Natalie Grover and Jennifer Rigby

LONDON (Reuters) – Health authorities around the world are investigating a mysterious increase in severe cases of hepatitis – inflammation of the liver – in young children.

Here is an overview of the facts about this outbreak.

WHAT’S HAPPENED?

There have been more than 130 confirmed cases, the majority of which are in Britain. Britain has already reported 108 cases since January.

The cases reported by other countries such as the United States of America, Israel and Denmark, Ireland, Spain, Denmark, Ireland, Ireland, Netherlands, Spain, and the Netherlands are also smaller.

WHY IS THIS A CONCERNING THING?

Although mild paediatric liver disease is common, it’s not uncommon. The first alarm was raised in Scotland on April 6th, when very sick children became aware of the existence. Many of these cases required liver transplants.

The other concern was that the cases were not linked to the typical viruses usually linked to the condition – hepatitis A, B, C, D and E.

Maria Buti from Barcelona, an hepatology professor and chair of the European Association of the Study of the Liver’s public health committee said that although there are still very few cases of the disease, the most concerning thing about the situation is the severeness of the spread. She has closely followed the ECDC’s response to the epidemic.

WHAT CAUSES IT?

The leading theory is viral infection, probably with an adenovirus – a common family of viruses that can cause the common cold, among other conditions.

Adenovirus one can cause acute gastroenteritis. There have also been reports that it may lead to hepatitis among immunocompromised kids. However, this has never happened in healthy children.

Jim McMenamin from Public Health Scotland said that work is underway to determine if the adenovirus in question has mutated enough to lead to more severe diseases or if it may be “in tandem with” another virus such as SARS-CoV-2 which could cause COVID-19.

According to him, 77% of British children had been tested for the adenovirus.

Scientists said that although it is possible for a new pathogen or toxin to be involved in the infection, there was more evidence suggesting that this explanation.

The link between COVID-19 and vaccines was ruled out as children living in Britain where most cases were found have not been vaccinated.

Another explanation could be a reduced immunity due to social mixing in the aftermath of the pandemic.

“This may be an over-response to stimulation to the immune system that is not used to such insult … that’s a good theory,” said Simon Taylor-Robinson, a consultant hepatologist and professor of translational medicine at Imperial College London.

Other experts cautioned that the outbreaks of adenovirus could just be coincidence, given their widespread spread at this time. Investigative efforts are ongoing.

WHAT DO PUBLIC-HEALTH AUTHORITIES CONTACT?

In the United States, public health warnings have been issued asking physicians to look out for the condition and for children to be tested for adenovirus.

Dark urine, yellowing eyes, skin and eyes (jaundice), sicknesses, fatigue, fever, nausea, vomiting; abdominal pain; light-coloured stool; joint pain.

Hepatitis can’t be treated with drugs, but steroids or other medications may help.

The advice to parents is to be on the lookout for signs and get in touch with a professional healthcare provider if necessary.

British Health Security Agency advised handwashing in order to stop further spreading.

Experts acknowledged that there has been a slow increase in the number of cases, but they warned that it was likely that more would be added.

Buti said, “If you pay more attention to one thing, then you will see more.”