The mysterious virus attacking liver has not been detected in Estonia

Children's hospital. Photo: Kristjan Teedema

The liver disease which is suspected to have been caused by an adenovirus, which can occasionally cause severe consequences and has infected nearly 200 children under the age of 10 globally, has not yet been found in Estonia.

“I recommend that we should stay calm for the time being,” says Katrin Luts, manager of Tallinn Children's Hospital, who says that there have always been adenoviruses and that other viruses, such as the influenza virus, can have very serious consequences as well.

A total of 200 cases of liver disease of unknown origin have been identified among children in the United Kingdom, Spain, Denmark, Ireland, the Netherlands, Italy, France, Norway, Romania, Belgium, as well as in the United States, Canada, Japan and Israel.

“Considering the small number of cases, there is too little data to research the disease and reach any definite conclusions. In any case, it is not a corona-like pandemic so that we could do something to prevent it,” says Luts. Severe corona infection can be prevented with vaccination, but the normal recommendation against adenovirus infection is to avoid contact with sick people, stay home when infected and wash the hands.

“I talked to my British colleagues last night who are studying the infection, and they also confirmed that they still know very little about the disease,” says Irja Lutsar, a microbiologist and former head of the government’s science council. “The number of cases is low but the consequences have been severe – there were nearly ten liver transplants due to liver failure and one child died.”

According to Lutsar, the search for the causes of the disease is still in progress. “The adenovirus type 41 is suspected, but it has not been found in nearly half of those infected, nor have all the victims been infected with the corona. The association with corona vaccines has not been confirmed either, as almost none of these children have received vaccine shots,” she explains.

Lutsar mentioned the recent isolation due to the corona pandemic as an indirect cause. “Viruses are changing rapidly and the organism must be exposed to viruses all the time, but the children stayed home for a long time during the lockdown. It is the younger children who have had fewer social contacts who are currently ill,” the microbiologist said.

“Adenovirus infections are often severe in people with immunodeficiency, so that we are not dealing with a harmless thing,” Lutsar says. “The virus does not cause cold in the head, but inflammation of the lymph nodes and eyes – inflamed eyes happen often in kindergartens.” This is often followed by a fever lasting up to ten days, which is confused with bacterial inflammation, which is not subject to antibiotic treatment.

“There are numerous subtypes of adenoviruses but they are not identified in everyday work just like the variants of the coronavirus – we do not have that ability,” says the hospital manager Luts and adds that adenovirus also differs from influenza virus in that besides the respiratory symptoms it causes gastrointestinal symptoms such as diarrhea and stomach ache.

At present, however, more urgent issues are waiting for solutions in the children's hospital. Luts says that a lot of energy is spent on rearranging the queues in case a small patient or the child’s parents have tested positive for corona and cannot come for surgery, for example. Moreover, flu and stomach viruses have not gone anywhere.

In addition, the burden of the emergency room has expanded significantly: “Almost 20 percent of the work is related to the war refugees from Ukraine,” says Luts. Historically, viral illnesses have been the predominant cause of admission to children's hospitals. Too many families arrive in the emergency room, whose mothers are worried about the child's illness, and believe that a phone call to the general practitioner’s nurse is not enough. “Pediatricians were taught that if a mother is seriously worried, something must be done to remove that worry, and this may require physical contact with the doctor,” says the hospital manager. It also helps to detect unknown diseases faster.