On the 5th of April 2022, cases of adenovirus-induced hepatitis were reported in Scotland and then reached multiple parts of the world. While adenovirus normally presents with diarrhea, vomiting, and fever, these novel cases also resulted in the development of fulminant hepatitis in non-immunocompromised cases. The responsible pathogen “Adenovirus 41” is an enterovirus. Enteroviruses are spread by the fecal-oral route and are resistant to drying. As such, they predominate in sewage water. Hepatitis is normally restricted to poorer countries, yet this new wave seems to be confined to mostly high-income countries in Europe and the USA. These countries treat and recycle a higher percentage of sewage water. We also propose that the fulminant nature of this strain could be due to either a cross-species mutation or the general decrease in trained immunity post-COVID-19 lockdown. Evidence strongly suggests that the link between these new hepatitis cases is recycled sewage water. This should warrant further investigations on the origin of this outbreak by re-visiting the role of recycled sewage water in causing such outbreak.

中文翻译：

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重新审视循环污水在高收入国家在“2022 年小儿肝炎”暴发等腺病毒暴发中被忽视的作用

2022 年 4 月 5 日，苏格兰报告了腺病毒引起的肝炎病例，然后传播到世界多个地区。虽然腺病毒通常表现为腹泻、呕吐和发烧，但这些新病例也导致非免疫功能低下病例发展为暴发性肝炎。负责任的病原体“腺病毒 41”是一种肠道病毒。肠道病毒通过粪口途径传播，对干燥有抵抗力。因此，它们在污水中占主导地位。肝炎通常仅限于较贫穷的国家，但这一新浪潮似乎仅限于欧洲和美国的大部分高收入国家。这些国家处理和回收更高比例的污水。我们还提出，这种菌株的暴发性可能是由于跨物种突变或 COVID-19 锁定后受过训练的免疫力普遍下降所致。证据有力地表明，这些新的肝炎病例之间的联系是循环使用的污水。这应该有必要通过重新审视回收污水在导致这种爆发中的作用来进一步调查这次爆发的起源。