Causes behind sudden rise in pediatric hepatitis cases, what we know so far

While Covid-19 and monkeypox is grabbing headlines of late, Hepatitis, also known as black jaundice is also slowly making its way in some parts of India and the world. The number of mysterious hepatitis cases under investigation among children has exceeded 600, the European Center for Disease Prevention and Control said last week.

The main causes of both Hepatitis B and C can be the repeated use of the same needle by drug addicts, use of infected needles during tattooing, transfusion of infected blood or infected life partner. But its treatment is now possible and there is no need to panic.

Read | What is pediatric hepatitis? Mysterious outbreak in US worries health officials

Cases of this liver inflammation have been reported in more than 22 countries, with majority cases in the UK (around 175) and the US (around 180). What’s worrying is that most of the affected children are under 5 years. Centers for Disease Control and Prevention data says 9% of Hepatitis patients in US needed liver transplants.

Back in India, mysterious spike in unexplained Hepatitis in children who tested positive for Covid-19 is a matter of concern. Experts from the Bundelkhand Medical College, Sagar, Madhya Pradesh and the Post Graduate Institute of Medical Research, Chandigarh investigated 475 children, who tested Covid positive from April-July in 2021.

Of these, 37 children which is about 8% had Covid Acquired Hepatitis (CAH). Sporadic reports of Hepatitis from various parts of India have emerged in the last two years but this was the first systematic investigation. Covid Acquired Hepatitis symptoms include nausea, loss of appetite, weakness, and mild fever. A high level of liver enzymes, called transaminases was found.

What is Hepatitis?

Hepatitis or black jaundice refers to an inflammatory condition of the liver. It is commonly the result of a viral infection, but there are other possible causes of hepatitis. There are two main types of black jaundice – Hepatitis B and Hepatitis C. In general, there can be hundreds of potential causes of hepatitis, liver inflammation can result from toxins, viruses or contaminated food and water.

In 1942, 28,585 soldiers became infected with hepatitis after inoculation with the yellow fever vaccine. The number of cases of hepatitis during the Second World War was estimated to be 16 million. Only in the twentieth century were the main agents causing viral hepatitis identified.

Symptoms of Hepatitis

Symptoms of Hepatitis or inflammation of the liver include yellow skin or eyes (jaundice), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools and joint pain.

Symptoms are variable and include yellowing of the eyes, abdominal pain and dark urine. Some people, particularly children, don’t experience any symptoms. In chronic cases, liver failure, cancer or scarring can occur.

Causes of Hepatitis

The main causes of both Hepatitis B and C can be the repeated use of the same needle by drug addicts, use of infected needles during tattooing, transfusion of infected blood or infected life partner.

In these recent cases, experts have their eyes on a particular adenovirus, type 41, which has been identified in a majority of Hepatitis cases in Europe and many cases in the United States.

Adenovirus 41 usually results in an upset stomach, but it isn’t usually associated with Hepatitis in otherwise healthy kids. It has been linked to Hepatitis in children, but with weakened immune systems.

But experts also haven’t ruled out the possibility that Covid-19 may be an underlying contributor in Hepatitis cases surge, since the wave of cases seems to have arisen during the pandemic.

Only 10% to 15% of the children with the mysterious Hepatitis in the United States had Covid-19, according to nasal swab tests given when they checked into a hospital, health officials say.

Treatment for Hepatitis

Several antiviral medications can help fight the virus and slow its ability to damage your liver. These drugs are taken orally but with doctor’s prescription.

Most people who are vaccinated with hepatitis B vaccine are immune for life. Hepatitis B vaccine is usually given as 2, 3, or 4 shots. Infants should get their first dose of hepatitis B vaccine at birth and will usually complete the series at 6-18 months of age.