Reports of mysterious form of hepatitis in children being investigated in Canada

Canadian health officials are investigating reports of a mysterious form of hepatitis in children that has caused concern across about a dozen other countries.

The Public Health Agency of Canada “is aware of reports of severe acute hepatitis of unknown origin in young children in Canada,” wrote spokesperson Charlaine Sleiman in an email Tuesday.

“These are being investigated further to determine if they are related to cases in the United Kingdom and the United States. As the investigation evolves, we will keep the public updated accordingly,” she added. She was not able to provide more information about the number of reports or what provinces are impacted.

Ontario’s Ministry of Health is “actively monitoring for severe acute hepatitis of unknown origin in children and not aware of any cases currently in Ontario,” said spokesperson Bill Campbell in an email.

The World Health Organization (WHO) is sounding the alarm in the wake of a spate of nearly 200 cases of the sudden liver disease in children.

First reported in Scotland earlier this month, viruses known to cause hepatitis were not found in any of the infected children. So far there’s been one death, according to the WHO and about 10 per cent of the impacted children have required liver transplants.

The majority of cases reported to the agency are in the United Kingdom, but there are now cases in several European countries including Spain, Denmark, and the Netherlands, according to a news release on the WHO’s website. There are 12 cases reported in Israel, nine in the United States, and a possible case inJapan.

The children with this illness range in age from one to 16 and 17 have needed liver transplants. A WHO spokesperson did not respond to a question from the Star about where the death occurred.

On April 21, the US Centers for Disease Control and Prevention (CDC) issued an alert about a cluster of the mysterious hepatitis in previously healthy children at a hospital in Alabama, dating back to November 2021.

On Monday, the UK Health Security Agency released a technical briefing on the topic, which had a running total of 111 cases within that country, most of them in children under five. Seven children in England needed liver transplants.

Symptoms of the illness include abdominal pain, diarrhea, vomiting, increased liver enzyme levels and jaundice.

“I think its important to emphasize that the causes of the cases remain very much under investigation,” Dr. Philippa Easterbrook, a senior scientist in the Global Hepatitis Program at the WHO told reporters at a press conference, Tuesday.

“But it is helpful to summarize what we’ve learned so far,” she said, namely that it appears that common viruses that cause hepatitis (A, B, C, D and E) have not been detected in any of the cases.

There also doesn’t appear to be any clear link to a particular food, drug or travel destination, she added. Common bugs and bacteria that cause stomach upset or gastroenteritis in children were also not detected.

“And importantly, there is nothing to suggest a link to the COVID vaccine as the vast majority of the children did not receive the COVID vaccine,” she said.

An adenovirus, a type of virus that results in coldlike symptoms, has been found in at least 74 cases, and a further 18 have a specific version, called adenovirus type 41, according to the WHO. It has not caused hepatitis like this in healthy kids before.

Twenty cases were positive for the SARS-CoV-2 virus that causes COVID, and 19 had both SARS-CoV-2 and adenovirus.

One theory doctors have considered is that young children may be more susceptible to viruses because they got out less during the pandemic. They could also be dealing with a new kind of adenovirus, or a SARS-CoV-2 co-infection.

“It is unusual for an adenovirus to cause this kind of severe symptoms and this is what is being actively investigated,” Easterbrook said.

“It is simply a signal at the moment,” she added.

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