Acute severe hepatitis in children

Beginning in early April 2022, the World Health Organization has reported an increase in cases of acute severe hepatitis in children not caused by known hepatitis viruses, such as hepatitis A, B, C and E. The Public Health Agency of Canada (PHAC) is collaborating with provincial and territorial health partners across the country to investigate cases in Canada. This investigation is ongoing and updates will be made to this page as the investigation evolves.

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What is acute severe hepatitis

Hepatitis is an inflammation of the liver. Depending on the cause, the disease can be very sudden and progress to liver failure over a few days to weeks (acute). Some types of hepatitis can be treated and most cases recover. Acute severe hepatitis in children is a rare condition in Canada, and in many cases, an underlying or contributing cause is not known.

What we are doing

PHAC is working closely with provincial, territorial, and international partners to further investigate any reported cases of acute severe hepatitis in children not caused by known hepatitis viruses. All provinces and territories are working to identify and report potential cases to PHAC. This will help to further define the national scope in Canada, and help determine if cases in Canada are related to other cases reported around the world.

At this time in Canada, we do not know if there has been an increase in acute severe hepatitis cases in children not caused by known hepatitis viruses. We are analyzing Canadian hospitalization data to determine the number of cases that we would normally see in Canada over time. This baseline information will allow us to determine if we are seeing an increase in cases reported.

Cases reported in Canada

As of July 6, 2022, there are 21 cases of acute severe hepatitis in children in Canada meeting the national case definition. The breakdown by province is as follows:

The children, who are between 0 and 13 years old, became sick between November 3, 2021 and June 23, 2022. All children were hospitalized. Two children have required a liver transplant. No deaths have been reported. Some children may live in one jurisdiction and receive treatment in another jurisdiction. These children are being counted in the province where they live.

It is important to note that the definition being used to include cases in the national investigation is very broad. This means that any children with acute severe hepatitis where a cause is not certain are being included in initial investigations. Some of these children may have a diagnosis for their liver condition, but they are being included to explore possible factors that may have triggered the condition. PHAC is reporting information to the World Health Organization. Additional information for cases is being reviewed, and the investigation into the possible causes is ongoing.

What is causing these illnesses

At this time, the cause of illness is not known and an active investigation continues in multiple countries. Adenovirus is currently one of the possible causes being explored. Adenovirus is a common virus that typically causes cold or flu-like illness or gastroenteritis. Investigators continue to consider other possible causes in their investigations, in order to identify other possible contributing factors such as exposure to toxins or other infections.

According to the World Health Organization, side effects from the COVID-19 vaccines are not suspected, as the vast majority of affected children were too young and did not receive COVID-19 vaccination.

What parents can do

As a parent or caregiver, you should be aware of the symptoms of hepatitis and contact your healthcare provider with any concerns. Symptoms of severe acute hepatitis in children may include:

Other things you can do:

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