Reports of hepatitis in children being investigated by Canadian health officials

It is unclear if this is connected to the outbreak of severe liver disease reported in 12 countries and linked to the death of one child.

Emma Jones 4 minute read April 27, 2022

Investigators believe that the cases are related to common viruses that can cause fevers, sore throats, pneumonia, diarrhea, and pink eye. GETTY/iSTOCK

Canadian health officials are investigating cases of severe liver disease in children, however, they have not yet confirmed if these cases are linked to the mysterious outbreak reported by the World Health Organization (WHO).

The WHO originally shared news of an outbreak regarding acute hepatitis of “unknown aetiology” in Great Britain and Northern Ireland on April 15. At least 169 cases in 12 countries have been reported since then, although the WHO notes that it is not clear if the condition is continuing to spread or if the uptick is due to enhanced testing. One child has died and roughly 10 per cent of the total cases — 17 children — have required a liver transplant.

On Tuesday, the Public Health Agency of Canada confirmed they are investigating reports of “severe acute hepatitis of unknown origin in young children in Canada,” according to the CBC. More information is needed to clarify if there is a connection to the outbreak in the U.K.

Japan’s ministry of Health, Labour and Welfare also released information on a child under the age of 16 who was hospitalized for hepatitis on April 21. The team is still working to determine if this case is linked to the outbreak.

Hepatitis outbreak in children may be linked to adenovirus

Investigators believe that this onslaught of cases is related to adenovirus, common viruses that can cause fevers, sore throats, pneumonia, diarrhea, and pink eye.

“Information gathered through our investigations increasingly suggests that this rise in sudden onset hepatitis in children is linked to adenovirus infection,” Dr. Meera Chand, director of clinical and emerging infections at the U.K. Health Security Agency (UKHSA) said in a news release. “However, we are thoroughly investigating other potential causes.”

Investigators say adenovirus strain F41 could be the culprit. This strain is known to cause gastroenteritis and is a “a prominent cause of diarrhea and diarrhea-associated mortality in young children worldwide,” according to Science Advances.

Hepatitis refers to inflammation of the liver, reports Johns Hopkins University, and is usually caused by one of the hepatitis viruses (hepatitis A-E), genetics, exposure to drugs, alcohol or other chemicals, or an autoimmune disorder.

Unclear how adenovirus is linked to hepatitis in children

Adenovirus was detected in 75 per cent (40 of 53) cases tested. Sixteen per cent of cases were also positive for SARS-CoV-2, however, the report from the UKHSA notes that there was already a high case count of COVID-19 during this time so it is not entirely unexpected that some children would also test positive.

How adenovirus is linked to this condition is unclear, however, researchers say it could be due to a number of possibilities. Because children haven’t been exposed to many different viruses and germs through the pandemic, suddenly being exposed to adenovirus may lead to a more intense immune response than would otherwise occur. Another possibility is the evolution of a new adenovirus that may cause the liver to become inflamed.

Scientists are also searching to understand if a previous COVID infection followed by infection with adenovirus could lead to liver inflammation.

Common symptoms include diarrhea, nausea

An investigation by the UKHSA, Public Health Scotland, Public Health Wales and the Public Health Agency, found cases are mostly occurring in young children under the age of 5. Common initial symptoms include gastroenteritis illness (diarrhea and nausea), followed by jaundice.

In the U.K., the COVID vaccine is not yet eligible for children under five years of age and none of the children tested were vaccinated — so there is no link to the COVID vaccine.

There have been at least 169 cases reported worldwide as of April 23, with 114 reported in the United Kingdom of Great Britain and Northern Ireland, 13 in Spain, 12 in Israel, nine in the United States, six in Denmark, approximately five in Ireland, four in the Netherlands, four in Italy, two in Norway, two in France, one in Romania and one in Belgium.

Emma Jones is a multimedia editor with Healthing. You can reach her at or on Instagram and Twitter @jonesyjourn.


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