A review on acute, severe hepatitis of unknown origin in children: A call for concern

Abstract

Hepatitis is defined as the inflammatory reaction of the liver parenchyma. It is either acute, which resolves within six months or may be chronic. An outbreak of severe, acute hepatitis of unknown origin in children was reported in nearly all World Health Organisation (WHO) regions except in the Africa. As per the recent update on the 26th of May, approximately 650 cases have met the WHO's probable criteria. While some are yet to be confirmed, the WHO warns that the figure may be underestimating the real situation. The observed clinical presentation includes outstanding immoderate levels of transaminases, vomiting from the previous presentation, pale/mild stools, and jaundice. So far, the viruses which can cause viral hepatitides, like Hepatitis A, B, C, D, and E, have not been detected in any of the identified cases. Some literature reported human enteric adenovirus type 41F in the majority of cases aged sixteen or younger, with few cases of co-infection with SARS-CoV-2. Currently, only several hypotheses have discussed the causality of the outbreak. However, no consensus has been reached. During this outbreak, it is important to adhere to both hand and body hygiene, general infection and control prevention strategies, and lastly, case presentation matching the criteria of case definition set by the WHO. Said identified cases should be reported to concerned health authorities on an urgent basis and must be kept under proper surveillance.

Highlights

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  Hepatitis is defined as the inflammatory reaction of the liver parenchyma. It is either acute, which resolves within six months or may be chronic.

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  An outbreak of severe, acute hepatitis of unknown origin in children was reported in nearly all World Health Organisation (WHO) regions except in the Africa.

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  Although extensive research has not been conducted on the rapidly-progressing AHUO in children, current literature has reported human enteric adenovirus type-41F in most cases aged sixteen or younger.

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  Potential confounding coronavirus infection is one of several theories currently being considered in acute non-hepatitis A–E viral hepatitis origin.

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  During this outbreak, it is important to adhere to both hand and body hygiene, general infection and control prevention strategies, and lastly, case presentation matching the criteria of case definition set by the WHO.