Mysterious spate of hepatitis cases in children may be partly down to lockdowns weakening their immunity, experts say

• 74 children have tested positive for inflammatory liver condition in Britain so far 
• Scottish experts claim it could be caused by less social mixing in pandemic 
• Reduced interactions in lockdown may make them more at risk of adenoviruses

Covid lockdowns may partly explain the mysterious spate of hepatitis cases among children, experts claim.

Seventy-four youngsters under 10 have been struck down with the inflammatory liver condition in Britain so far since January. Six have needed a liver transplant. 

Sick children have also been reported in the US, Ireland, Denmark, the Netherlands and Spain — but scientists are still unsure what is behind the cases.

The UK Health Security Agency believes adenoviruses — a family of common viruses which usually cause mild colds, vomiting and diarrhoea — may be playing a role. 

Experts tasked with investigating the spate of illnesses believe the endless cycle of lockdowns may have played a contributing role, weakening children’s immunity and leaving them at heightened risk of adenovirus. 

Writing in the journal Eurosurveillance, the team — led by Public Health Scotland epidemiologist Dr Kimberly Marsh — said more children could be ‘immunologically naive’ to the virus because of restrictions.

They said: ‘The leading hypotheses centre around adenovirus — either a new variant with a distinct clinical syndrome or a routinely circulating variant that is more severely impacting younger children who are immunologically naive. 

‘The latter scenario may be the result of restricted social mixing during the pandemic.’ 

Other scientists said it may have been a virus that has acquired ‘unusual mutations’.

Covid lockdowns may be behind the mysterious spate of hepatitis cases in children because they reduced social mixing and weakened their immunity, experts claim

Five out of the 13 hepatitis cases in Scotland tested positive for adenovirus. Five also had Covid, with two testing positive for both viruses.

The UKHSA has noted Covid as well as other infections and environmental triggers are still being probed as possible causes of the illnesses.

But Professor Graham Cooke, an expert in infectious diseases at Imperial College London, said it is unlikely Covid was responsible.

He said: ‘Mild hepatitis is very common in children following a range of viral infections, but what is being seen at the moment is quite different. 

WHAT IS HEPATITIS? 

Hepatitis is inflammation of the liver that is usually caused by a viral infection or liver damage from drinking alcohol.

Short-term hepatitis often has no noticeable symptoms.

But if some develop they can include dark urine, pale grey-coloured poo, itchy skin and yellowing of the eyes and skin.

They can also include muscle and joint pain, a high temperature, feeling and being sick and being unusually tired all of the time. 

When hepatitis is spread by a virus, it’s usually caused by consuming food and drink contaminated with the faeces of an infected person or blood-to-blood or sexual contact.

Source: NHS 

‘If the hepatitis was a result of Covid it would be surprising not to see it more widely distributed across the country given the high prevalence of (Covid) at the moment.’

He said the theory that younger children may suffer more serious symptoms because of lower immunity from lockdown was ‘speculative but possible’.

Professor Cooke told The i: ‘There is going to be a group of children under the age of two who have not been exposed to the same number of viruses that they would have been exposed to normally.’

Just two of the cases in Scotland were aged two or younger. 

A virology specialist at Imperial told The Telegraph it is ‘very unusual and rare’ for children to suffer severe hepatitis, especially to the extent that they require a liver transplant.

The expert, who wished to remain anonymous, said: ‘The number of cases is exceptional. 

‘It makes people think there is something unusual going on — such as a virus that has mutated or some other cause. 

‘It has sent alarm bells ringing.’

Hepatitis often has no noticeable symptoms — but they can include dark urine, pale grey-coloured faeces, itchy skin and the yellowing of the eyes and skin.

Infected people can also suffer muscle and joint pain, a high temperature, feeling and being sick and being unusually tired all of the time. 

When hepatitis is spread by a virus, it’s usually caused by consuming food and drink contaminated with the faeces of an infected person or blood-to-blood or sexual contact.

US authorities have also spotted nine cases among children in Alabama, all of whom tested positive for adenovirus. Two had to have liver transplants.

Some doctors have noted that adenoviruses are so common in children that finding them in those with hepatitis does not necessarily mean the viruses are responsible for the liver disease. 

While they do not typically cause hepatitis, it is a known rare complication of the virus.

Adenoviruses are commonly passed from person to person and by touching contaminated surfaces, as well as through the ‘respiratory route’, the UKHSA said.

It ruled out any links to Covid vaccines, saying none of the affected children were vaccinated.

The World Health Organization noted that although there has been an increase in adenovirus in Britain, which is spreading at the same time as Covid, the potential role of those viruses in triggering hepatitis is unclear.

Some of the children have tested positive for coronavirus, but the WHO said genetic analysis of the virus was needed to determine if there were any connections between the cases.

It said no other links had been found between the children in the UK and none had recently travelled internationally. Lab tests are also under way to determine if a chemical or toxin might be the cause.

The WHO said there were fewer than five possible cases in Ireland and three confirmed cases in Spain, in children aged 22 months to 13 years.

The UN health agency said that given the jump in cases and heightened surveillance, it is ‘very likely’ more cases will be detected before the cause of the outbreak is identified.

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