GENEVA | The World Health Organization (WHO) announced on Tuesday that it had identified 348 probable cases of hepatitis of unknown origin, and favored the hypothesis of an adenovirus to explain this mysterious disease which mainly affects children.

According to the WHO, these cases of hepatitis of unexplained origin have been identified in 20 countries. A total of 70 other suspected cases, identified in 13 countries, are waiting to be confirmed by tests.

Only six countries have more than five cases, but the UK alone has reported 160 patients.

“Significant progress has been made with respect to further investigations and the refinement of working hypotheses,” Philippa Easterbrook of the WHO’s Global Hepatitis Program told a news conference.

Britain has coordinated a set of studies looking at affected children’s genes, immune response, viruses and other epidemiological studies, she said.

The United Kingdom had initially reported to the WHO on April 5 ten cases of severe hepatitis in Scotland, in children under ten years old.

In the United States, health authorities said on Friday they were investigating 109 similar cases, including five fatalities. Three children also died in Indonesia.

“At present, the main hypotheses remain those involving the adenovirus, also taking into important consideration the role of COVID-19, either as a co-infection or as a prior infection” , said Ms Easterbrook.

Tests carried out last week confirmed that around 70% of cases were positive for adenovirus, with subtype 41 – normally associated with gastroenteritis – being the most common, she added.

Adenoviruses are usually spread through personal contact, respiratory droplets and surfaces. They are known to cause respiratory symptoms, conjunctivitis or digestive disorders.

Tests also showed that around 18% of patients tested positive for COVID-19.

“Next week we will focus on serology testing for previous COVID-19 exposures and infections,” Ms Easterbrook said.

After the discovery of the first 169 cases, the WHO indicated that the hepatitis A, B, C, D and E viruses had not been detected in any of the patients.

Most patients presented with gastrointestinal symptoms, including abdominal pain, diarrhea and vomiting, or jaundice. Some cases have caused liver failure and required transplantation.

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