US doctors on the front lines of childhood hepatitis epidemic – Consumer Health News

WEDNESDAY, April 27, 2022 (HealthDay News) — As health experts around the world try to figure out why nearly 200 children in 12 countries have become seriously ill with severe hepatitis, doctors in Alabama are investigating nine case of this type in this State.

In each case, apparently healthy children ended up in hospital with acute liver inflammation.

What’s happening is “definitely not the norm,” said Dr. Helena Gutierrez, medical director of the pediatric liver transplant program at the Children’s of Alabama, a hospital in Birmingham, who treated the nine patients, ages 1 to 6 years.

“It’s quite rare to see hepatitis severe enough to require hospitalization in children this age,” Gutierrez noted. “On average, we see maybe four to five cases a year at most. So to see that number spike like that is incredibly rare.”

Alabama’s first case was diagnosed last October, while the most recent case emerged in February.

All patients were admitted with some of the telltale signs of severe liver damage: yellowing of the skin (jaundice); yellowing eyes; and the type of fluid accumulation and bleeding tendencies that often accompany acute liver failure.

At Children’s of Alabama, treatment focused on close monitoring along with hydration and nutritional support, Gutierrez said; there is no miracle drug for such cases.

So far, none of these children have succumbed to their disease. But two of the nine suffered such severe liver failure that they had to undergo liver transplants.

What makes this so unusual, Gutierrez said, is that while mild liver inflammation is fairly common, severe inflammation requiring hospitalization is not.

“Hepatitis is an umbrella medical term used to describe inflammation of the liver,” she explained. “In adults, alcohol can be the cause. In children, there are well-known viruses – such as hepatitis A, B or C – that can cause inflammation of the liver. And now, with the Obesity is so prevalent, we also have non-alcoholic fatty liver disease causing hepatitis, so mild hepatitis is not unusual.

But as to why severe hepatitis suddenly strikes children, “we don’t know,” Gutierrez said.

For one thing, “all of these patients are otherwise healthy,” she noted. “They have no significant medical history. At most, a few had environmental allergies.”

Yet Gutierrez and his colleagues, Dr. Henry Shiau and Dr. Markus Buchfellner, discovered a common thread that connects the nine patients: In addition to hepatitis, all were also infected with a common cold virus known as adenovirus.

“Adenovirus comes in waves and has been around for ages,” Gutierrez said. “It’s very common. Usually it causes a runny nose, coughing, sneezing and gastrointestinal symptoms like diarrhea and vomiting. do not cause any kind of liver inflammation or disease, unless the patient is immunocompromised,” which means they are fighting cancer or have had an organ transplant.

“But these kids are all healthy,” Gutierrez said. “That’s what’s new here.”

Gutierrez acknowledged that although testing is still ongoing around the world, not all of the 116 UK patients with acute hepatitis have tested positive for the adenovirus. And she warned that whether or not this particular virus – or a dangerous mutation of it – is directly responsible for the outbreak remains unclear.

“Of course we wonder, but it’s too early to draw conclusions,” she said. “We absolutely need to get more data, get more patients tested, and have viral samples genetically sequenced.”

In the meantime, Gutierrez has some advice for parents: “Don’t worry. Be aware.”

“I am a mother myself,” she said. “And what I want parents to know is that it’s very common for children to develop symptoms like vomiting or fever, and they’re generally fine. They don’t develop any serious problems.”

But, Gutierrez said, “If at any time one of your children develops other symptoms — like jaundice or very dark-colored urine or yellow eyes — those symptoms should be reported to the pediatrician. Do -Let them know what’s going on. But common things are common. So don’t worry.

More information

There is more on the hepatitis epidemic at the World Health Organization.

SOURCE: Helena Gutierrez, MD, assistant professor, University of Alabama at Birmingham, and medical director, Pediatric Liver Transplant Program, Children’s of Alabama, Birmingham

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