At least 12 children worldwide, including one in Ireland, have died from a severe form of hepatitis that is baffling doctors.
t emerged this week that around half-a-dozen cases of the severe hepatitis – inflammation of the liver – have been diagnosed here, leading to one death and another child needing a liver transplant.
The latest report from the European Center for Disease Prevention and Control (ECDC) said there had been around 450 cases of the illness globally.
Ireland is among 20 countries that have detected cases of hepatitis in children aged one to 12, although parents are assured it is still very rare.
The UK accounts for 176 cases, with 110 in the United States.
Common hepatitis viruses have been ruled out as a cause and there are various theories, including the impact of adenovirus, which is associated with colds. There is speculation that this adenovirus may have acquired unusual mutations, making it easier to catch and able to get around children’s immune defenses.
Ireland is looking to the UK Health Security Agency and the Centers for Disease Control in the United States, which are investigating the illness, to provide more concrete evidence on what might be triggering the cases.
More intensive testing for the adenovirus is getting under way in children.
Parents are advised to seek medical help if their child has symptoms such as pale stools, dark urine or a yellowing of the eyes and skin.
Covid-19 vaccines have been ruled out as a possible cause of the condition because they do not contain organisms that grow in the human body.
The HSE said that “other possible causes such as another infection – including Covid-19 – or something in the environment are also being investigated”.
None of the Irish cases who were tested on admission to hospital had evidence of Covid-19 infection at the time.
“The majority of cases had not received Covid-19 vaccination,” the HSE said.
At a news conference earlier this week, Professor Philippa Easterbrook of the World Health Organization (WHO) global hepatitis program said that currently the “leading hypotheses remain those which involve an adenovirus, but I think with also an important consideration about the role of Covid as well, either as a co-infection or as past infection ”.
Adenoviruses can lead to a range of different illnesses, from mild to more severe, and one type has been identified as having a possible link to the hepatitis cases.
More testing is being carried out to determine how many patients are positive for adenovirus and how many are or have been infected with coronavirus.
Prof Easterbrook said: “Looking at tissue samples, liver samples, none of these show any of the typical features you might expect with a liver infection due to adenovirus, but we are awaiting further examinations of biopsies.”
She said a big focus of the next week was looking at testing for previous exposure
and infections with Covid-19.
“We are hopeful within the week there will be data from the UK comparing whether detection rate of adeno-
virus in children with liver
disease differs from that in other hospitalized children, ”she said.
“That will help hone down whether adeno is an incidental infection that has been detected or there is a causal or likely causal link”.
Ireland’s Health Protection Surveillance Center (HPSC) said other symptoms might include muscle and joint pain, a high temperature, feeling and being sick, feeling unusually tired all the time, a general sense of feeling unwell, loss of appetite, tummy pain or itchy skin .
Good respiratory and hand hygiene is recommended, including supervising hand- washing in young children.