The current mysterious outbreak of acute hepatitis (inflammation of the liver) in children in the United States, specifically in Alabama, could be caused by an adenovirus infection that children are more susceptible to because of COVID-19 pandemic-related social distancing policies, according to a report released by the U.S. Centers for Disease Control and Prevention (CDC) on Apr. 29, 2022. The agency has been tracking at least nine cases since October 2021. It issued a nationwide health alert on Apr. 21 to notify health care providers and public health authorities about the outbreak.1 2 3 4 In a prepared statement, the CDC said:
At this time, we believe adenovirus may be the cause for these reported cases, but other potential environmental and situational factors are still being investigated. Adenovirus type 41 is not usually known as a cause of hepatitis in otherwise healthy children, and no known epidemiological link or common exposures among these children has been found.1
Pediatric Hepatitis Cases Reported in Multiple States
In addition to Alabama, cases of acute hepatitis in children have also been reported in North Carolina, Wisconsin and possibly Illinois. On Apr. 27, the Wisconsin Department of Health Services (DHS) issued a health alert regarding the first pediatric death associated with this outbreak.5 6 DHS officials stated:
Since being notified of this adenovirus-associated hepatitis cluster, DHS is now investigating at least four similar cases among children in Wisconsin. This includes two children who had severe outcomes, one liver transplant, and one fatality.5 6
Acute Hepatitis in Children Reported Around the World, WHO Calls for Investigation
Outbreaks of “acute hepatitis of unknown origin” in children have also been reported in at least a dozen other countries, including Belgium, Denmark, France, Ireland, Israel, Italy, Norway, Romania, Spain, The Netherlands, United Kingdom and the U.S. In at least 10 percent of the cases, the condition has been so severe that the children needed liver transplants. The World Health Organization (WHO) has called for an investigation into these cases.7 8 9
Social Distancing Policies Weakened Immune Systems of Children
Most of the pediatric hepatitis cases have been children five years old and younger. Although health officials maintain they do not believe COVID-19 or COVID vaccines are associated with the outbreaks (COVID vaccines have not been approved in the U.S. for children under age five), they are pointing to adenovirus type 41 infections as a possible source of the cases of severe liver inflammation. There appears to be a view held by some clinicians and public health officials that children have become more susceptible to adenoviruses due to weakened immune systems as a result of COVID social distancing and lockdown policies.10 11 12 13
Over the past two years, government implemented and enforced social distancing policies designed to stop the spread of SARS-CoV-2 have dramatically lowered exposure to common infections during children’s “formative years.” There is speculation that this absence of exposure to common infections has increased the susceptibility of children to certain adenoviral infections. In short, social distancing and lockdown policies, while theoretically helping to curb the spread of t SARS-CoV-2, may have sacrificed the overall health of children by unwittingly compromising immune system function.
This possible development should not come as a complete surprise. As a recent article in the Daily Mail noted, “Experts warned during pandemic locking down children could leave them with subpar immunity to infections.”10
Many experts warned during the pandemic that locking down children, despite their low risk of severe Covid, could weaken their immunity against other illnesses, as well as hamper their education and long-term healths.10
An article in The Scotsman noted:
Experts believe that the lack of exposure a virus in infants due to lockdown may have lowered their immunity and sparked a hepatitis outbreak.12
Recognizing Hepatitis Symptoms
Hepatitis can be caused by viruses, heavy consumption of alcohol, toxins, medications, certain other medical conditions and even contaminated food. The most common causes of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C viruses. Symptoms of hepatitis include abdominal and joint pain, fever, fatigue, loss of appetite, nausea and vomiting, dark urine, light-colored stools, and jaundice.5
“The main symptoms to look out for with inflammation of the liver or hepatitis are severe abdominal pain, yellow eyes, yellow skin,” says pediatrician Karen Acker, MD of New York-Presbyterian Komansky Children’s Hospital and Weill Cornell Medical Center in New York.11
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Click here to view References:
1 Kimball S. CDC says adenovirus may have caused Alabama outbreak of severe hepatitis in children. CNBC Apr. 29, 2022.
2 U.S. Centers for Disease Control and Prevention. Acute Hepatitis and Adenovirus Infection Among Children — Alabama, October 2021–February 2022. Morbidity and Mortality Weekly Report Apr. 29, 2022.
3 Hudson K. CDC issues nationwide alert after hepatitis was found in children. Fox 2 Now Apr. 25, 2022.
4 Press Release. CDC Alerts Providers to Hepatitis Cases of Unknown Origin. CDC Apr. 21, 2022.
5 Health Alert Network. Wisconsin DHS Health Alert #42: Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology. Wisconsin Department of Health Services Apr. 27, 2022.
6 Sudhakar S. Wisconsin reports first death in U.S. possibly linked to puzzling hepatitis outbreak in children. Fox News Apr. 28, 2022.
7 Associated Press. One child has died in mystery liver disease outbreak, WHO says. NBC News Apr. 25, 2022.
8 Edwards E. Severe hepatitis cases in kids continue to rise as WHO calls for investigations. NBC News Apr. 28, 2022.
9 World Health Organization. Multi-Country – Acute, severe hepatitis of unknown origin in children. Apr. 23, 2022.
10 Boyd C. Alarming outbreak of hepatitis in children may have been brought on by Covid lockdowns weakening immunity to a ‘normal’ virus, health chiefs say as US cases hit 11. Daily Mail Apr. 26, 2022.
11 McAdams A. Hepatitis spike among kids linked to COVID lockdowns: UK docs. Fox News Apr. 26, 2022.
12 Merrick J. Hepatitis outbreak linked to a lack of exposure due to Covid lockdown. The Scotsman Apr. 20, 2022.
13 The Press Association. Could Covid Lockdowns Be Behind Hepatitis Surge in Children? Bloomberg Apr. 26, 2022.