Hepatitis Is Everywhere. Apparently, So Is Gastroenteritis
Coincidence? Correlation? Causation? The World Wonders....
As the number of pediatric hepatitis cases continues to grow globally, clear evidence of the underlying causative agent or pathogen continues to evade clinicians and researchers. The outbreak is nearing the two month mark and the basic answer to the question of cause remains “I do not know.”
According to the latest WHO Disease Outbreak News bulletin on the topic, there are now some 650 suspected or probable cases of pediatric hepatitis worldwide.
Six hundred and fifty probable cases of acute hepatitis of unknown aetiology in children have been reported to WHO from 33 countries in five WHO Regions between 5 April and 26 May 2022. The aetiology of this severe acute hepatitis remains unknown and under investigation; the cases are more clinically severe and a higher proportion develops acute liver failure compared with previous reports of acute hepatitis of unknown aetiology in children. It remains to be established whether and where the detected cases are above-expected baseline levels. WHO assesses the risk at the global level as moderate.
“Unknown aetiology” (“etiology” in American English) is a four dollar phrase medical experts frequently use as a stand-in for “I don’t know”. As the WHO bulletin illustrates, the unknowns are outpacing the knowns—including whether this outbreak represents an increase over the baseline incidence of hepatatis in children. We describe the issue in terms of an outbreak, but it remains possible that, for at least some areas, there is no unusual increase in hepatitis cases among children.
Doctors simply do not know.
Adenovirus Type 41 Remains The Most Popular Hypothesis
Currently, Adenovirus, and in particular Type 41, is the prime suspect for the causative pathogen, by virtue of its prevalance in an apparent but moderate majority of cases globally:
According to the latest Joint Surveillance Report by the WHO Regional Office for Europe (EURO) and the European Centre for Disease Prevention and Control (ECDC) on cases from EU/EEA countries which have been reported through the European Surveillance System (TESSy), as of 20 May 2022:
Three quarters (75.4%) of cases are <5 years of age.
Of 156 cases with information on hospital admission, 22 (14.1%) were admitted to an intensive care unit. Of the 117 cases for which this information was available, 14 (12%) have received a liver transplant.
Overall, 181 cases were tested for adenovirus by any specimen type, of which 110 (60.8%) tested positive. The positivity rate was the highest in whole blood specimens (69.5%).
Of the 188 cases PCR tested for SARS-CoV-2, 23 (12.2%) tested positive. Serology results for SARS-CoV-2 were only available for 26 cases, of which 19 (73.1%) had a positive finding.
Of the 63 cases with data on COVID-19 vaccination, 53 (84.1%) were unvaccinated.
One reason that conclusive proof remains elusive is that comprehensive viral screenings have not been done in the majority of cases. As the WHO bulletin illustrates, only 181 of the 650 cases were tested for Adenovirus, while only 188 cases were tested for SARS-CoV-2. With little more than one-fourth of the probable cases being screened for even the likely pathogens, establishing clear patterns of infection and disease presentation are all but impossible. Articulating a definitive pathway for Adenovirus Type 41 to cause hepatitis in otherwise presumptively healthy children so far has not happened.
COVID Inoculations Are Still Unlikely. COVID Itself…Maybe?
Just as Adenovirus Type 41 remains the prime suspect, the extant data continues to all but rule out a causative role for the COVID inoculations. The majority of cases are children too young to be legally inoculated (although as we have seen only yesterday there are doctors willing to illegally inoculate the very young against COVID).
COVID itself, however, remains a tantalizing alternative cause. Certainly among cases within the United Kingdom, the SARS-CoV-2 virus crops up enough times in addition to Adenovirus to remain a distinct possibiity, although a fairly remote probability.
Based on the working case definition for probable cases, laboratory testing has excluded hepatitis A-E viruses in these children. SARS-CoV-2 and/or adenovirus have been detected in a number of the cases, although the data reported to WHO are incomplete. The United Kingdom has recently observed an increase in adenovirus activity, which is co-circulating with SARS-CoV-2, though the role of these viruses in the pathogenesis is not yet clear.
Nor is the CDC ruling out the SARS-CoV-2 virus:
CDC continues to examine possible causes, including testing for and ruling out some of the viruses that commonly cause hepatitis (hepatitis A, B, C, D, and E). Adenovirus has been detected in nearly half of the children and continues to be a strong lead. Further laboratory tests are being conducted to look more closely at the virus genome and other potential pathogens, such as SARS-CoV-2. In addition, CDC is communicating with key medical groups and continues to provide updated reporting and laboratory guidance for clinicians who may identify hepatitis of unknown cause in children. A Community Outreach and Clinician Activity (COCA) call is scheduled for Thursday, May 19th, where CDC will provide key updates and experts in treating hepatitis will answer clinical questions.
Blame It On The Lockdowns
The most favored COVID-related hypothesis for the hepatitis outbreak is that lockdown, isolation, and social distancing has stunted the normal development of children’s immune systems, making them more susceptible to adenovirus infection.
Dr. Jay Butler, CDC deputy director for infectious diseases, said on a conference call that around half of the children diagnosed in recent months were also infected with a type of adenovirus, a virus that causes the common cold, but the agency is still investigating the exact cause of the illness.
"Evidence is accumulating that there is a role for adenovirus, particularly adenovirus-41," he said.
Butler said one theory is that pandemic mitigation measures may have limited exposure to adenovirus, leading to a "catch up" in infections as social distancing and other efforts were eased.
This notion that children of the pandemic era are “immunologically naive” was first advanced in a retrospective analysis of hepatitis cases in Scotland, and while the hypothesis has not been conclusively proven, no competing data has emerged to disqualify the hypothesis either.
However, hepatitis is not the only condition or disease which lends itself to this notion that the lockdowns—what the CDC euphamistically calls “pandemic mitigation measures”. Over the past several months there have been a number of unusual viral and disease outbreaks.
Consider what we’ve been seeing of late.
The past two winters were among the mildest influenza seasons on record, but flu hospitalizations have picked up in the last few weeks — in May! Adenovirus type 41, previously thought to cause fairly innocuous bouts of gastrointestinal illness, may be triggering severe hepatitis in healthy young children.
Respiratory syncytial virus, or RSV, a bug that normally causes disease in the winter, touched off large outbreaks of illness in kids last summer and in the early fall in the United States and Europe.
With its usual lack of irony and self-awareness, the same corporate media that promoted and defended the lockdowns is unable to acknowledge that immune retardations which make these otherwise “normal” viral pathogens far more virulent in presentation is a direct—and foreseeable—consequence of locking down half the world in knee-jerk overreaction to the COVID pandemic.
These viruses are not different than they were before, but we are. For one thing, because of Covid restrictions, we have far less recently acquired immunity; as a group, more of us are vulnerable right now. And that increase in susceptibility, experts suggest, means we may experience some … wonkiness as we work toward a new post-pandemic equilibrium with the bugs that infect us.
The Pandemic Panic of the past two years may very well have left people overall sicker and less able to ward off infectious disease than before.
Larger waves of illness could hit, which in some cases may bring to light problems we didn’t know these bugs triggered. Diseases could circulate at times or in places when they normally would not.
“I think we can expect some presentations to be out of the ordinary,” said Petter Brodin, a professor of pediatric immunology at Imperial College London. “Not necessarily really severe. I mean it’s not a doomsday projection. But I do think slightly out of the normal.”
Marion Koopmans, head of the department of viroscience at Erasmus Medical Center in Rotterdam, the Netherlands, said she believes we may be facing a period when it will be difficult to know what to expect from the diseases that we thought we understood.
“I do think that’s possible,” Koopmans said.
This phenomenon, the disruption of normal patterns of infections, may be particularly pronounced for diseases where children play an important role in the dissemination of the bugs, she suggested.
Indeed, we have clear evidence hepatitis not the only unusual illness rising in the world today. In a video presentation to Canadian media outlet CTV News, Dr. Tali Bogler of St Michael’s Hospital in Toronto made an interesting statement: Gastroenteritis is “everywhere”.
The full video is available here.
Consider the implications of that statement for a moment.
Adenovirus Type 41 normally produces hepatitis among immunocompromised individuals. Yet among otherwise healthy children, the virus often results in…wait for it…gastroenteritis.
However, gastroenteritis—AKA, “stomach flu”—is caused by more pathogens than just Adenovirus Type 41. The most common cause of gastroentiritis is norovirus—and norovirus cases have been occurring more frequently this year than in years past.
Meanwhile, 448 norovirus outbreaks were reported in the U.S. from Aug. 1, 2021, to March 5, 2022, according to the agency. In comparison, that's 370 more outbreaks than reported from Aug. 1, 2020, to March 5, 2021, when 78 stomach virus outbreaks were seen.
Moreover the symptoms of norovirus are not that different to the described symptoms the WHO uses to define relevant heptatis cases.
“It causes symptoms like vomiting, diarrhea, stomach pain, sometimes fever. It comes on really quickly, but it also goes away pretty quickly,” said Dr. Robert Sanders, the associate medical director at University Health’s Pedi Express clinic downtown (San Antonio, Texas)
Additionally, norovirus itself has been linked to cases of hepatitis, just as has Adenovirus Type 41. As with Adenovirus, hepatitis from norovirus infection is found mainly among immunocompromised patients, and patients with at least some level of immune system dysregulation arising from various co-morbidities.
Of all the cases with transaminitis, 17.6% (n = 3) had underlying medical conditions (comorbidities); one case previously had cholelithiasis and had undergone cholecystectomy, however the duration for recovery from norovirus induced acute hepatitis was not much longer than other cases. Two other cases previously had liver transplants; therefore, they were immunocompromised. Their duration for recovery of symptoms (14 days and 150 days respectively) and LFT results were significantly longer than other cases with an average of 375 days (Table 2).
Other viruses are also capable of producing the symptoms of gastroenteritis. For example, rotavirus is known to cause gastroenteritis, particularly among young children—the very patient cohort now seemingly at risk for hepatitis.
Not Identified, Yet Not Eliminated
The primary stumbling block from crying “aha!” and pointing to either norovirus or rotavirus as the causative pathogen behind the hepatitis outbreak is the conspicuous lack of any mention of either virus in any of the reporting to date. While absense of evidence is not, of itself, evidence of absense, norovirus and rotavirus are certainly among the “usual suspects” for gastrointestinal illness, and it strains credulity to suppose that no one has thought to check for them while thinking to check for Adenovirus. While neither pathogen can be affirmatively eliminated as a possibility, neither has been identified as present among the detected pathogens for any of the reported hepatitis cases.
Yet we still have a profusion of gastroenteritis cases, from whatever cause. The rise in cases is sufficient in Wyoming, for example, to warrant some media attention:
Gastroenteritis can be caused by rotaviruses, noroviruses, adenoviruses, sapoviruses and astroviruses, along with some bacteria (such as E. coli and salmonella). Noroviruses are most common.
Illness can hit quickly between 12 to 48 hours after a person has been exposed. Symptoms can last from one to 10 days, depending on which virus caused the illness, and go away without causing long-term problems.
Which brings us back to the hypothesis that has been advanced repeatedly, particularly among UK researchers: the lockdown protocols imposed to contain SARS-CoV-2 virus (and which failed, we should not forget) have as a consequence impaired peoples’s immune systems, and children's immune systems in particular.
Dr Meera Chand - who is heading the UK Health Security Agency's investigation into the rise in cases - said the virus may be hitting young children hardest, because lockdown restrictions meant they were not exposed to it in their early years.
This suggested “a susceptibility factor - so lack of prior exposure of that particular age group during the formative stages that they've gone through during the pandemic”, she said.
Thus, while identification of a specific virus as the causative pathogen behind the hepatitis outbreak remains so far elusive, media reports are showing that children specifically, and people in general, are overall sicker in the post-COVID era than in the pre-COVID era.
Coincidence? Correlation? Causation?
One could argue ad infinitum whether the reason for the general sickening of the public is from the demonstrably toxic mRNA inoculations sold to the public as the pathway to immunity from COVID or the demonstrably lunatic lockdown protocols most jurisdiction foolishly attempted as “pandemic mitigation”. However, that debate may, in large part, hinge on a distinction without much difference: regardless of the particular mechanisms and causes in individual circumstances, we are faced with a reality within corporate media reporting of growing evidence that people in general are simply sicker than they were before.
Not only have the measures foisted upon a credulous world by “experts” to stop COVID-19 failed in their primary objective, they have harmed people by making them more vulnerable to sickness and disease. Weaker immune systems appear to be a major part of the general legacy of what the “experts” have argued was necessary to mitigate and stop the spread of COVID-19.
Are the rises in cases of gastroenteritis merely coincidental with the seeming rise in cases of pediatric hepatitis? Are they correlated? Is the gastroenteritis itself the cause of the hepatitis?
Obviously, corporate media reporting alone will not lead to definitive answers to these questions. Yet it is not at all unreasonable to posit at least a correlation between the two documented outbreaks. When larger numbers of people are getting sick, it is exceedingly normal for some to become extremely sick. Hepatitis arising from severe gastroenteritis is a known phenomenon, so it would not be surprise for it to be the case this time.
Yet even if there should be no provable link, correlation or causation, between the hepatitis and gastroenteritis outbreaks, both outbreaks are themselves testimony to the degree of imbalance between humanity today and the world around us. The human immune system is not merely a defense mechanism against disease, it is also a primary mode of interaction between our bodies and the natural world. As we are exposed to various microbes, our immune systems hold them in check and keep them from overwhelming our bodies—at least, that is what is supposed to happen.
At present, for significant numbers of people, that is not happening. Despite the lockdowns, the inoculations, and the other therapeutics proffered to contain the SARS-CoV-2 virus, and arguably because of them, we are in a time of growing immunological disequilibrium. We are more sick more often, and less able to ward off sickness.
To the extent this can be attributed to consequences of the Pandemic Panic of the last two years, to that extent at least the “experts" have demonstrably failed to live up to their own hype. At this most fundamental level of general health, the “experts” have failed even by their own standards.