis in children since October.

Nine children with no known causes of hepatitis have been identified. They come from different parts of the state and have nothing to do with each other. Everything is healthy and there is no medical condition. According to the information, the average age is 3 years, from 1 to 6 years.

Three of the nine children in the Alabama cohort died of acute liver failure. Two of them received liver transplants. According to the CDC, all nine children are currently recovering, including those with liver transplants.

CNN: How come there are so many cases from one state?

Wen: We do not know. I don’t think there’s anything special about Alabama, but there are probably cases that haven’t been reported in other states. Because of this, the CDC has issued a health advice so that clinics can monitor and track these cases.

The UK was the first to report to the WTO. They are actively looking for work. His health agency identified at least 163 confirmed cases in England, Scotland, Wales and Northern Ireland. Now that American clinicians know, there could be more cases.

CNN: How do we know what caused this hepatitis?

Wen: When patients present with symptoms of hepatitis, they undergo a diagnostic test to determine if they have hepatitis A, B, or C; whether they were exposed to toxins and drugs; do they have specific autoimmune markers; etc. All this is still negative in children.

The CDC report has one thing in common with the first nine cases in Alabama: all have blood tests that show an adenovirus infection. (Two more children have been identified since those nine cases were first registered.)

Given the possible link, this is why the CDC has issued a special health warning. He urges doctors to monitor cases of pediatric hepatitis and report them immediately to the CDC and state health authorities. He also instructs medical staff to give these children a special adenovirus test.

CNN: Could these cases be related to Covid-19?

Wen: It seems impossible. None of the Alabama children are in the hospital due to Covid-19 infection. It also has nothing to do with the Covid-19 vaccine. The UK’s health agency says none of the more than 100 cases have been vaccinated.

CNN: How worried should parents be and what signs should they pay attention to?

Wen: Such cases of unexplained hepatitis in children are very rare. However, some were very serious. Parents should not worry too much, but they should know that this is something that is being studied, and if they are worried, they should see a doctor.

The initial symptoms of hepatitis are non-specific, meaning that many people experience these symptoms for other reasons. These include nausea, vomiting, abdominal pain, fever, fatigue, loss of appetite, and joint pain. Later symptoms include dark urine and light-colored stools, as well as (as well as jaundice) – the skin turns yellow and is seen in the whites of the eyes and eyelids.

Most children suffer from gastrointestinal illnesses, viral infections that can lead to fever and fatigue. If your child is not able to lose fluids, this is a sign that you need to see a doctor. Also, see your doctor if your symptoms persist or if your child becomes lethargic.

The most dangerous symptoms are dark urine, light-colored stools, and yellowing of the whites of the eyes. If your child develops general viral symptoms and then develops these symptoms, you should seek medical attention immediately.

CNN: What can be done to prevent these hepatitis cases?

Wen: The causes are unknown, so we cannot say what measures will be taken to prevent them. If you are really associated with an adenovirus, the strategies we have used during a coronavirus pandemic would be helpful, such as washing your hands thoroughly with soap and water and encouraging people to stay home when they become ill.

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