The emergence of a serious liver disease affecting very young children, a pathology whose origin is unknown, is being closely monitored by European and American health authorities.
It all started in March 2022 in Scotland where there was an abnormal increase in the number of severe acute hepatitis in children.
The disease then spread throughout the United Kingdom and the United States.
What cause concern because it quickly became apparent that it was a new disease: the viruses usually associated with these pathologies were not detected in the young patients.
To date, approximately 600 children worldwide, the majority under the age of 5, have been victims, with serious consequences: hospitalizations for liver failure, and for some the absolute need for a transplant.
We deplore a dozen deaths.
Ordinarily, severe hepatitis affects adults.
It is not impossible for children to experience inflammation of the liver, but they are usually asymptomatic and therefore go completely unnoticed.
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Jean-Michel Pawlotsky, head of the virology department at the Henri-Mondor hospital in Créteil nevertheless wants to be reassuring:
“There is nothing to worry about at the moment, the number of cases in the world remains extremely low and the no cases have yet been observed in France.
Indeed
, in the spring, a small number of cases were suspected in France, but it was not ultimately about this new pathology.
The future will tell if France will be spared: at the time of writing these lines, a few cases are being investigated at the National Reference Center for Hepatitis B, C and Delta.
Liver inflammation
Professor Pawlotsky and his teams have the mission to explore any new hepatitis with an unknown agent, and find its cause.
Hepatitis can be triggered by viruses (A, B or C for example) or by other factors such as alcohol.
In response to these attacks, the liver will respond with inflammation that can lead to liver failure if too many cells are destroyed.
But here, we don't know.
The CNR is equipped with a genetic sequencing platform which has advanced tools known as metagenomics.
This makes it possible to detect all the DNA and RNA present in a sample: viruses, bacteria, fungi and other parasites.
“Thanks to this technique, and if the disease is caused by one of these germs, it should be detected even if the pathogen is not yet known and described by the scientific community.
It is also possible not to detect anything, in which case it would be better to turn to other avenues such as toxic molecules present in food or on toys for example.
Nothing is to be ruled out”
indicates Jean-Michel Pawlotsky.
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What intrigues the professor is the geographical distribution of the disease: why do the United Kingdom and the United States concentrate the most patients?
Especially since these children had no close ties between them.
No “clusters” are observed either.
Everything happens as if the contaminations were not direct: one patient does not transmit it to the next.
Should we conclude that viruses are to be excluded?
It seems far too early to tell.
Another question: can we predict how this start of the epidemic will evolve?
It's impossible for the moment, the phenomenon could grow and stop on its own without anyone ever knowing what happened.
To monitor
Acute infantile hepatitis is extremely rare, but if your child has symptoms of jaundice as well as severe fatigue, nausea, vomiting and acute diarrhea, the liver may be involved, you should quickly consult a doctor.