Symptoms, situation in France… What we know about cases of hepatitis in children

Still no clue on the causes of the disease, but the map of young patients is expanding. After the discovery of cases of hepatitis in children in the United Kingdom, new cases have been detected in other European countries, the European Center for Disease Control and Prevention (ECDC) announced on Tuesday.

How did these children contract hepatitis? For the time being, the origin of their illness has still not been identified, but investigations have been launched in all the countries concerned, and the coronavirus could be linked to this case.

Where and when were these cases of childhood hepatitis identified? Is France concerned?

It was at the beginning of the month that the first cases were observed across the Channel. “On 5 April, the UK notified the WHO of ten cases of severe acute hepatitis of unknown etiology in previously healthy young children aged 11 months to 5 years in central Scotland, details the WHO. Of these ten cases (detected during hospitalization), nine presented symptoms in March, while one presented symptoms in January”. Three days later, further inquiries across the UK identified a total of 74 cases. “Additional cases in children have been reported in Denmark, Ireland, the Netherlands and Spain”, indicates the European agency. But the ECDC was unable to give the number of cases by country. On the other side of the Atlantic, in the United States, nine suspected cases have been identified in children aged 1 to 6, in Alabama, according to the ECDC.

In France, after the launch of “active research”, “two cases of acute hepatitis, the etiology of which is still undetermined, were reported by the University Hospital of Lyon” in children under 10 years of age and “are under investigation”, explained Santé Publique France.

What is the cause of these cases of hepatitis in children?

“Laboratory investigations excluded viral hepatitis types A, B, C, D and E in all cases,” says the ECDC. Research is therefore continuing “in all countries reporting cases. Currently, the exact cause of hepatitis remains unknown”, but the British investigators “consider that an infectious cause is the most probable because of the clinical and epidemiological characteristics”.

Moreover, on the British side, “SARS-CoV-2 and/or adenoviruses have been detected in several cases, reports the WHO. The UK has recently observed an increase in the activity of adenoviruses, which co-circulate with SARS-CoV-2, although the role of these viruses in the pathogenesis [le mécanisme par lequel la maladie se développe] is not yet clear”. Covid-19 could thus have a link with these cases of hepatitis. But “genetic characterization of the viruses should be undertaken to determine any potential association between cases.” On the other hand, “no other epidemiological risk factor has been identified to date, including recent international travel, continues the UN agency (…). Laboratory tests for other infections, chemicals and toxins are ongoing.”

“Cases of acute hepatitis of undetermined etiology in children are not uncommon. The occurrence of these two cases [dans l’Hexagone] is not unexpected and does not testify, at this stage, to an excess of cases in France”, underlines for its part Public Health France.

What symptoms have been observed in sick children?

Among the British children affected, “many cases showed signs of jaundice”, or jaundice of its learned name, notes the ECDC. And “some of the cases reported gastrointestinal symptoms, including abdominal pain, diarrhea and vomiting in the previous weeks.”

If no death has been recorded, some children “had to be transferred to hepatology units, details the WHO. And six of them underwent a liver transplant.” According to Public Health France, “other reports are probably to be expected in the coming days” given the active search launched.

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