Occurrence of hepatitis of unknown origin in children in 11 countries

Recently, 11 countries around the world are experiencing an outbreak of unspecified severe acute hepatitis in children, mainly affecting children under 10 years of age.

World Health Organization (WHO).

11 countries have outbreaks of unspecified hepatitis in children

According to the World Health Organization (WHO), acute hepatitis in children is breaking out in 11 countries, including the US, so far, 169 cases have been recorded, the youngest patient is 1 month old. age, at least 1 patient died and 17 children required liver transplantation.

According to a statement from WHO on April 23: 'It is not yet clear whether hepatitis cases are on the rise, or whether hepatitis is occurring at the rate expected but previously. has been diagnosed, and is currently being detected, due to increased awareness of hepatitis'. 'Although adenovirus is a possible hypothesis, an investigation into the pathogen has been launched.'

The statement said: 'The symptoms of the confirmed case were acute hepatitis, markedly elevated liver enzymes.'

According to CNN, the patients ranged in age from 1 month to 16 years old.

WHO says laboratory tests have ruled out hepatitis A, B, C, D and E.

CNN reports that although the majority of children do not have a fever, many have gastrointestinal symptoms such as abdominal pain, diarrhea and vomiting, as well as elevated liver enzymes and jaundice 'before developing inflammatory disease. severe acute liver'.

On April 19, the European Center for Disease Control and Prevention (ECDC) announced that hepatitis of unknown cause, first detected in children in the UK, has been found in several countries Europe and America. WHO has also begun monitoring, warning that more cases could be detected until the cause is identified and specific prevention and control measures are in place.

The ECDC has also issued a notice reminding doctors that there have been several cases of severe acute hepatitis of unknown cause in children in the UK, US and parts of Europe, the Middle East and Asia. . Hepatitis A, B, C, D, E. viruses were ruled out after laboratory testing.

Hepatitis is usually caused by a virus, of which there are at least 74 cases where a common virus known as 'adenovirus' has been found, but adenoviruses do not usually cause severe hepatitis in people without serious health problems.

According to WHO and ECDC, as of April 21, a total of 169 cases have been confirmed, including 114 in the UK, 13 in Spain, 12 in Israel and 9 in the US. In addition, countries such as Denmark, Italy, the Netherlands, Ireland, France, Norway, Belgium and Romania, also reported similar cases, and recently in Japan also reported a suspected case. doubt.

According to the Japanese Ministry of Health, Labor and Welfare, a patient in Japan is suspected of having severe acute hepatitis of unknown cause in children, but did not disclose age, address, sex and other patient information.

Symptoms of hepatitis of unknown origin are jaundice, diarrhea, vomiting, abdominal pain

The WHO said the investigation should focus on whether children with less exposure to the adenovirus have become more susceptible to the adenovirus as a result of reduced transmission during the COVID-19 outbreak, or whether the possibility of a new strain of adeno virus or not, or a combination with a new corona virus.

The US CDC issued medical advice this week on cases of acute hepatitis of unknown origin, recommending that children with hepatitis should consider testing for adenovirus.

According to the ECDC, most cases are under the age of 10 and have symptoms such as jaundice, diarrhea, vomiting and abdominal pain. Most of the cases did not have fever, some were severe, of which 17 patients required liver transplantation and 1 patient died.

Tested cases ruled out hepatitis A, B, C, D and E viruses, while novel coronavirus (SARS-CoV-2) or adenovirus was detected in some cases. During the investigation of the pathogenic mechanism, no clear epidemiological correlation has been found, however infectious, chemical and toxic symptomatic factors need to be fully investigated.

ECDC urges all physicians to be on high alert, such as children with acute hepatitis symptoms and ALT elevations more than 2.5 times, excluding factors such as drugs, toxic hepatitis, hepatitis autoimmune, alcoholic hepatitis, biliary tract disease, cardiovascular disease, and serology, if the results of medical laboratory markers (IgM anti-HAV, IgM anti-HBc, HBsAg, anti-HCV, IgM anti -HEV) are negative, please go to the infectious disease notification system as soon as possible and select the 'acute unspecified viral hepatitis' disease section to provide information.