WHO Warns of Two Pandemics that May Be Targeting Children
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Two separate trends suggest pandemics may be targeting children, albeit on a smaller scale than the COVID-19 pandemic. The World Health Organization issued an alarming statement that details a 79% increase in child measles outbreaks globally, as well as another statement warning that 11 countries have reported peculiar acute cases of hepatitis in children.
Acute Hepatitis of Unknown Origin
The concern regarding global cases of acute cases of hepatitis in children stems from an initial report that announced there were 74 cases in the UK alone. This number represents how many cases were reported in children aged 11 months to five years old, over just one month. Clinical presentation includes jaundice, gastrointestinal issues and elevation of liver enzymes. Of the 74 cases reported, no deaths have occurred. Six children have received liver transplants, and several others spent time in hospital settings specialized in liver care.
As of the April 15 report, the UK is considered to be in a status of clinical and public health response. Since the report, 10 additional countries have raised concerns. The WHO indicates that an investigation into whether an adenovirus is responsible for the development of hepatitis is ongoing. Of the 169 cases reported globally, 74 have confirmed the presence of either COVID-19, F-type 41 adenovirus or a combination infection. 17 children globally have undergone liver transplants, and one child has died.
A joint investigation is underway, as the WHO and The European Centre for Disease Prevention and Control determine how to respond to the outbreaks.
Measles in Children
As social distancing guidelines relax with the COVID-19 pandemic, the potential for communicating disease increases. This is true for the highly contagious measles disease. Combined with decreased child vaccinations during the pandemic, the potential for outbreaks of measles increases daily.
According to the statement issued by the WHO, in the first two months of 2022, 17,338 cases were reported globally. This stands in comparison with the 9,665 cases seen in January and February 2021. The countries with the highest numbers of cases are Somalia, Yemen, Ethiopia, Afghanistan and Nigeria. The sharp increase in global child measles cases could be attributed to decreased vaccinations or diminished immunity due to vaccine efficacy or biological factors.
Immediate responses include an increased push for vaccination campaigns to minimize outbreaks.
Vaccine Failures
An article published in Nature, authored by a team of U.S. and U.K.-based experts in clinical science, epidemiology and infectious disease, hypothesized whether low vaccination rates in densely populated areas are the root cause of the measles resurgence, first documented in the late 1980s. This could be due to general inadequate healthcare, resulting from global socioeconomic inequalities.
The article goes on to describe challenges associated with the fact that immunity reliance upon only vaccines is not as strong as a vaccination combined with trans-placentally-given measles antibodies. Thus, children are less equipped to fight infection than when birthed by mothers that had actually contracted the infection.
Speculation has also surrounded vaccine efficacy. Analysis of U.S. measle case data between 2001 and 2019 shows the median percentage of vaccinated cases was 15%. While this number does not specifically report on child cases, the percentage is arguably significant enough to warrant further regulatory investigation.
When vaccinated, the assumption is that a child is protected against contracting measles. However, even with adequate access to healthcare, a substantial number of eligible children do not receive measles vaccinations, as reported by JAMA Pediatrics. This is attributed to a mix of physician opinion and parental vaccine resistance.