Health officials are still trying to identify the cause of cases of acute and severe hepatitis that have infected scores of children in 16 countries, mainly in Europe.

Over 170 cases of acute severe hepatitis in children aged between 1 month and 16 years have been reported from 16 countries, 12 in Europe.  Most cases have been found in Britain.  Other infections have been reported from the United States, Canada, Israel, and Japan.

The World Health Organization reports 17 children have required liver transplantation and one child has died.  Hepatitis in children sometimes can lead to chronic liver disease and liver failure.

Philippa Easterbrook is a scientist at the WHO’s program of Global HIV, Hepatitis and Sexually Transmitted Infections.  She said the origin of these infections in children remains unknown.  She said investigations have shown that none of the children have the common viral causes of hepatitis A, B, C or E.

“The questionnaires have not identified any common exposure—be it to a toxin or a particular food and no strong travel history.  And importantly, very few of the children have received COVID vaccinations.  So, there does not appear to be a link with COVID vaccine,” she said.

Easterbrook says one line of inquiry is to see whether there is a possible link to adenovirus.  This is a common infection in children, which can cause respiratory illness, gastroenteritis, conjunctivitis and bladder infection.

She said a few cases of unexplained hepatitis in children occur every year in most countries.  She said scientists are trying to ascertain whether the current apparent infection rate is truly unusually high or just a result of better reporting.

“The suggestions are there is a clear significant increase above that background rate in several of the countries that have been able to report this data with some confidence.  But that is what we are trying to establish in the various countries now that we are working with to investigate those cases and establish whether this is the case,” said Easterbrook.

The WHO says toxicology, immunology, and other studies will continue in hospitals.   It notes the likelihood that more cases will be detected before the cause of this infection can be confirmed and before more control and prevention measures can be taken. 
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Many Chinese are marking a quiet May Day holiday this year as the government’s zero-COVID approach restricts travel and enforces lockdowns in multiple cities.

All restaurants in Beijing are closed to dine-in customers from Sunday through the end of the holiday on Wednesday, open only for takeout and delivery. Parks and tourist attractions in the Chinese capital are limited to 50% of their capacity. The Universal Studios theme park in Beijing, which opened last year, said it had shut down temporarily.

The pandemic situation varies across the vast nation of 1.4 billion people, but the Transport Ministry said last week that it expected 100 million trips to be taken from Saturday to Wednesday, which would be down 60% from last year. Many of those who are traveling are staying within their province as local governments discourage or restrict cross-border travel to try to keep out new infections.

China is sticking to a strict zero-COVID policy even as many other countries are easing restrictions and seeing if they can live with the virus. Much of Shanghai — China’s largest city and a finance, manufacturing and shipping hub — remains locked down, disrupting people’s lives and dealing a blow to the economy.

The major outbreak in Shanghai, where the death toll has topped 400, appears to be easing. The city recorded 7,872 new locally transmitted cases on Saturday, down from more than 20,000 a day in recent weeks. Outside of Shanghai, only 384 new cases were found in the rest of mainland China.

Beijing, which has tallied 321 cases in the past nine days, is restricting activity to try to prevent a large outbreak and avoid a city-wide lockdown similar to Shanghai. Individual buildings and housing complexes with coronavirus cases have been locked down. Visitors to many office buildings and tourist sites such as the Great Wall must show proof of a negative COVID-19 test within the previous 48 hours.

Online booking agency Ctrip said last week that people were booking travel to cities that were mostly virus-free, such as Chengdu in Sichuan province and the nearby city of Chongqing. Other popular destinations included Wuhan, where the world’s first major outbreak of COVID-19 occurred in early 2020. About half the orders on the Ctrip platform were for travel within a province.
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