A British scientist investigating a mysterious global hepatitis outbreak that has infected hundreds of children globally believes researchers are getting closer to identifying its cause as more clues begin to emerge.
Judith Breuer, professor of virology and director of the pathogen genomics unit at University College London, was approached by the UK Health Security Agency to investigate a cluster of cases detected in Scotland last month.
She and a research team at Great Ormond Street Hospital in London are using metagenomics, the study of genetic material, to analyse which viruses are present in the RNA and DNA samples belonging to affected children in the hope it can offer insight into the source of the outbreak.
Although firm conclusions have yet to be made, adenovirus and immune systems weakened by coronavirus lockdowns are thought to be key factors.
What do we know so far?
At least 348 children around the world have been diagnosed with this new hepatitis, with some being forced to undergo liver transplants and some countries, such as Ireland and Indonesia, reporting a small number of deaths.
As of May 12, the HSA reported 176 confirmed cases of sudden onset hepatitis in under-10s in Britain. At least 11 of those have had liver transplants.
The cases are predominantly in children under 5, who showed initial symptoms of gastroenteritis, including diarrhoea and nausea, followed by the onset of jaundice.
None of the usual viruses that cause hepatitis (hepatitis viruses A to E) have been found in the children who have suffered from the recent cases.
What is the role of the adenovirus?
Many of the children who have fallen ill with the condition have tested positive for adenovirus, a typically harmless family of viruses that can cause illnesses ranging from conjunctivitis and pneumonia to the common cold.
Previous findings showed that 91 out of 126 children had adenovirus in their bloodstream.
Prof Breuer says her team is monitoring numerous different examples of adenovirus, including F41, a common type known to cause gastrointestinal problems in children, but which rarely develops into serious illness.
"It's difficult to know whether adenovirus is going around at the moment or if it is just an incidental finding," she told The National. "They're quite difficult to determine what type it is just from ordinary laboratory tests."
Other causes
Prof Breuer also indicated that the HHV-6, a herpes virus which infects young children and sometimes causes hepatitis, has been discovered in the liver samples and may be one of the competing explanations.
Another virus, known as AAV2 or adeno-associated virus has been found "at the highest levels" in all of the liver samples and some theories suggest that it is latent in the body until it is triggered by inflammation or a "catastrophic happening".
Researchers are also looking at whether the hepatitis is an abnormal immunological response within the children to these viruses. Prof Breuer said the cause could be either of these, or perhaps all of the above and that concrete answers remain frustratingly elusive.
Genetic sequencing has revealed that the hepatitis has not been caused by a novel virus, which Prof Breuer says is a welcome development.
Has Covid played a part?
Researchers have also looked at whether Sars-Cov-2, and in particular the Omicron variant, could be to blame for the outbreak of hepatitis in children.
Prof Breuer says Omicron's role is a "big question" but admitted "we don't have the answer".
Although many of the children have tested positive for Covid, metagenomic tests have seemed to play down an adverse reaction to Omicron as the main cause.
"We haven't found Omicron in our tests as a whole but it has certainly has been found in some children," Prof Breuer said. "We haven't found it from our metagenomics, for example. So at the moment, it remains uncertain what role it might in the in the genesis of this of this problem".
However, she does believe that social distancing resulting from coronavirus lockdowns may have resulted in lowered immune systems as viruses begin to circulate all at once.
"It's difficult to exclude the fact that this has happened now and it has not really been observed before," Prof Breuer said. "So I would speculate that something to do with the pandemic has actually affected this."
"It was such an upheaval, it's such as a schism in our lives. Who knows what impact that will have had on our immune systems and on the pathogens that are circulating?"
With vaccine scepticism still a widespread issue, Prof Breuer said the children are too young to have received their coronavirus shots and vaccination is not a line of inquiry.
What should parents do?
Prof Breuer said she was hopeful that the outbreak may have peaked and said that recent evidence showed the rate of increase in cases was falling.
However, she said she was unsure as to why Britain seems to be the epicentre of this outbreak as it accounts for nearly half of all global cases. Health authorities in Britain may have been more vigilant, Prof Breuer says, and expects the rest of the world will soon catch up.
In lieu of government advice, concerned parents have been urged to practise good hygiene and to seek medical advice if their children show symptoms of hepatitis, which include yellow or pale eyes and discoloured faeces.
"It's difficult to know what one would do without knowing what causes it," Prof Breuer said. "We're still trying to investigate what causes it and to take time and do the tests rigorously.
"I think the advice that has been given people is to practice good hygiene. We can't really say anything specific about what people should do to prevent it, we would not be correct in doing that."
Company%20profile
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Racecard
2pm Handicap Dh 90,000 1,800m
2.30pm Handicap Dh120,000 1,950m
3pm Handicap Dh105,000 1,600m
3.30pm Jebel Ali Classic Conditions Dh300,000 1,400m
4pm Maiden Dh75,000 1,600m
4.30pm Conditions Dh250,000 1,400m
5pm Maiden Dh75,000 1,600m
5.30pm Handicap Dh85,000 1,000m
The National selections:
2pm Arch Gold
2.30pm Conclusion
3pm Al Battar
3.30pm Golden Jaguar
4pm Al Motayar
4.30pm Tapi Sioux
5pm Leadership
5.30pm Dahawi
UAE v Gibraltar
What: International friendly
When: 7pm kick off
Where: Rugby Park, Dubai Sports City
Admission: Free
Online: The match will be broadcast live on Dubai Exiles’ Facebook page
UAE squad: Lucas Waddington (Dubai Exiles), Gio Fourie (Exiles), Craig Nutt (Abu Dhabi Harlequins), Phil Brady (Harlequins), Daniel Perry (Dubai Hurricanes), Esekaia Dranibota (Harlequins), Matt Mills (Exiles), Jaen Botes (Exiles), Kristian Stinson (Exiles), Murray Reason (Abu Dhabi Saracens), Dave Knight (Hurricanes), Ross Samson (Jebel Ali Dragons), DuRandt Gerber (Exiles), Saki Naisau (Dragons), Andrew Powell (Hurricanes), Emosi Vacanau (Harlequins), Niko Volavola (Dragons), Matt Richards (Dragons), Luke Stevenson (Harlequins), Josh Ives (Dubai Sports City Eagles), Sean Stevens (Saracens), Thinus Steyn (Exiles)
The President's Cake
Director: Hasan Hadi
Starring: Baneen Ahmad Nayyef, Waheed Thabet Khreibat, Sajad Mohamad Qasem
Rating: 4/5
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
'The worst thing you can eat'
Trans fat is typically found in fried and baked goods, but you may be consuming more than you think.
Powdered coffee creamer, microwave popcorn and virtually anything processed with a crust is likely to contain it, as this guide from Mayo Clinic outlines:
Baked goods - Most cakes, cookies, pie crusts and crackers contain shortening, which is usually made from partially hydrogenated vegetable oil. Ready-made frosting is another source of trans fat.
Snacks - Potato, corn and tortilla chips often contain trans fat. And while popcorn can be a healthy snack, many types of packaged or microwave popcorn use trans fat to help cook or flavour the popcorn.
Fried food - Foods that require deep frying — french fries, doughnuts and fried chicken — can contain trans fat from the oil used in the cooking process.
Refrigerator dough - Products such as canned biscuits and cinnamon rolls often contain trans fat, as do frozen pizza crusts.
Creamer and margarine - Nondairy coffee creamer and stick margarines also may contain partially hydrogenated vegetable oils.
More coverage from the Future Forum
Gulf Under 19s final
Dubai College A 50-12 Dubai College B
Specs
Engine: Duel electric motors
Power: 659hp
Torque: 1075Nm
On sale: Available for pre-order now
Price: On request
The biog
Born: Kuwait in 1986
Family: She is the youngest of seven siblings
Time in the UAE: 10 years
Hobbies: audiobooks and fitness: she works out every day, enjoying kickboxing and basketball
Who's who in Yemen conflict
Houthis: Iran-backed rebels who occupy Sanaa and run unrecognised government
Yemeni government: Exiled government in Aden led by eight-member Presidential Leadership Council
Southern Transitional Council: Faction in Yemeni government that seeks autonomy for the south
Habrish 'rebels': Tribal-backed forces feuding with STC over control of oil in government territory
Milestones on the road to union
1970
October 26: Bahrain withdraws from a proposal to create a federation of nine with the seven Trucial States and Qatar.
December: Ahmed Al Suwaidi visits New York to discuss potential UN membership.
1971
March 1: Alex Douglas Hume, Conservative foreign secretary confirms that Britain will leave the Gulf and “strongly supports” the creation of a Union of Arab Emirates.
July 12: Historic meeting at which Sheikh Zayed and Sheikh Rashid make a binding agreement to create what will become the UAE.
July 18: It is announced that the UAE will be formed from six emirates, with a proposed constitution signed. RAK is not yet part of the agreement.
August 6: The fifth anniversary of Sheikh Zayed becoming Ruler of Abu Dhabi, with official celebrations deferred until later in the year.
August 15: Bahrain becomes independent.
September 3: Qatar becomes independent.
November 23-25: Meeting with Sheikh Zayed and Sheikh Rashid and senior British officials to fix December 2 as date of creation of the UAE.
November 29: At 5.30pm Iranian forces seize the Greater and Lesser Tunbs by force.
November 30: Despite a power sharing agreement, Tehran takes full control of Abu Musa.
November 31: UK officials visit all six participating Emirates to formally end the Trucial States treaties
December 2: 11am, Dubai. New Supreme Council formally elects Sheikh Zayed as President. Treaty of Friendship signed with the UK. 11.30am. Flag raising ceremony at Union House and Al Manhal Palace in Abu Dhabi witnessed by Sheikh Khalifa, then Crown Prince of Abu Dhabi.
December 6: Arab League formally admits the UAE. The first British Ambassador presents his credentials to Sheikh Zayed.
December 9: UAE joins the United Nations.
Messi at the Copa America
2007 – lost 3-0 to Brazil in the final
2011 – lost to Uruguay on penalties in the quarter-finals
2015 – lost to Chile on penalties in the final
2016 – lost to Chile on penalties in the final
2024%20Dubai%20Marathon%20Results
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BULKWHIZ PROFILE
Date started: February 2017
Founders: Amira Rashad (CEO), Yusuf Saber (CTO), Mahmoud Sayedahmed (adviser), Reda Bouraoui (adviser)
Based: Dubai, UAE
Sector: E-commerce
Size: 50 employees
Funding: approximately $6m
Investors: Beco Capital, Enabling Future and Wain in the UAE; China's MSA Capital; 500 Startups; Faith Capital and Savour Ventures in Kuwait
THE BIO
Mr Al Qassimi is 37 and lives in Dubai
He is a keen drummer and loves gardening
His favourite way to unwind is spending time with his two children and cooking
The%20pillars%20of%20the%20Dubai%20Metaverse%20Strategy
%3Cp%3EEncourage%20innovation%20in%20the%20metaverse%20field%20and%20boost%20economic%20contribution%3C%2Fp%3E%0A%3Cp%3EDevelop%20outstanding%20talents%20through%20education%20and%20training%3C%2Fp%3E%0A%3Cp%3EDevelop%20applications%20and%20the%20way%20they%20are%20used%20in%20Dubai's%20government%20institutions%3C%2Fp%3E%0A%3Cp%3EAdopt%2C%20expand%20and%20promote%20secure%20platforms%20globally%3C%2Fp%3E%0A%3Cp%3EDevelop%20the%20infrastructure%20and%20regulations%3C%2Fp%3E%0A
Desert Warrior
Starring: Anthony Mackie, Aiysha Hart, Ben Kingsley
Director: Rupert Wyatt
Rating: 3/5
Where to buy
Limited-edition art prints of The Sofa Series: Sultani can be acquired from Reem El Mutwalli at www.reemelmutwalli.com
Match info
Manchester United 0-0 Crystal Palace
Man of the match: Cheikhou Kouyate (Crystal Palace)
%E2%80%98FSO%20Safer%E2%80%99%20-%20a%20ticking%20bomb
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