Opinion

The enigma of acute hepatitis in children

photo_camera hepatitis

So far it is an enigma: where has acute hepatitis in children come from? Since last April it began to be reported in the UK and Ireland and has gradually spread to more countries and there are now around twenty countries with almost 250 children affected, 10% have had liver transplants and deaths are beginning to be reported.

In Lisbon, Gerald Rockenschaub, regional director of WHO Emergencies, said that they are giving it "absolute priority" and are working in coordination with the European Centre for Disease Prevention and Control.

He stresses that they are conducting investigations in countries that have identified cases and include more detailed exposure and medical histories with toxicology and virological testing, as well as additional microbiological testing.

One of the hypotheses involves adenovirus type F41. The WHO explains that adenoviruses are common pathogens that generally cause self-limiting infections.

"They spread from person to person and most often cause respiratory disease, but depending on the type, they can also cause other diseases such as inflammation of the stomach or intestines, pink eye and bladder infection," according to Rockenschaub.

There are more than 50 immunologically distinct types of adenoviruses that can cause infections in humans. Adenovirus type F41 typically presents as diarrhoea, vomiting and fever, often accompanied by respiratory symptoms. While there are reports of hepatitis in immunocompromised children with adenovirus infection, adenovirus type F41 is not known to be a cause of hepatitis in otherwise healthy children.

According to WHO, hypotheses related to side effects of the COVID vaccines are unsupported, as the vast majority of affected children did not receive the coronavirus vaccine.

On the subject

A few days ago I spoke to Juan Jesús Gestal Otero, in his opinion the data collected lack any relation to each other, which has many people "perplexed" looking for the common thread that causes such serious hepatic manifestations in infants.

He said he was concerned that we are not out of trouble, and in between, Russia's war with Ukraine. Public health is unpredictable because a problem can appear on the edge of the world and then spread.

Gestal Otero argues that if it were an infectious origin due to an adenovirus, it would infect the people nearby; the other mystery, a toxic origin, it would be necessary to find out what that toxic substance is that could be present everywhere in order to infect people in this way.

As head of the Preventive Medicine Service at the Santiago University complex, he has seen many cases of infections, illnesses, as well as outbreaks of measles.

I asked him if given the very rarefied climate worldwide with the geopolitical tensions, what we are experiencing with the pandemic and now with acute childhood hepatitis of unknown origin, if it could all be part of a deliberate biological warfare; for Gestal Otero these are pure conspiracy theories that do not adhere to reality.

Although he acknowledged that China has not allowed full and wide access to carry out the relevant investigations, which will result in it remaining a suspicion.

Then there is the question of whether we have been so careful over the past two years with extreme measures of hygiene, limited social contact, isolating children from classrooms that perhaps the viruses and other pathogens could be more harmful and resistant.

Gestal Otero told me that a few days ago at a Microbiology Congress, the participants pointed out that all our attention has been focused on COVID-19 and that they did not rule out resistance in bacteria. Especially in hospital germs which may be on the rise. The coronavirus is sure to leave us with a wide range of aftermath.