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At the very least 169 instances of acute hepatitis in kids aged one month to 16 years outdated have been recognized in an outbreak that now includes 11 international locations, the World Well being Group (WHO) mentioned on Saturday.

Among the many instances of acute hepatitis, no less than one youngster has died and 17 kids have required liver transplants, the WHO mentioned in a information launch.

“It’s not but clear if there was a rise in hepatitis instances, or a rise in consciousness of hepatitis instances that happen on the anticipated price however go undetected,” the WHO mentioned in an announcement. “Whereas adenovirus is a doable speculation, investigations are ongoing for the causative agent.”

The scientific syndrome “amongst recognized instances is acute hepatitis (liver irritation) with markedly elevated liver enzymes,” the discharge mentioned. Many instances reported gastrointestinal signs equivalent to stomach ache, diarrhea and vomiting “previous presentation with extreme acute hepatitis,” in addition to elevated ranges of liver enzymes or alanine aminotransaminase and jaundice.

Most reported instances didn’t have a fever, the WHO mentioned, and the frequent viruses that trigger acute viral hepatitis – equivalent to hepatitis viruses A, B, C, D and E – haven’t been detected in any of those instances.

Hepatitis is irritation of the liver, an important organ that processes vitamins, filters the blood and helps struggle infections. When the liver is infected or broken, its operate will be affected.

Most frequently, hepatitis is brought on by a virus, and adenoviruses are a typical kind of virus unfold from person-to-person that may trigger a spread of delicate to extra extreme diseases. However these viruses are solely not often reported as a explanation for extreme hepatitis in wholesome folks.

The WHO mentioned the investigation into the trigger must give attention to components equivalent to “elevated susceptibility amongst younger kids following a decrease degree of circulation of adenovirus in the course of the COVID-19 pandemic, the potential emergence of a novel adenovirus, in addition to SARS-CoV-2 co-infection.”

Nearly all of the instances – 114 – have been reported in the UK. There have been 13 instances in Spain, 12 in Israel, 9 in the US and a smaller variety of instances confirmed in Denmark, Eire, the Netherlands, Italy, Norway, France, Romania and Belgium, based on the WHO.

On Thursday, the US Facilities for Illness Management and Prevention (CDC) issued a well being advisory which alerted well being care suppliers and public well being authorities of an investigation into acute instances of hepatitis with unknown causes.

The CDC advisable suppliers take into account adenovirus testing in kids with hepatitis when the trigger is unknown, including that testing the blood in complete – not simply blood plasma – could also be extra delicate.

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