Alberta doctors on the lookout for severe and unexplained hepatitis in kids

Doctors in Alberta are watching for any signs of a severe and mysterious form of hepatitis in kids and teens that is baffling doctors and scientists around the world.

Nearly 200 cases of acute liver disease have been found in kids, ranging in age from one month to 16, in at least a dozen countries.

So far, 17 children have required liver transplants and there has been at least one death.

While federal health officials say several cases are under investigation in young Canadian children, the condition has not been identified in any Alberta kids.

"There have been no confirmed cases of severe unexplained hepatitis in Alberta to date. We'll continue to update Albertans as appropriate," Alberta Health spokesperson Lisa Glover said in a statement emailed to CBC News on Friday.

Officials did not respond to questions from CBC News about whether any of the Canadian cases under investigation are in Alberta.

No identified cause

The illness is particularly puzzling because researchers have been unable to pinpoint a cause. 

"There are many causes for hepatitis, but in these cases the most common causes have been ruled out and it is not clear what led to the condition," said Dr. Deena Hinshaw, Alberta's chief medical officer of health, in a news conference on Wednesday.

"There is a great deal of work being done on this globally and some cases have had an adenovirus, which is a common cold virus, identified. It is not clear if this virus is causing the hepatitis, but it is one possible cause being explored."

The World Health Organization said this week that adenovirus has been detected in at least 74 cases, SARS-CoV-2 has been identified in other cases and some children have tested positive for both.

The unexpected surge in acute hepatitis in children has doctors in Alberta on alert.

"I am concerned," said  Dr. Tehseen Ladha, an Edmonton-based pediatrician and assistant professor in the faculty of medicine at the University of Alberta.

"It's made us more on the lookout and more vigilant for some of these symptoms that we may not normally do blood work for. So if a child has abdominal pain, diarrhea, vomiting — those are not normally things that we would work up with blood work. But knowing that hepatitis is occurring all over the world in children, those sorts of things we will look at more closely now to determine whether that child needs blood work and more investigations."

Alberta Children's Hospital ER physician Dr. Stephen Freedman cautioned parents against panic.

"The risk to children in Canada is exceedingly, exceedingly low at this point in time," said Freedman who also teaches pediatrics at the University of Calgary's Cumming School Of Medicine.

"I don't think parents should be worrying about it in the day to day activities of their life."

Freedman noted gastrointestinal symptoms are commonly seen in the pediatric emergency room. However, he's seeing no worrisome signs.

"What really should be a red flag to parents or physicians [and] health care providers is children who have any really dark, tea-coloured urine, or if their skin or eyes have a yellow-ish hue to them. That would be concerning that the liver is actually involved in whatever process is going on," he said.

"None of the kids that we are seeing to the best of my knowledge have any additional concerning features that would make us worry about liver failure."

Health officials say if there is an infectious cause behind this illness, measures such as handwashing, mask-wearing, and staying home when sick, can help.

"We are working to provide information to frontline physicians on this topic as usual," Glover said.

"We are working closely with federal, provincial and territorial partners to monitor emerging information, and are waiting on [the Public Health Agency of Canada] to provide a standardized national minimum data reporting set, which we anticipate will be available soon."