Acute severe hepatitis has been recognized globally, often associated with illness in children under the age of 10 of which a high proportion have been co-infected with SARS-CoV-2. As of April 25, 2022, at least 169 cases have been reported in pediatric patients (1 month to 16 years old) from 12 countries.
These cases tested negative for the usual viral causes of hepatitis A, B, C, D, and E, as well as other viruses that can occasionally cause hepatitis (e.g., Epstein Barr Virus and Cytomegalovirus).
A detailed report from the UK indicated that Adenovirus was detected in 74 of 85 cases tested; 18 were identified as type 41. SARS-CoV-2 was detected in less than 10% of cases tested so far.
The severity of the disease in these young, otherwise healthy children is concerning. Seventeen children (approximately 10%) have required a liver transplant. To date one child has been reported to have died of liver failure..
The Public Health Agency of Canada (PHAC) is collaborating with provincial and territorial health partners across the country to investigate cases in Canada.
PHAC investigation of acute severe hepatitis in children
The BC Centre for Disease Control (BCCDC), BC Children’s Hospital and BC Women’s Hospital are aware and monitoring this emerging issue.
- The European Centre for Disease Prevention and Control (ECDC) reports that UK laboratory investigations excluded viral hepatitis types A, B, C, D and E in all cases.
- Detailed information collected about food, drink and personal habits has so far failed to identify any common exposure. No link to COVID-19 vaccines has been identified.
- The UK Health Security Agency (UKHSA) has identified adenovirus as the most common pathogen in 40 of 53 (75%) confirmed cases of sudden onset of acute hepatitis (liver inflammation) in children under the age of 10 years.
- While adenovirus is a possible hypothesis, investigations are ongoing to identify the causative agent.