Rise of acute hepatitis among kids: Find out what is causing it, symptoms to note and all about the role of vaccines

According to the European Centre for Disease Prevention and Control (ECDPC), nearly 450 children have been affected by mysterious acute hepatitis worldwide.

The World Health Organization (WHO) confirms that 21 countries have now reported cases of 'severe hepatitis of unknown origin' among children, who are mostly under the age of 10.

The United Kingdom was the first country to report the liver disease, which has now led to 12 deaths in various parts of the world including Indonesia, Ireland and the US.

India too is grappling with a spike in unexplained hepatitis among children who’ve tested positive for COVID-19.

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Hepatitis is a condition in which the liver becomes inflamed and damaged, affecting various bodily functions. Drinking too much alcohol, prevalence of toxins in the body, overuse of certain medications can all lead to hepatitis.

However, the recent surge in acute hepatitis cases among kids have been attributed to a particular adenovirus, type 41. Adenoviruses are a common family of viruses responsible for infections such as mild cold or flu or other eye infections.

UK reports suggest out of 176 cases , 126 have been tested for the adenovirus, of which 91 have tested positive with the virus.

The ECDPC has said, "Other hypotheses and possible cofactors are under investigation. Most cases continue to be reported as sporadic un-linked cases."

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Besides the adenovirus 41, scientists continue to investigate COVID-19 as a potential underlying cause of the rise in recent cases of acute hepatitis in children.

An Indian study conducted by a team of researchers from the Bundelkhand Medical College (BMC), Sagar, Madhya Pradesh and the Post Graduate Institute of Medical Research, Chandigarh found that of 475 children, who tested positive for COVID-19 from April-July in 2021, 37 were diagnosed with COVID Acquired Hepatitis (CAH).

"We observed a peculiar rise in hepatitis cases. Usually, the beginning of monsoon marks a rise in hepatitis cases. Last year (2021) we started to see this in April, or summer, in covid positive children who were part of follow-up. Most of them in fact had recovered from their covid,” said Sumit Rawat, Associate Professor, Microbiology, BMC, and one of the authors of the study.

“Hepatitis A and E are specific to certain villages or regions, B is present through the year and D is usually from a parent or from a blood transfusion. Last year, following the Delta wave we saw these cases from all over the state, defying the usual histories,” he added.

Another recent case study suggested a possible link between liver disease and COVID-19.

The study published in the Journal of Pediatric Gastroenterology and Nutrition observed a previously healthy three-year-old girl who developed acute liver failure a few weeks after recovering from a mild COVID infection.

Dr. Anna Peters, a pediatric gastroenterologist at the Cincinnati Children's Hospital Medical Center and the lead author of the study said, ""The patient had liver biopsy findings and blood testing consistent with a type of autoimmune hepatitis which may have been triggered by COVID infection."

"I think it's important for physicians to be aware that this is a rare condition that may happen during or after COVID infection. It's important to check liver tests in patients who aren't improving as expected," she added.

Acute hepatitis in children can arise with various symptoms. It includes:

- Nausea

- Vomiting

- Diarrhea

- Malaise

- Loss of appetite

In severe cases children may show signs of jaundice including yellowing of the skin, dark urine and pale stools.

Certain types of hepatitis including hepatitis A and B can be prevented with routine vaccines.

There are two types of hepatitis A vaccine. According to the US Centers for Disease Control and Prevention (CDC), the first type, which is a single-dose hepatitis A vaccine, is to be given as two shots 6 months apart, and both shots are needed for long-term protection against hepatitis A.

The other type is a combination vaccine that protects people against both hepatitis A and hepatitis B.

People from all age groups are eligible for hepatitis B vaccines.

"The hepatitis B vaccine is recommended for all infants, all children or adolescents younger than 19 years of age who have not been vaccinated, all adults aged 19 through 59 years, and adults aged 60 years or older with risk factors for hepatitis B infection. Adults who are 60 years or older without known risk factors for hepatitis B may also receive hepatitis B vaccine," says the CDC.