Hepatitis in Children: What Parents Need to Know


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Hepatitis in Children: What Parents Need to Know

If you’re a parent, you’re probably scared about the latest health fear involving children, Hepatitis. And as we read and listen to the daily news reports of cases, many of us may be wondering what we need to know about Hepatitis — especially Hepatitis in children. We chatted and Dr. Karen Ackerpediatric infectious diseases specialist NewYork-Presbyterian Komansky Children’s Hospital and assistant professor of clinical pediatrics at Weill Cornell Medicine.

What is Hepatitis?

Hepatitis is a general term that refers to inflammation of the liver. Hepatitis has many possible causes including infection, medications (usually Tylenol), alcohol, and autoimmune conditions. Hepatitis is usually caused by viruses, and the particular viruses we associate with hepatitis are usually Hepatitis A, B, and C (hence their names). Other viruses we also associate with hepatitis, although often milder than Hepatitis viruses, are Epstein-Barr virus and cytomegalovirus that cause infectious mononucleosis (“mono”). Inflammation of the liver in children with mono is usually mild and resolves on its own. In the past, adenoviruses were not commonly associated with hepatitis in previously healthy children.

What does the medical profession know so far about the current outbreak?

The common link to most of these cases of hepatitis is the detection of adenovirus 41. Adenovirus 41 is a strain of adenovirus that causes vomiting and diarrhea, most commonly in children. Adenovirus infections are not commonly associated with hepatitis which is one reason why these cases prompt further investigation. However, we still do not know if all of these cases are related to or caused by adenovirus.

The World Health Organization (WHO) first reported cases of acute hepatitis of no known cause on April 15, 2022. As of April 21, the WHO reported 169 cases in children aged 1 month to 16 years. Many have stomach pain, vomiting, and diarrhea before showing up to have hepatitis, which is manifested by increased levels of liver enzymes or jaundice (yellowing of the skin).

the CDC Posted a health advisory on April 21 announcing to the public that nine patients were admitted at a large Alabama hospital between October 2021 to February 2022 treated for hepatitis and found to have evidence in adenovirus infection. They advised physicians to consider testing for adenovirus in patients with hepatitis and an unclear cause, and recommended that local health departments report cases of hepatitis of no clear etiology.

What do parents need to know about the increase in unexplained cases of Hepatitis that seem to affect young children?

These reports should not create further alarm among parents as these cases are rare and still require further investigation. These reports do not mean that we are seeing more hepatitis than ever before or that there should be an outbreak of adenovirus. Whenever a bunch of cases are found to have a common link or have an unknown cause, further investigation is needed. These alerts and warnings are intended to ensure that we keep a close eye on new potential cases. Parents should consult their pediatricians if they think their child has symptoms consistent with hepatitis, such as severe abdominal pain with vomiting and diarrhea, or yellow eyes or skin.

What are the ages of children who seem to be affected by Hepatitis?

Most of the children affected are under 10 years of age, even if the cases come from children aged 1-16.

Is it related to COVID-19?

We do not know if these cases are related to COVID-19 but they have also been investigated.

What are the signs or symptoms that parents should watch out for?

Symptoms of hepatitis may include abdominal pain, vomiting, diarrhea, yellow skin (jaundice), yellow eyes. If a child develops and worsening abdominal pain, vomiting, and diarrhea, or if they have jaundice, they should see their child’s pediatrician for evaluation. In these cases, their pediatrician may test their child’s liver enzymes to see if they are high.

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