Mysterious cases of hepatitis in children – knowledge of SWR

Hepatitis in children is usually extremely rare – but recently in Europe and the US there have been increasing reports of liver inflammation in children under 10 years of age. What is hidden behind it?















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So far there have been about 190 cases of hepatitis (as of April 27). So far, one case has been reported in Germany, but the child was already ill in January. We have not had any other reported cases since then.

So far, most children are sick in the UK. Children under 5 are particularly affected. Many have a mild course, but some also needed liver transplants and one child died. What could be after that?



Recently, there have been increased reports of hepatitis in younger children. The exact causes are still being investigated.


imago images



imago imago / hKuprevich


Inflammation of the liver (hepatitis) can have different causes

Hepatitis means inflammation of the liver – and there are a number of possible causes. The most common are specific hepatitis viruses – but they are not found in affected children.

In addition, alcohol, drugs, toxins or even spoiled food can lead to hepatitis; none of this seems to matter here. In addition to hepatitis viruses, other viruses can also cause inflammation of the liver.



Recently there have been several cases of hepatitis in children.  (Photos: imago images, imago images / Library of scientific photographs)

Recently there have been several cases of hepatitis in children. However, the exact cause is not yet known. Hepatitis viruses (like type B here) can also cause inflammation of the liver.


imago images



imago images / Library of scientific photographs


Viruses can also cause hepatitis

British experts currently consider adenoviruses to be the most likely cause, especially adenovirus F41. It was found in about three-quarters of the children tested for it. Normally, this type of virus is mostly harmless – young children are often infected with it, resulting in cold symptoms, mild diarrhea and vomiting.

It is unclear why the common pathogen can suddenly cause inflammation of the liver: is there suddenly a new, more malignant variant in circulation? A previously unknown virus is also possible.



British experts currently consider adenoviruses as the most likely cause of hepatitis cases in children.  (Photo: imago, imago images / Library of scientific photographs)

British experts currently consider adenoviruses as the most likely cause of hepatitis cases in children.


imago images



imago / Library of scientific photographs


Children’s immune system may be overloaded

Many experts have another suspicion: over the past two years, strict protective measures imposed by the coron pandemic have caused young children to come into contact with far fewer pathogens than usual. Now they are exposed to a large number of viruses and bacteria after being exposed – this can defeat the immune system in some children.

The impact of previous illnesses is still being investigated

At least it is clear that it has nothing to do with a coronary vaccination – none of the affected children have been vaccinated. There were acute Covid infections, but not so many. It is still being investigated whether a long time ago disease plays a role.

The Robert Koch Institute informed pediatric medicine associations in early April and asked doctors to report suspicious inflammation of the liver. So far, the authorities in this country know only one case, the disease was three months ago. 111 cases have been reported in the UK since January, which is actually an extremely high number from the RKI’s point of view.

In the case of the rest of Europe, on the other hand, it is still unclear whether there are indeed many more diseases than usual. Renowned British pediatrician, Professor Alastair Sutcliffe reassures anxious parents and sees no reason to panic: most sick children are already walking better and the risk of liver failure is very low.



It is still being investigated whether a previous coronary heart disease may be behind the mysterious hepatitis diseases in children.  (Photo: imago images, IMAGO / Bihlmayerfotografie)

It is still being investigated whether a previous coronary heart disease may be behind the mysterious hepatitis diseases in children.


imago images



Photography IMAGO / Bihlmayer


These are the warning signs of hepatitis

The most obvious warning sign of hepatitis is pale yellowed skin – when the whites of the eyes turn yellow, this is a clear alarm signal. Also, some of the affected children complained of abdominal pain, diarrhea and vomiting. On the other hand, fevers were rare. Other possible symptoms of hepatitis include dark urine, itchy skin, frequent bruising and extreme fatigue.

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