12 cases of unexplained hepatitis found in children in Israel

The Health Ministry is examining the reports from Shaare Zedek Medical Center and Schneider Children's Medical Center.

 Hepatitis A virus (HVA) causes acute inflammation of the liver and is the most common of all forms of viral hepatitis (photo credit: ALAIN GRILLET/FLICKR)
Hepatitis A virus (HVA) causes acute inflammation of the liver and is the most common of all forms of viral hepatitis
(photo credit: ALAIN GRILLET/FLICKR)

A Health Ministry announcement on Tuesday that 12 Israeli children under the age of five have been diagnosed with acute hepatitis caused some panic, but most of the cases – which required two youngsters to undergo transplants of liver lobes donated by their parents – occurred a year ago.

The ministry sent a letter this week to pediatricians and other doctors around the country asking that they keep an eye out for children experiencing acute hepatitis of an unknown cause and report any such cases to officials.

Seven of the cases, including the two transplants, occurred at Schneider Children’s Medical Center in Petah Tikva and the other five at Shaare Zedek Medical Center (SZMC) in Jerusalem. Both medical institutions received the young patients from various parts of the country, and they did not come from any specific ethnic or religious groups.

Dr. Eyal Shteyer, director of the pediatric liver unit at SZMC, told The Jerusalem Post that all their patients have been released.

The ministry announcement said the cases occurred “in the last few months” but Schneider said the transplants at their hospital occurred a year ago.

Shaare Zedek Medical Center. (credit: COURTESY SHAARE ZEDEK)Shaare Zedek Medical Center. (credit: COURTESY SHAARE ZEDEK)

“There have been about 50 such cases in various European countries, and it is very strange. We don’t know the cause of these cases, but there is no reason for panic. It is very rare.” The liver inflammation caused the children’s skin and eyes to turn yellow from jaundice and the liver enzymes reached an abnormal level. There is no connection between acute hepatitis and hepatitis A, B, C, D or E, Shteyer added.

A Schneider spokesman said that all of the seven children had recovered from COVID-19, but there was no proof of any connection to the acute hepatitis. A vaccine against acute hepatitis is available, but it has not yet been approved for children under five.

Since the outbreak in Britain began, outbreaks have spread to other countries, including the US, Denmark, Ireland, the Netherlands and Spain. Nine cases of acute hepatitis have been reported in children under the age of 10 in Alabama, according to the state’s health department. The affected children in Alabama have experienced symptoms of a gastrointestinal illness and varying degrees of liver injury including liver failure.

According to the Alabama Department of Public Health, analyses have revealed a possible association of this hepatitis with Adenovirus 41. None of the children had underlying health conditions. The UK Health Security Agency also stated that adenoviruses is one of the possible causes being investigated.

According to the European Center for Disease Prevention and Control (ECDC), the hypotheses of the incident team in the UK centered around an infectious agent or a possible toxic exposure. No link to the COVID-19 vaccine was found and detailed information collected about food, drink and personal habits failed to identify any common exposure.

Laboratory investigations have excluded hepatitis types A, B, C, D and E as possible causes in these cases.