Case Update, May 24th, 2022; Omicron variants BA.4 and BA.5, Monkeypox, and Hepatitis in Children of Unknown Cause

This is a case update.  I’ll also talk briefly about new Omicron variants, BA.4 and BA.5, and also the new Monkeypox virus, and several cases of hepatitis in children.

New confirmed cases are still increasing due to the new Omicron BA.2 and BA.2.12.1 variants, which are now nearly 100% of cases in the US.  Hospitalizations are also up in the US.  However, new daily deaths are still not rising in the US or California, with only a temporary blip in San Diego County.  I have often cautioned that deaths trail cases by 2-5 weeks, but for the first Omicron wave in December and January, deaths trailed cases by just 1 week. Since we still aren’t seeing an increase in deaths after 6 weeks, this suggests that the BA.2 variants are not as deadly as even the BA.1 Omicron variants.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Hospitalizations, from the CDC website.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. Graph is presented in a logarithmic format to emphasize small numbers. San Diego County now only releases information Monday and Thursday each week. Data points shown are extrapolated using this information.
Graph is by me, from data collected from San Diego County Public Health. Graph is presented in a linear format. San Diego County now only releases information Monday and Thursday each week. Data points shown are extrapolated using this information.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

I’ll also point out that I continue to have friends who are getting COVID right now, meaning they are getting one of the BA.2 variants.  While some feel bad, none are going to the hospital, and none are becoming a “confirmed case” by getting tested in a medical setting.  If this is true on large scale, then we have lots of infections, maybe even most of them, that are not showing up in the “confirmed case” data.

BA.4 and BA.5:  I’ve heard some news about some more new Omicron variants BA.4 and BA.5.  So far, these variants have not come to the US and have not had a large impact on the pandemic.

Monkeypox virus:  There have been several clusters of Monkeypox cases in Europe, and just a few cases in Canada and the US, about 120 cases in total.  Monkeypox is a pox virus similar to Smallpox.  It is much less much deadly than Smallpox, but can cause death.  It is endemic (widespread and likely permanent) in Africa but does not usually cause serious outbreaks in non-African countries.  It is only moderately infectious, spread by contact and also by respiratory droplets.  It is not spread in aerosol form. Asymptomatic people do not generally transmit the disease.

Those vaccinated against smallpox will still have some immunity against monkeypox.  Pox viruses do not mutate quickly.

All this to say, most infectious disease experts do NOT think that Monkeypox poses a serious health risk to most people, and that it does NOT pose a potential pandemic risk.  Why am I covering this then? Because it’s in the news, and I wanted to clear up any anxiety about the virus.  It will mostly likely not become a big issue in the US.

As a side note, I do NOT intend to cover new infectious diseases forever when the pandemic is over, but may occasionally cover items of special concern.

Mystery hepatitis in children: The suffix “-itis” refers to swelling or inflammation in the body.  The term “hepatitis” refers to swelling or inflammation of the liver.  There are several Hepatitis viruses, (A, B, C, D, and E) but these viruses are not related to each other, and having hepatitis does not necessarily mean that you have one of these viruses.  It can be caused by other things.

A few weeks ago, hundreds of children in countries all over the world had sudden onset hepatitis.  So far, 11 children have died and medical care was necessary for many, including liver transplants.  None of the children had an infection of a Hepatitis virus.

Testing showed that many but not all patients were infected with an Adenovirus upon examination.  Adenovirus infections are very common, and usually have no symptoms, so are often not addressed medically.  Some adenoviruses can cause common cold like symptoms.

So far, 20 individuals tested have had a history of COVID infection, and most individuals were NOT vaccinated against COVID, so at this point, a connection to COVID or a COVID vaccine seems unlikely.

All this to say, the cause of these cases is still unknown, but many in the medical community are currently speculating that they are related to Adenovirus type 41.  At this point, there is no reason for general concern about hepatitis in children, but I will certainly let you know if this changes.

If you or your child experience any of the following, especially in combination, seek medical attention immediately, at least a phone call to your doctor:

Nausea
Abdominal pain
Vomiting
Diarrhea
Jaundice (yellowing of the skin)

Don’t fear, but be smart,
Erik

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