Toronto SickKids Hospital Reports 7 Probable Cases of Acute Hepatitis of ‘Unknown Origin’

The Hospital for Sick Children in Toronto is shown on April 5, 2018. The Canadian Press/Doug Ives

Toronto’s Hospital for Sick Children says it has identified seven probable cases of severe acute hepatitis of unknown origin.

The research and pediatric hospital, also known as SickKids, says the cases were identified between Oct. 1, 2021, and April 30, 2022, and reported to Public Health Ontario (PHO).

“SickKids physicians from the Divisions of Infectious Diseases and Gastroenterology, Hepatology and Nutrition are aware of the international reports concerning children with severe acute hepatitis of unknown origin,” said spokeswoman Jessamine Luck in a May 11 statement.  

“They are looking out for patients with signs and symptoms of hepatitis such as new onset jaundice (yellow eyes), dark urine and/or pale stool that will require further testing, and are recommending a lower threshold for referral for specialist care.” 

The unexplained hepatitis outbreak has affected more than 300 children worldwide.

Luck said that every year the hospital sees children with severe acute hepatitis of unknown origin who, like the rest of their patient population, come from throughout Ontario and Canada. She could not say if the seven cases singled out by SickKids were different from prior years. 

“It remains to be seen whether this number represents an increase in cases of unknown origin compared to similar time periods in previous years or if any of these cases will be confirmed to be caused by a novel clinical entity,” Luck said.  

The Epoch Times sought comment from PHO and was referred to the provincial Ministry of Health (MOH). 

MOH spokesman Bill Campbell said the seven cases at SickKids are in the “process of being officially reported to the appropriate health authorities.” 

He added that the province is monitoring for new cases, and working with PHO and the Public Health Agency of Canada (PHAC).

“The Chief Medical Officer of Health has reached out to primary care providers, paediatricians, and public health units and has requested clinicians be vigilant in watching for infants and children up to 16 years of age presenting with signs and symptoms of hepatitis,” Campbell said in a statement. 

Worldwide Cases

The mysterious cases of acute hepatitis found in children were first reported by the UK International Health Regulations National Focal Point on April 5.

On April 23, the World Health Organization (WHO) announced that at least 169 cases of acute hepatitis of unknown origin had been reported from a dozen countries, with the UK having the most at 114.  

WHO says the hepatitis cases involved children aged 1 month to 16 years old, many of whom suddenly developed gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting, followed by an onset of jaundice.

The organization also noted that most of them did not have a fever, and none of them had any of the five common hepatitis viruses—A, B, C, D, and E.

By May 10, the WHO updated that 348 probable cases have been reported in 21 countries, with 26 children requiring liver transplants. 

In an emailed statement to The Epoch Times on May 11, the PHAC confirmed it is aware of the cases at SickKids.

“These cases are being reviewed by the province, and those that meet the case definition will be reported to PHAC to be included in the national investigation,” spokesperson Anne Génier said.  

She added that the agency had alerted provincial and territorial public health authorities on April 14 to watch for potential cases and, like the SickKids’ assessment, PHAC could not identify the underlying cause. 

“At this time, we do not know if we are seeing an increase in the number of cases of acute hepatitis of unknown cause in children. More information is needed to assess the situation and any potential risks to people in Canada,” Génier said.

She stressed that the agency is working closely with provincial, territorial, and international partners on “this evolving event.” 

“We are prepared to carefully and thoroughly investigate any cases reported to PHAC that meet the national case definition. This will help us to determine the national scope in Canada, and to determine if cases of acute hepatitis in Canada may be related to other cases reported around the world.” 

Vaccines Ruled Out

On May 6, the U.S. Centers for Disease Control and Prevention (CDC) said 109 cases across 24 U.S. states and Puerto Rico are under investigation. Approximately 90 percent of the children required hospitalization. Five have died, and others needed liver transplants.

In its report, the CDC said it didn’t find any evidence that COVID-19 vaccines caused this outbreak of hepatitis among children as none of the initial patients in Alabama had received the vaccine.  

The same day, the UK Health Security Agency reported that dating back to early January, the country’s case count rose to 163, with 11 children receiving liver transplants so far.  

“Adenovirus remains the most frequently detected potential pathogen. Amongst 163 UK cases, 126 have been tested for adenovirus of which 91 had adenovirus detected,” said the agency. “Amongst cases the adenovirus has primarily been detected in blood.” 

UK officials also ruled out the COVID-19 vaccine as a potential cause.

Meanwhile, a report published in the U.S. Journal of Hepatology in late April suggests taking COVID-19 vaccines “may trigger immune-mediated hepatitis.”

The report describes the case of a 52-year-old man in Germany who developed acute hepatitis two to three weeks after receiving an mRNA-based COVID-19 vaccine from Pfizer-BioNTech.  

Researchers said the man’s immune response to the vaccine may have contributed to his liver inflammation as it “may trigger immune-mediated hepatitis by mechanisms linked to vaccine-induced cellular immunity.” 

Jack Phillips, Gabrielle Stephenson, and The Canadian Press contributed to this report.