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Information about acute hepatitis affecting children aged 16 years and younger in Europe, Asia and the United States makes us all alert. At least 169 cases were reported as of April 21, 2022 with approximately 10% requiring a liver transplant and one death. This condition is very worrying. So, how did this outbreak occur? Find out more about symptoms, transmission and who is at risk of developing acute hepatitis in children through the following review.
What is Acute Hepatitis?
Acute hepatitis is a term used to describe acute inflammation of the liver parenchyma or hepatocyte injury. Why is it said to be acute? Hepaitis is classified as acute because the duration of inflammation is short and sudden.
The common cause of this condition is a viral infection. However, acute hepatitis can be caused by various non-infectious causes, such as drugs (drug-induced hepatitis), alcohol (alcoholic hepatitis), immunology (autoimmune hepatitis, primary biliary cholangitis) or the result of bile duct dysfunction (cholestatic hepatitis), pregnancy-related liver dysfunction, shock or metastatic disease. Meanwhile, for cases of acute hepatitis that are currently emerging, it is not yet known where they come from.
Acute Hepatitis in Children
Acute hepatitis is actually common in patients of all ages. However, recently cases of acute hepatitis whose cause is unknown have been increasing in children in various countries, Europe, America and Asia. This acute hepatitis attacks children aged 16 years and under. This event has been designated by the World Health Organization as an Extraordinary Event (KLB) since April 15 2022.
Acute hepatitis in children is considered unusual and WHO is still investigating further. In many cases adenovirus infection is detected in affected children. The relationship between the two is being investigated as one hypothesis for the underlying cause.
Adenovirus is a common virus that causes respiratory symptoms, vomiting and diarrhea. In general, these viral infections have a limited duration and do not develop into serious conditions. However, especially severe adenovirus infections can cause hepatitis in people who have immune problems. Meanwhile, in this case, the infected children were previously healthy.
The investigation is ongoing and includes laboratory testing for other infections, chemicals and toxins. A minority of cases also have coinfection with SARS-CoV-2, but the role of this virus in the pathophysiology is unclear. According to information, there is no proven link with the COVID-19 vaccine.
Who is at risk?
Cases of acute hepatitis with unknown causes occur in children aged 1 month to 16 years. No specific risk factors have been identified, but investigations are ongoing.
Symptoms and Transmission of Mysterious Acute Hepatitis (Cause Not Known)
Most cases report gastrointestinal symptoms including abdominal pain, diarrhea and vomiting followed by the onset of jaundice. However, in almost all cases children do not experience fever. Based on laboratory testing, it identified an increase in liver enzymes. Meanwhile tests for hepatitis A, B, C, D and E were all negative.
This acute hepatitis, whose cause is unknown, has become a global concern. Parents and guardians need to be alert for symptoms of hepatitis including jaundice and seek immediate medical attention. Give children an understanding of normal hygiene measures, such as washing their hands thoroughly with soap and rinsing them with running water.
Also ensure that the food and drinks consumed are cooked and clean. Get used to using personal equipment (cutlery, nail clippers, toothbrush) and not sharing with other people. Apart from that, parents also need to complete their children's vaccinations to prevent disease even though there is no vaccine to prevent hepatitis, the cause of which is still unclear, and get used to a healthy lifestyle.
Has been reviewed by Dr. Febriani Kezia Hartanto
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