First two cases acute hepatitis whose causes (etiology) are undetermined have been reported in France. These two cases, which occurred in children under 10 years of age, are under medical investigation. For Public Health France, the identification of these cases, at the Lyon University Hospital, “is not unexpected and does not reflect, at this stage, an excess of cases in France”.
Currently, 93 cases have been recorded by the World Health Organization (WHO) and the European Center for Disease Prevention and Control (ECDC). The bulk comes from the UK, with 74 children suffering from liver inflammation of unknown origin. Franceinfo takes stock of our current knowledge of this childhood hepatitis.
A series that started in Scotland
This acute hepatitis of unknown etiology, which only affects children, was detected on April 5 in ten children under the age of 10 living in central Scotland. A week later, on April 12, the United Kingdom announced that 61 other children, mostly between the ages of 2 and 5, were affected by the same disease, and were the subject of a health investigation in England, in Wales and Northern Ireland, reports the ECDC on his site (article in English).
This European agency works in partnership with national health agencies and the WHO to monitor investigations, share information and identify cases. Thus, since April 15, three confirmed cases have been reported in children, aged 22 months to 13 years, in Spain.
Two other cases have been identified in France. And “other reports are probably to be expected in the coming days”, warned Public Health France. But also elsewhere in the world and this “before the etiology has been found”, WHO said (article in english). Thus, nine suspected cases were also identified in children aged 1 to 6 years in Alabama, United States, on April 19.
Some children had to undergo a liver transplant
Based on early cases studied in the UK (article in english)almost all sick children had “a jaundice”but also “gastrointestinal symptoms, including abdominal pain, diarrhea or vomiting, and lethargy”. None suffered from a fever in the weeks preceding their admission to hospital.
Some children were transferred to specialized units and “six children underwent liver transplantation”reports the WHO. “As of April 11, no deaths have been reported among these cases and one epidemiologically linked case has been detected.”
The Covid-19 vaccine is not the cause
All patients were healthy before showing clinical signs of liver infection. “No link with the Covid-19 vaccine has been identified”, assures the ECDC. Indeed, none of the sick and treated children in the UK had been vaccinated against Covid-19, the British government has assured. (article in english).
However, some cases have tested positive for “Sars-CoV-2 and/or adenovirus”, says the WHO. Adenoviruses are a family of common viruses that typically cause a range of mild illnesses, such as the common cold or respiratory infections. The vast majority of patients recover without complications. Hepatitis is nevertheless one of the possible (but rare) complications of these adenoviruses.
“But the adenovirus is a virus that is very often found in children, so there is no certainty that he is responsible.anticipates the pediatrician Robert Cohen, infectious disease specialist at Créteil hospital (Val-de-Marne), at the microphoneEurope 1. In severe hepatitis, the first causes are not viral, they are toxic.
The infectious cause is preferred
Although cases of acute hepatitis of undetermined etiology in children “are not rare” recalls Public Health France, research is underway to determine the exact cause in order to guide clinical and public health actions. Laboratory tests ruled out “hepatitis viruses type A, B, C and E in all cases”says the WHO.
Together with the tracks of the adenovirus and a contamination with Sars-CoV-2 having led to a long Covid, other tracks are dug by the British health authorities. In particular that of contamination of food origin (by water or poorly washed food), or that of an environmental origin. In addition, explains Professor Yazdan Yazdanpanah, who heads the ANRS-Emerging Infectious Diseases Health Agency in France, “the cause can be infectious and viral”. This cause is also “the most probable because of the clinical and epidemiological characteristics of the cases studied”, according to the ECDC.
Hand washing to prevent it
The best way to guard against infection is to follow the usual sanitary rules with thorough hand washing, especially in young children. In case of symptoms − jaundice, white stools, dark urine with or without fever −, Public Health France recommends consulting a specialist.
The WHO has not yet advised restricting travel to the UK or any other country where cases are identified.