JAPAN TIMES



 

Infection with the omicron variant of the coronavirus may have a role in recent cases of severe acute hepatitis in children, according to new research presented at a health ministry panel meeting Wednesday.

Kyoto University professor Hiroshi Nishiura told the ministry’s coronavirus advisory board that countries with a large number of omicron infections such as Britain and the United States were also found to have reported a relatively higher number of childhood hepatitis cases.

According to the World Health Organization, 348 probable cases of unexplained hepatitis in children have been confirmed worldwide, with only six countries reporting more than five cases. Japan’s health ministry has identified seven domestic cases so far, while the U.S is currently investigating 109 child hepatitis cases of unknown origin, according to the Centers for Disease Control and Prevention.

Adenovirus, a common virus that can cause a range of illnesses including gastroenteritis (stomach flu), has been suspected as a possible cause of the severe liver disease.

In Britain, which has reported 163 cases so far, 126 cases have been tested for adenovirus. Among them, adenovirus was detected in 72%, or 91 cases, according to the U.K. Health Security Agency. The agency says that over 75% of the children are age 5 or younger.

Patient symptoms correspond with the World Health Organization’s working definition of a “probable case” of the acute, severe hepatitis. Reported symptoms include abdominal pain, diarrhea, vomiting, jaundice and elevated liver enzyme levels.

Such probable cases are defined as hospitalized patients who have seen spikes in their liver enzyme levels, but for which hepatitis viruses A, B, C, D and E have all been ruled out as the cause.

Nishiura told reporters after the panel meeting that, since toddlers and infants are currently ineligible for coronavirus vaccine shots, they may be at an increased risk of severe hepatitis following their adenovirus infection if they are in countries where large-scale COVID-19 infections are occurring.

Further research is necessary to establish a causal link between omicron infections and child hepatitis, Nishiura said, pointing to the limitations of his study, such as omicron infection data that covers all ages, and not just children.

“We cannot deny the possibility that infection with omicron has some relation to the occurrence of severe hepatitis in children,” Nishiura stated in the presentation submitted to the panel. To prevent acute childhood hepatitis, he said, governments should focus on mitigating the spread of the omicron variant.

In the research, soon to be published in an academic journal, Nishiura’s team looked at the relationship between the cumulative number of omicron cases in 38 OECD countries and Romania between Dec. 1 and April 27, and the reported number of probable cases of severe child hepatitis as defined by the WHO until April 27. As of that date, 12 countries had reported cases.

The WHO received the first report of 10 unexplained hepatitis cases in children under the age of 10 in Scotland on April 5.

“At present, the leading hypotheses remain those which involve adenovirus — with also still an important consideration about the role of COVID as well, either as a co-infection or a past infection,” Philippa Easterbrook, a scientist with the WHO’s global hepatitis program, told a news conference on Tuesday.