A child in Wisconsin has died and another needed a liver transplant following a battle with hepatitis as a mystery outbreak of a “severe strain” of the disease sweeps the world.
If the child’s death was caused by the hepatitis, it will be the first ever recorded case of a fatality due to the disease in the country.
The Wisconsin Department of Health issued a warning as four children, including the child who died, have been struck with the severe strain of the disease. One of the four children required a liver transplant and the other two are in a serious condition, the Wisconsin DHS said.
According to the WHO, there have been 169 cases of the strain of the disease in at least 12 nations across the world, with most of the patients aged between 1 and 5, but it also struck children right up to the age of 16. Almost all were previously healthy.
The majority of cases  have been in the UK with at least 8 children needing a liver transplant as a result of the disease, but reports are rising across US states, including cases in North Carolina, Delaware and New York as well as Wisconsin.
The strain causes inflammation of the liver and some of the early symptoms can include dark urine, itchy skin, muscle pain, loss of appetite and a high temperature. Hepatitis is usually the result of a viral infection, but can also be caused by drug or alcohol abuse, chemicals or genetic disorders.
Almost all of the affected children had not received the Covid-19 vaccination, so it has been ruled out as a possible triggering factor.
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Although scientists are still unsure of the exact cause of the sudden spike in cases, many are speculating there could be a link to adenovirus – a common virus in children which causes colds, vomiting and diarrhoea.
The Wisconsin DHS warned doctors to be vigilant and monitor children closely for any signs which could indicate the presence of hepatitis, adding that there are a number of cases “with significant liver injury, including three with acute liver failure, who also tested positive for adenovirus”.
UKHSA’s chief medical advisor Professor Susan Hopkins told the BBC that the adenovirus was the “most likely” trigger and that 77 percent of the patients had tested positive for some form of it.
“Transplants in this age group are extremely rare so therefore we are concerned, and we want to understand why this is happening and what else we can do”, professor Hopkins told the BBC.
As it stands, health organizations including the WHO are keeping an open mind as to the cause of the freak rise in cases of the “rare” strain, and the UKHSA says it has not ruled out Covid itself as a possible trigger:
“The good things that we’ve learnt from reducing transmission of Covid will help us reduce the transmission of whatever is causing this as well”, said Hopkins.
Another theory is that lockdowns and Covid restrictions across the world resulted in weakened immune systems in children, perhaps contributing to the mysterious outbreak.