Adenovirus – the suspect causing the mysterious hepatitis

Experts surmise that adenovirus 41 – a cold virus – is the culprit behind a series of mysterious hepatitis cases in young children recently.

Adenoviruses are a common group of viruses that commonly infect the lining of the eyes, airways, lungs, intestines, urinary tract, and nervous system. They can cause fever, cough, sore throat, diarrhea and pink eye.

The condition occurs more often in children than in adults, but the virus can generally infect any age group. Most children will have at least one type of adenovirus by age 10. Symptoms are usually mild and clear up on their own after a few days, but can be more severe in people with weakened immune systems.

Adenovirus 41

According to the World Health Organization (WHO), as of May 3, globally, 228 children were infected, 4 children died from mysterious hepatitis. The patients had a high density of adenovirus. Experts speculate that adenovirus 41 strain is the cause of this condition, but have not officially concluded. WHO records adenovirus 41 strain in at least 70 cases of hepatitis.

Adenoviruses 40 and 41 are called enteric adenoviruses, because they can cause gastroenteritis. They are considered the second most common cause of diarrhea in studies of hospitalized children in developed countries, after rotavirus.

Compared with rotavirus, adenovirus 41 does not have as strong a seasonal pattern of development. Rotavirus is more common in the winter months. Both adenovirus 40 and 41 are highly circulating during warm weather. Children under 2 years of age often contract the virus in the intestinal tract.

Adenovirus 41 is mainly transmitted by the fecal-oral route, and is recognized as the cause of hepatitis in immunocompromised children. It may also be one of the (unofficial) factors promoting hepatitis in healthy children. However, experts are still learning about the link between the virus and hepatitis in general.

It is estimated that 50% of children develop antibodies to adenovirus 40 and 41 by the age of 4 years. The incubation period of this virus is about three to 10 days. Typically, children are characterized by prolonged diarrhea accompanied by fever and vomiting for a short time. In cases of adenovirus 41 infections, the median duration of diarrhea was 12 days, and symptom duration was not uncommon.

The fevers are also quite mild, occurring for about two to three days, the child’s temperature is moderately high. Adenovirus 40 and 41 are less likely to cause respiratory infections.

Electron microscope image simulates adenovirus. Image: Native Antigen

Other types of adenovirus

Each strain of adenovirus leaves different manifestations in patients. The virus can cause bronchitis, runny nose, cough, and chills. They also cause colds, stuffy nose, cough, sore throat, and swollen glands.

Some children develop ear infections, which cause severe pain, discomfort, and fever. Other children have conjunctivitis, which causes red, watery, watery eyes, and a sensation of a foreign body in the eye.

Some strains of adenovirus lead to swelling of the brain and spinal cord. Characterized by headache, fever, stiff neck, nausea and vomiting (this is rare)

Experts recommend contacting your doctor or nearest medical facility if your baby under 3 months of age has symptoms such as difficulty breathing, swelling around the eye area, fever that persists for several days, dehydration, such as urinating. less or less tears.

To diagnose a child with adenovirus infection in general, the doctor needs blood tests, urine tests, nasal swabs, stool tests, and in some cases, a chest X-ray.

Treatment of children with adenovirus infection

According to the US Centers for Disease Control and Prevention (CDC), children with adenovirus infections are not usually prescribed antibiotics, because drugs can only kill bacteria. Usually, the disease goes away on its own within a few days. Some problems like infection, pink eye, or pneumonia last a week or more. Children with weakened immune systems need to be treated in the hospital.

With children infected with the virus, parents should let them drink lots of water. Usually, children become dehydrated due to fever, vomiting, and diarrhea. According to experts, the best option is juice or water, which can give children extra electrolytes.

Have your child blow their nose often. For infants, the CDC recommends that family members put a few drops of physiological saline into the baby’s nose, then suck the nose with a syringe.

Families can turn on a humidifier and mist to ease congestion and help children breathe easier.

Before using fever-reducing medications such as acetaminophen or ibuprofen, parents should consult their doctor. Experts advise against giving children aspirin-containing products because it can lead to a rare but serious condition called Reye’s syndrome, which causes swelling in the brain and liver and affects the health and development of children. The child is recovering from a viral infection.

Thuc Linh (According to CDC, Stanford, WebMD)


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