Puzzling cases of severe liver disease in children spark international probe

Health officials in Scotland published early findings from an international investigation into dozens of puzzling cases of severe liver inflammation among children. A few cases have led to serious health problems.

13 severe cases in Scotland, mostly in children between the ages of 3 and 5, occurred in March and April this year. In children over the course of an entire year, Scotland usually has fewer than four unexplained liver inflammation cases. One of the 13 cases this year in Scotland has resulted in a transplant. There have been no deaths reported.

In England, health officials reported 60 unexplained severe hepatitis cases, most of which were in young children. Some of those cases have led to the need for a transplant. There have been no deaths reported.

Scotland officials have been in touch with researchers at the US Centers for Disease Control and Prevention, who are looking into a cluster of cases of hepatitis in children. Ars asked the US CDC for more information on the cluster, including how many children are involved and the severity of their cases. If more information becomes available, this story will be updated.

Health officials are trying to understand what causes the illnesses. The most obvious infectious culprits that cause inflammation in the body have been ruled out, as the children have consistently tested negative. A common food, drink, or personal care product has not been found to explain the illnesses. There are no clear connections between the cases. Researchers haven't seen strong evidence ofbacterial infections.

Hypotheses

Some children have tested positive for an adenoviruses. Five of the 13 children in Scotland tested positive for an adenoviruses, two by throat swab, two by blood tests, and one by stool samples. According to the health officials in Scotland who have been in touch with CDC researchers, the US cluster of unexplained hepatitis cases is also linked to adenoviruses.

A large family of viruses that circulate widely and are linked to respiratory and eye infections are called adenoviruses. They can cause many illnesses, including gastrointestinal and disseminated infections. It is rare in children who are not immunocompromised that adenoviruses cause severe hepatitis.

Some children in the UK have tested positive for the disease. There are 13 children in Scotland who have recently tested positive. None of the children had received a vaccine.

According to health officials in Scotland, the leading hypothesis is that the illnesses are caused by an infectious agent rather than a toxic exposure. There are two possibilities if an adenoviruses is behind the acute cases, one is that a new adenoviruses has evolved to cause severe liver injury, the other is that an existing variant that circulates in children is causing severe disease because they have not previously been exposed to adenoviruses

There is a chance that the clusters are related to infections with the omicron subvariant BA.2, which is sweeping through the UK and the US.

Health officials in the UK are telling doctors to look out for children with hepatitis symptoms, such as dark urine, pale feces, jaundice, itchy skin, nausea, vomiting, and lethargy, while researchers continue their investigation.