Image: Manuel Fernando Araújo/ Lusa

Portugal registers first suspected case of child with acute hepatitis: ‘false alarm’

Mystery outbreaks across world, but this case confirmed today as ‘Gripe A’

A child has been treated at Porto’s São João Hospital for suspected ‘acute hepatitis’.

The news went out on Thursday evening as laboratory tests were still waiting on confirmation.

That confirmation has since come through, and the little boy (his age given differently by different media sources) has ‘Gripe A’, not acute hepatitis.

This was nonetheless the first case flagged in Portugal as elsewhere health systems are describing “an unexpected and significant increase in cases of severe, acute hepatitis of unknown origin in young, previously healthy children, all under the age of 10”.

This child, according to Expresso, is a little boy, aged three. Other news sources have put his age at 21 months.

Had the diagnosis been confirmed, he would have joined the 200-odd other children registered since the start of the month in an outbreak no-one yet seems able to understand.

According to a report by the Guardian yesterday “the common hepatitis viruses have not been detected in any of the children affected.

Associate Professor Asha Bowen, a clinician at Perth children’s hospital in Australia and an infectious diseases researcher at Telethon Kids Institute told the paper: “This is definitely unusual, and I can’t think of many times in my career where we have faced something like this.

“What’s unusual is that it’s fulminant hepatitis, which basically means the liver has failed completely in these children. That’s extremely rare in childhood. And it has put us all on high alert.”

The World Health Organisation has so far registered cases in Europe, the United States, Israel, the Netherlands, Romania and JapanCanada too is investigating “an undisclosed number of cases to see if they are linked to the outbreak”. 

Children affected range from one month old to 16 years old (in other words, there do seem to have been cases in older children, or at least one older child).

One child has reportedly died, and about 10% of cases in UK (meaning 17 children) have required liver transplants.

With no handle yet on this new strain, it is simply being called ‘atypical hepatitis’.

Symptoms include abdominal pain, vomiting, diarrhea, yellowing of whites of the eyes, and darkened urine.

So far the majority of cases appear to have come in UK.

The only reassuring aspect of the number of children who have required liver transplants is that these have been done through family and friends. Liver transplants do not require donors to be recently deceased – and therefore there is less likelihood, in children’s cases, of transplants not being available.

But it is a hugely worrying situation, nonetheless – not least because no one can fathom where this virus has come from.

One train of thought coming out of UK has suggested the disease is being caused by an adenovirus or possibly as a consequence of Covid-19.

Another idea is that children could be ‘extra vulnerable’ to infections due to the lack of contact with germs as a result of Covid lockdowns and restrictions.

For now, it is a question of seeing how things develop and trying to be prepared.

Said Correio da Manhã in Thursday’s edition (before news of the first suspected case in Portugal came through) : “There is a pediatric transplant team in Coimbra that is prepared to deal with the eventuality of a case appearing in this country.

“We are prepared for this to happen at any time”, Rui Tato Marinho, the director of the national programme for virtual hepatitis told the paper.

It is basically taken as inevitable that cases in children in Portugal will transpire. One can only hope they will be light and easily treatable.

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