Seven more cases of hepatitis have been detected in Ohio with a child needing a liver transplant, doctors said, while the US tally rose to 40, including one death in Wisconsin.
All of the children were between 18 months and 10 years old and were treated for the disease at Cincinnati Children’s Hospital.
North Dakota also confirmed its first case of hepatitis in a child today, with health chiefs revealing the patient was now recovering at home. They did not need a liver transplant.
A total of 14 states have now reported cases of the mysterious hepatitis, including six liver transplants and one death.
Scientists are puzzled by what is triggering the rush of cases because none of the infected children have tested positive for the normal viruses that cause hepatitis.
The leading theory is that adenoviruses, which can trigger the common cold, could be behind the spate of illnesses. But suggestions that weakened immunity from lockdowns or a previous Covid infection are behind the cases have not yet been ruled out.
Ohio and North Dakota have become the 13th and 14th states to report confirmed or suspected cases of the mysterious hepatitis illness.
To date, more than 220 cases of the mystery illness have been reported around the world, in countries including the UK, Ireland and Spain.
A total of four deaths have been recorded so far, one in the United States and three under investigation in Indonesia.
Q&A: What is the mysterious global hepatitis outbreak and what’s behind it?
What is hepatitis?
Hepatitis is inflammation of the liver that is usually caused by a viral infection or liver damage from drinking alcohol.
Some cases resolve on their own, with no ongoing problems, but a fraction can be fatal, forcing patients to need liver transplants to survive.
Why do the experts care?
Hepatitis is usually rare in children, but experts have already detected more cases in the current outbreak than would normally be expected in a year.
The cases are of “unknown origin” and are also serious, according to the World Health Organization. It has caused up to two deaths and 18 liver transplants.
What are the main theories?
Experts say the cases may be linked to the adenovirus, commonly associated with colds, but further investigation is underway.
This, in combination with covid infections, could be causing the rise in cases.
The adenovirus reported by the WHO has been detected in at least 74 of the cases. At least 20 of the children have tested positive for the coronavirus.
British experts tasked with investigating the onslaught of disease believe the endless cycle of lockdowns may have contributed.
The restrictions may have weakened children’s immunity due to reduced social mixing, leaving them at higher risk of contracting adenoviruses.
This means that even ‘normal’ adenovirus could be causing serious outcomes, because children are not responding as they did in the past.
Other scientists said it may have been the adenovirus that acquired “unusual mutations.”
This would mean that it could be more transmissible or more able to circumvent the natural immunity of children.
New Covid variant
UKHSA officials included ‘a new variant of SARS-CoV-2’ in their working hypotheses.
Covid has caused liver inflammation in very rare cases during the pandemic, although these have been in all ages rather than isolated in children.
The UKHSA has noted that environmental triggers are still being investigated as possible causes of the illnesses.
These could include contamination or exposure to particular drugs or toxins.
Dr. Jorge Bezerra, director of the Pediatric Liver Care Center in Cincinnati, revealed that they had seven cases of the disease.
He told NB: ‘We’ve seen six, today we’re going to see a seventh. They are still coming.
South Dakota yesterday became the 12th state to report cases of hepatitis.
His epidemiologist, Dr. Josh Clayton, has asked doctors across the country to be on the lookout for any other children who may have the condition.
The other states that have also reported cases of the disease so far are Alabama, Delaware, Louisiana, Tennessee, North Carolina, Wisconsin, California and Minnesota.
New York, Illinois and Georgia say they are investigating suspected cases of the disease.
It’s not yet clear what triggers the condition, and experts warn it could take at least three months to find out.
Dr. Nicole Saphier, a radiologist at Memorial Sloan Kettering in New Jersey, told DailyMail.com today that the cases may be due to weakened immunity.
She said: ‘For the past two years, children have been protected from daily exposure to pathogens through masking, decreased social interactions and remote learning.
‘[As a result]children protected from the pandemic may now have more severe reactions to common pathogens such as adenovirus.’
On Tuesday, the World Health Organization stated that at least 228 probable cases of hepatitis in children had been reported in 20 countries.
He said there were more than 50 other cases under investigation.
Most of the cases were from the UK, 145, and the US, 20, they said, which have some of the strongest surveillance systems.
The agency did not disclose which countries reported additional cases, but other health agencies revealed that Austria, Germany, Poland, Japan and Canada have detected cases, while Singapore is investigating a possible case in a 10-month-old baby.
Indonesia said on Tuesday that three children had died of suspected hepatitis of unknown cause.
Children affected by hepatitis in the United States were generally less than 10 years old.
Those with the condition suffered from vomiting, diarrhea and jaundice, where the skin and whites of the eyes turn yellow, the CDC said.
More than half also suffered from a fever due to the condition.
Most of the children sampled have tested positive for adenoviruses, fueling theories that this could be behind the onslaught of illnesses.
But some are not convinced, pointing out that it is not uncommon to be infected with this virus.
The director of clinical and emerging infections at the British health agency UKHSA, Dr. Meera Chand, has told parents that the chance of their child developing hepatitis is “extremely low”.
She said: “However, we continue to remind parents to be vigilant for signs of hepatitis, particularly jaundice, which is most easily detected as a yellow tinge to the whites of the eyes, and to contact their doctor if they are worried,” he said. saying.
Dr Chand added: ‘Normal hygiene measures, including thorough handwashing and making sure children wash their hands properly, help reduce the spread of many common infections.
“As always, children experiencing symptoms such as vomiting and diarrhea should stay home and not return to school or daycare until 48 hours after symptoms have resolved.”
Hepatitis is usually rare in children, but experts have already detected more cases in the UK, at the center of the outbreak, since January than would normally be expected in a year.
Scientists have previously suggested that the cases could just be the ‘tip of the iceberg’, with more likely to be out there than has been seen so far.
Searching for an unknown cause is especially difficult because cases can have multiple factors behind them that are not consistent across diseases.