The working hypotheses on the cases of children affected by hepatitis of unknown origin. Child Jesus pin: “Unlikely new pandemic, a known virus could be more aggressive due to a series of contributing causes”
The authorities investigate the cases of severe hepatitis of unknown origin that have affected the children in more than a dozen countries around the world.
The point of the situation
The point, made on Tuesday by Andrea Ammon, director of the European Center for Disease Prevention and Control (ECDC), talks about 200 almost global: the Great Britain is the country most affected (or the one that monitors best) with 111 cases in the latest count, another 40 cases were identified in theEuropean Unionbut reports also come from United States, Israel and Japan.
The current outbreak has led to at least 17 liver transplants in patients under the age of 16 and a a deathaccording to the World Health Organization (WHO).
In Italy there would be «less than 10 cases defined probable “, said the Director of Prevention of the Ministry of Health, Gianni Rezza, and added:” Clearly with the activation of the network and monitoring every day there are new reports, but we do not yet know if this number represents an increase or not compared to other years “.
While the monitoring continues, we asked Carlo Federico Perno, director of Microbiology and Immunology Diagnostics at the Bambino Gesù Hospital in Rome: what are the hypotheses at stake regarding the origin of these hepatitis?
“A premise: what I exclude with absolute certainty is the correlation with anti Covid vaccines, because we are talking about a population that, by definition, is not vaccinated (the cases on average concern children under the age of 5, ed), or has very low vaccination rates (6-11 years) ».
Is it a new pandemic?
‘It is relatively unlikely that a totally new virus has appeared which is the origin of these hepatitis. The other two virological hypotheses are essentially: a known virus which for some reason has become more aggressive, or a known virus which has changed its genetic characteristics a little and has become more dangerous. In the first case, at the most probable moment, we are talking about a virus that our body for some reason (masks, distancing and anti Covid measures) has not seen for two years: our immune system has not “weakened”, but has become a little more “torpid” towards these germs, with the result that even a “trivial” virus can become more infectious and potentially dangerous ».
Is it an adenovirus?
“The fact that adenoviruses have been found in about half of the cases studied can be suggestive, and therefore we must look in that direction, but beware: adenoviruses are also present in healthy people, if we look for them we find them, so we need to understand first of all if there is really an increase in the circulation of these viruses, then, in the case, it would be necessary to demonstrate the cause-effect correlation, that is to understand if these adenoviruses are involved in some way in these hepatitis, since they normally do not cause them except in particularly immunosuppressed, very serious subjects “.
In the English report on hepatitis, attention is focused on a type of adenovirus called F41: could it be a mutated adenovirus that has become more dangerous?
«Adenoviruses are very different from each other, there are more than 50 types that infect humans, 41 is one of them. He has never had evidence of hepatitis, but in the past we have never looked for it in hepatitis. This virus has been found in a significant number of cases, but not in all (less than half) and we have no evidence of the “cause and effect” correlation between the virus and hepatitis ».
Could it be another mutated virus?
«It is unlikely that it has already spread to all continents, escaping control. We can never rule it out, but it is unlikely that such a thing has happened. It is more likely, as mentioned, that it is a virus (which could be adenovirus and could be 41) to have acquired an ability to damage the liver resulting from other factors, for example the lowering of the immune defenses, or the co-presence of SARS-CoV-2 occurred in the past “.
Is there a direct cause hypothesis for SARS-CoV-2?
“I think a direct correlation with the virus is unlikely, because the young patients who have these hepatitis in most cases do not have Covid in an active form, many instead have antibodies that demonstrate a previous infection. We know that Long Covid exists: we cannot exclude that hepatitis may be an unusual manifestation of it, or that Long Covid, having altered immune responses (with inflammation carried on over time as often happens during infections of this type) may having favored a liver infection by another virus, for example adenoviruses. They are absolutely reasonable hypotheses, to be explored ».
Could social distancing and masks have made us “weaker”?
«As mentioned, our immune system may be less trained to” see “some viruses after this period of isolation. Spacing and above all masks have been tools for removing all the germs we encounter every day. In the period April 2020 and May-June 2021 we had almost eliminated the virus infections that are normally found. Last autumn all the respiratory viruses suddenly reappeared, there was a sudden and very violent resurgence, for example of respiratory syncytial viruses (RSV). This year’s late flu was also a signal: we practically altered all of our contacts with respiratory viruses for a while, and they are now making a comeback. Therefore, these adenoviruses, which normally do not cause hepatitis, could have a greater aggressiveness, perhaps in subjects who previously had Covid and hepatitis could also be related to the immunological alterations caused by Long Covid. However, for now it is only a working hypothesis ».
April 28, 2022 (change April 28, 2022 | 15:59)
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