Three children die from hepatitis in Indonesia, bringing the number of deaths worldwide to four in the middle of the outbreak

Three children in Indonesia have died due to a mysterious hepatitis that, if confirmed, would raise the death toll to at least four.

The country’s health ministry said the victims died of “suspected acute hepatitis” last month and were all in the Jakarta capital.

Symptoms included nausea, vomiting, severe diarrhea, fever, jaundice, seizures, and loss of consciousness, all signs of fatal liver disease.

Tests are underway to confirm his cause of death. Indonesia has not officially registered any cases of hepatitis since the outbreak began.

The children’s ages have not been revealed and it is unclear if they had any underlying health issues.

More than 200 cases of childhood hepatitis of unknown origin have been confirmed worldwide in the mysterious outbreak, which experts say is just the “tip of the iceberg.”

Most cases have been detected in the United Kingdom and the United States, which have some of the strongest surveillance systems.

The World Health Organization has confirmed one death, but has not revealed the location. One death is being investigated in the United States, along with all three in Indonesia. At least 18 of the young people have required liver transplants.

None of the cases tested positive for normal viruses that cause hepatitis, which has left scientists baffled about the origins of the disease.

A virus commonly known as the common cold, known as adenovirus, is thought to be involved.

But there are a number of theories as to why the normally harmless virus is causing critical illness in young and previously healthy children.

More than 200 children have been diagnosed with the disease worldwide in up to 14 countries since last October * No cases have been confirmed in Canada, Japan and Wisconsin, Illinois and New York.

The Indonesian Ministry of Health urged parents to be alert to symptoms of the disease, which include jaundice (yellowing of the skin and whites of the eyes), as well as abdominal pain, vomiting, diarrhea and dark urine.

He has instructed people to seek medical advice if their child has symptoms and has encouraged their population to maintain good hand hygiene, make sure food is clean and well cooked, and avoid contact with sick people.

Q&A: What is the mysterious global hepatitis outbreak and what’s behind it?

What is hepatitis?

Hepatitis is an inflammation of the liver that is usually caused by a viral infection or liver damage from drinking alcohol.

Some cases resolve on their own, with no ongoing problems, but some can be fatal, forcing patients to need liver transplants to survive.

Why do experts care?

Hepatitis is usually rare in children, but experts have already detected more cases in the current outbreak than would normally be expected in a year.

The cases are of “unknown origin” and are also serious, according to the World Health Organization. It has caused at least one death and 18 liver transplants.

How widespread are the cases?

Inflammatory liver disease has been detected in more than 200 children aged one month to 16 years.













Japan *

Canada *







Less than five








Unspecified number


* Cases in Canada, Japan and Illinois, Wisconsin and New York have not yet been confirmed

What could trigger it?

None of the cases were caused by any of the five typical strains of the virus – hepatitis A, B, C, D and E – leaving experts baffled by the outbreak.

Some children have tested positive for adenovirus, which usually causes a cold, while others have been infected with Covid, but no clear issue has emerged.

The UKHSA ruled out the Covid vaccine as a possible cause, so far no British case has been vaccinated due to its age.

What are the symptoms?

Hepatitis often has no noticeable symptoms, but may include dark urine, pale gray stools, itchy skin, and yellowing of the eyes and skin.

Infected people can also experience muscle and joint pain, high temperature, feeling sick and being unusually tired all the time.

How is it treated?

Treatment depends on the severity, with some patients being able to fight the disease on their own.

In more dangerous cases where the liver fails, children may go into an induced coma to deal with the swelling of the brain caused by the accumulated ammonia.

A liver transplant may be needed if the liver has been damaged by self-repair, although this is incredibly rare.

Officials are investigating the cause and investigating the epidemiology of the outbreak, the ministry said.

Health officials in the UK believe that adenovirus may be behind cases of sudden-onset hepatitis.

The 145 affected children in Britain, who are mainly aged five and under, initially suffered from diarrhea and nausea, followed by jaundice.

But the UK Health Security Agency (UKHSA) said it is not typical to see this pattern of symptoms in adenovirus, so it is still investigating other causes, including Covid itself.

He also noted that the confinements may have weakened children’s immunity and left them more susceptible to the virus, or it may be a mutated version of the adenovirus.

The UK agency is working with scientists and doctors across the country to “answer these questions as soon as possible”.

Indonesia did not impose a nationwide blockade, but implemented local restrictions that saw people being told to work from home, attend online school, and not dine at restaurants.

Experts are also investigating whether a new variant of coronavirus is responsible or whether it could be a previous or concurrent Covid infection.

Dr Meera Chand, director of clinical and emerging infections at UKHSA, said parents may be concerned, but that their child’s chances of developing hepatitis are “extremely low”.

“However, we still remind parents to be alert to signs of hepatitis, especially jaundice, which is easier to detect as a yellow tone in the whites of the eyes, and to contact your doctor if you worries, “he said.

Dr. Chand added: “Normal hygiene measures, including thorough hand washing and making sure children wash their hands properly, help reduce the spread of many common infections.

“As always, children with symptoms such as vomiting and diarrhea should stay home and not return to school or nursery until 48 hours after the symptoms have stopped.”

Hepatitis is usually rare in children, but experts have already detected more cases in the UK since January than they would normally expect in a year.

The cases are of “unknown origin” and are also serious, according to the World Health Organization.

Scientists have previously suggested that the cases could be just the “tip of the iceberg,” more likely to be there than has been detected so far.

Professor Alastair Sutcliffe, a leading pediatrician at University College London, said MailOnline health chiefs may not know the cause until late summer.

He said: “With modern methods, computing, advanced computing, real-time PCR and whole-genome screening, I think finding the cause with some reasonable reliability will take three months.”

Professor Sutcliffe said discovering the cause could be slowed down by bureaucracy across international borders, making it difficult to transport biomaterials between countries.

Parental consent, data protection and laws governing the use of human tissues in the UK could act to curb the investigation, he said.

Finding an unknown cause is especially difficult because cases can have multiple factors behind them that are not consistent across all diseases.

Health officials in the UK have ruled out the Covid vaccine as a possible cause, as none of the sick British children have been vaccinated because of their young age.

Liver experts described the series of cases as “worrying,” but said parents should not worry about the disease affecting their children.

The head of the European Center for Disease Prevention and Control (ECDC) said the disease was “quite rare”, but judged the risk to children to be “high” due to the possible impact.

The risk to European children cannot be accurately assessed, as evidence of human-to-human transmission was unclear and cases in the European Union were “sporadic with an unclear trend,” he said.

But given the unknown causes of the disease and the potential severity of the disease, ECDC said the outbreak “is a worrying public health event”.

The increase in hepatitis cases was first recorded in Scotland on March 31, with a child hospitalized in January with the disease. The Scottish case dates back to January.



Experts say the cases may be related to adenovirus, usually associated with colds, but more research is ongoing.

This, in combination with Covid infections, could be causing an increase in cases.

The WHO reports that adenovirus has been detected in at least 74 of the cases. At least 20 of the children tested positive for coronavirus.

Weakened immunity

British experts in charge of investigating the series of diseases believe that the endless cycle of blockages could have played a contributing role.

Restrictions may have weakened children’s immunity due to the reduced social mix, leaving them at increased risk for adenovirus.

This means that even “normal” adenovirus could be causing serious results, because children do not respond to it as they did in the past.

Adenovirus mutation

Other scientists said it could have been the adenovirus that has acquired “unusual mutations”.

This would mean that it could be more transmissible or more able to prevent children’s natural immunity.

New variant of Covid

UKHSA officials included “a new variant of SARS-CoV-2” in their working hypotheses.

Covid has caused liver inflammation in very rare cases during the pandemic, although they have occurred at all ages rather than being isolated in children.

Environmental triggers

The UKHSA has noted that environmental triggers are still being investigated as possible causes of disease.

These may include contamination or exposure to certain drugs or toxins.

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