Toronto’s SickKids hospital aware of seven probable cases of severe hepatitis in children


A Toronto children’s hospital says it has detected seven cases of severe acute hepatitis of unknown origin in children over a six month period, as global experts race to figure out what’s causing the unexplained illness.

A Hospital for Sick Children spokesperson said the hospital has come across cases in seven children that met Public Health Ontario’s case definition

“SickKids is closely monitoring for any cases of severe acute hepatitis and are reporting seven cases meeting the probable case definition to Public Health Ontario identified between Oct. 1, 2021, and April 30, 2022.”

“It remains to be seen whether this number represents an increase in cases of unknown origin compared to similar time periods in previous years or if any of these cases will be confirmed to be caused by a novel clinical entity.”

Public Health Ontario defines the cases as transaminitis, or liver inflammation, alongside jaundice and gastrointestinal dysfunction in children up to age 16, with no presence of the known hepatitis viruses A through E.

Other symptoms include lethargy, fever, dark urine, pale stools, loss of appetite and nausea.

The infection is confirmed through blood, respiratory or stool testing.

It’s been hard to discern these cases from others because they often present with somewhat typical symptoms of COVID-19, and then the usual viruses that cause hepatitis are not found in their blood.

“The challenge with this breakout of new cases is that the typical hepatitis viruses are not being found in these children,” pediatrician Dr. Dina Kulik told CP24.

“Some of these kids tested positive for COVID, some had previous documented COVID-19 infections, and many kids are testing positive for another typically benign virus known as adenovirus that doesn’t typically cause hepatitis or really severe illness at all.”

The World Health Organization says it is now aware of 348 cases of the unexplained hepatitis in children around the world, with one reported death and 17 liver transplants required so far in response.

“We are all as a global community on the lookout for these children to help intervene sooner to keep them from getting very sick or intervene with things like liver transplant if we need to and figure out the cause so we can prevent further cases,” Kulik said.

Ontario’s Ministry of Health says it requires hospitals to notify it of all cases that fit the definition.

“We want to reassure Ontarians that the risk for this severe acute hepatitis is low,” spokesperson told CP24. “However, anyone who is concerned about symptoms their child is experiencing should contact a health care professional.”

Multiple causes of the hepatitis cases are under investigation. British authorities have said a rare adenovirus may be to blame.

Meanwhile, researchers in India and Israel have found data that suggests previous COVID-19 infection might be the culprit.


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