Severe hepatitis cases in children reported in 13 countries, says ECDC

Cases of severe hepatitis in children have now been reported in 13 countries, the European Centre for Disease Prevention and Control (ECDC) said on Tuesday.

Experts are seeking the cause of a surge in the illness that has killed one child and led to 17 others requiring liver transplants.

Investigations into the cause of the illness indicate a link to a strain of adenovirus, a common virus for which many of the affected children tested positive, ECDC director Andrea Ammon told journalists.

“The investigations right now point towards a link to adenovirus infection,” Dr Ammon said.

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“So far, there is no connection between the cases and also no association to travel.”

Cases have now been registered in Ireland, the United States, Israel, more than 100 in the United Kingdom, and in nine other countries in the European Union and European Economic Area, the ECDC said.

“The most common clinical presentation was jaundice – getting yellow in the skin and in the eyes, followed by vomiting, also gastrointestinal symptoms, which is compatible with a adenovirus as some of the investigations point to,” Dr Ammon said.

“But then some of these children proceeded to more severe symptoms, really acute liver failure, that required to do emergency liver transplantations.”

There have been 169 cases detected as of April 21st, according to the World Health Organisation (WHO).

Adenovirus

The ages of the children affected ranged from one month to 16 years old.

Seventeen of them required liver transplants, a rate of 10 per cent, and at least one death was reported.

The WHO said this week in a public announcement that the cases were occurring in previously healthy children.

“An unexpected increase of such cases has now been reported by several other countries – notably Ireland and the Netherlands,” the WHO statement said.

Adenovirus alone “does not fully explain the severity of the clinical picture”, the WHO said.

The strain implicated in the cases is adenovirus type 41, which has not previously been associated with such symptoms.

Investigation is ongoing into whether there could be a link with the Covid-19 pandemic, such as simultaneous infection with adenovirus and Covid-19, or increased susceptibility among young children due to lower circulation of adenovirus during the pandemic period, the WHO said.

There is no link to Covid-19 vaccines because “the vast majority of affected children did not receive Covid-19 vaccination”, according to the health organisation.

Transmission of Covid-19 has dropped 20 per cent in a week in Europe while admissions to intensive care remain stable, the ECDC said, while noting that the situation differed between countries.