Childhood hepatitis: two studies shed some light on the mysterious disease

Since April last year, there have been cases of unidentified acute childhood hepatitis, the cause of which has not been established. Just over 1,000 cases have been identified in 35 countries, according to the World Health Organization (WHO). Most affected children are under 6 years of age. A total of 46 of them required a liver transplant, 22 died. Nine possible cases have been reported in France, and one is being investigated by the medical teams in charge of patients, according to data provided by Public Health France.

Initially, pediatricians and virologists speculated that adenovirus (a type of virus that causes upper respiratory infections associated with influenza-like illness) could be linked to the outbreak as well as the coronavirus.

Potentially responsible viral coinfection

However, two Anglo-Saxon studies, one British by the Great Ormond Street Hospital in London and the other Scottish by the University of Glasgow, put forward new theories. Both exclude Covid-19 infection. Coronavirus was not detected in the liver of the studied sick children, and the proportion of them with the presence of antibodies against Covid-19 was similar to the proportion of children not affected by these hepatitis.

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This is another virus that these two studies point to: a common virus called AAV2 (adeno-associated virus 2). It has been found at abnormally high levels in sick children. However, this virus is not known to cause serious illnesses like the one observed. This is why British and Scottish scientists are leaning towards co-infection of the two viruses. That is adenovirus 2 with another adenovirus or possibly with herpes virus (HHV6). “I think this is a plausible explanation for these cases,” Deirdre Kelly, a professor of pediatric hepatology at the University of Birmingham, who was not involved in the studies, said in a statement. “It appears that coinfection plays a key role.”

Questions remain unanswered

There are a few more questions that need clarification. Because two studies that have not yet been peer-reviewed do not allow us to say why certain children became infected. “We still do not understand why some children develop serious cases of the disease that require a transplant. There is a possibility that coinfection with something other than a virus is to blame,” Professor Deirdre Kelly told AFP. Another hypothesis is the discovery of a completely new virus that causes these infections.

Scientists also do not quite understand why these cases appear now. Among the plausible hypotheses is the idea that coronavirus-related restrictions had an impact, for example by changing the normal circulation of other viruses or by preventing children from building up some protection against viruses they had less exposure to.

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In late April, the European Center for Disease Control and Prevention (ECDC) said it was concerned about the number of cases of this mysterious hepatitis. “Given the etiology [NDLR : la cause de la maladie] While it is still unclear the pediatric population affected and the potentially severe impact, this represents a public health alarm at this stage.” a possible similar signal in the territory,” the French Public Health Service points out.


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