Summary of Common Childhood Viruses Linked to Severe Hepatitis Outbreak:
A recent study led by researchers at UC San Francisco has linked a puzzling outbreak of severe acute hepatitis among healthy children in 35 countries to co-infections from multiple common viruses, particularly a strain of adeno-associated virus type 2 (AAV2). Approximately 1,000 cases have been reported, with 50 of these children requiring liver transplants and a minimum of 22 resulting in death. AAVs are unknown to cause hepatitis independently, but they need “helper” viruses, such as adenoviruses that cause colds and flu, to replicate in the liver. The study suggests that for a small subset of these children, getting more than one infection simultaneously may have made them more vulnerable to severe hepatitis.
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Uncovering the Causes of Acute Pediatric Hepatitis Outbreaks in 2022
Introduction:
Hepatitis is a viral infection primarily affecting the liver, with symptoms ranging from mild illnesses lasting a few weeks to severe, long-term diseases. There are five main hepatitis viruses, designated A, B, C, D, and E. Of these, A, B, and C are the most common in the United States. However, a recent 2022 outbreak of severe acute hepatitis in healthy children, primarily linked to common viral pathogens and co-infections, has baffled healthcare officials and researchers.
The Outbreak:
During the spring of 2022, following the easing of COVID-19 lockdowns in 35 countries, including the United States, doctors began observing unexplained severe outbreaks of acute, severe hepatitis in healthy children. Pediatric hepatitis is uncommon, and to date, approximately 1,000 cases have been reported, with 50 of these children requiring liver transplants and a minimum of 22 resulting in death.
Linking the Disease to Co-Infections from Multiple Common Viruses:
A recent study led by researchers at UC San Francisco is helping to uncover the reasons behind the puzzling outbreak of severe acute hepatitis in healthy children. The study, published in March 2023 in Nature, links the disease to co-infections from multiple common viruses, particularly a strain of adeno-associated virus type 2 (AAV2). AAVs are unknown to cause hepatitis independently but need “helper” viruses, such as adenoviruses that cause colds and flu, to replicate in the liver.
Co-Infections and Vulnerability:
The study suggested that for a small subset of these children, getting more than one infection simultaneously may have made them more vulnerable to severe hepatitis. Children, in general, were found to be more susceptible to infections with these common pathogens post-COVID-19 lockdowns, particularly upon returning to school. Hand washing and staying home when sick remain important prevention measures.
Testing for Viruses:
For the study, which the Centers for Disease Control and Prevention (CDC), researchers collected and examined plasma, whole blood, nasal swab, and stool samples from 16 pediatric cases in six states – Alabama, California, Florida, Illinois, North Carolina, and South Dakota. The specimens were compared with 113 control samples. Testing was conducted using polymerase chain reaction (PCR), metagenomic sequencing, and molecular-testing methods. The genotyping of the 14 available blood samples found AAV2 was detected in 93% of the cases, and human adenoviruses (HAdVs) were found in all the circumstances; a specific type of adenovirus linked to gastroenteritis (HAdV-41) was found in 11 cases. Additional co-infections with Epstein-Barr, herpes, and enterovirus were found in 85.7% of cases.
Conclusion:
While acute pediatric hepatitis outbreaks are rare, the recent 2022 outbreaks have shown that widespread awareness and preventive measures are important. The study is helping to understand how the attack occurred, and it is important to remember that good hand hygiene and staying home if you are feeling sick could make a difference in preventing the spread of these common viral pathogens.
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