Health
Acute severe hepatitis of unknown cause in children reported in more than a dozen countries, 17 required liver transplantation
NewsDesk @ bactiman63
World Health Organization (WHO) this weekend Outbreak overview released Onset of acute severe hepatitis of unknown cause in children.
Here is some of that information:
As of April 21, 2022, at least 169 cases of unexplained acute hepatitis have been reported from 11 countries in the WHO European region and one in the WHO region of the Americas. Cases are UK and Northern Ireland (UK) (114), Spain (13), Israel (12), United States (9), Denmark (6), Ireland (<5), Netherlands (4), Italy (4), Norway (2), France (2), Romania (1), and Belgium (1).
Cases are 1 month to 16 years old. Seventeen children (about 10%) needed a liver transplant. At least one death has been reported.
The clinical syndrome in the identified case is acute hepatitis (liver inflammation) with markedly elevated liver enzymes. In many cases, gastrointestinal symptoms such as abdominal pain, diarrhea, and vomiting are reported, severe acute hepatitis occurs, and liver enzymes (aspartate transaminase (AST) or alanine aminotransaminase (ALT) exceed 500 IU / L). And the level of jaundice has increased. In most cases, there was no fever. The common viruses that cause acute viral hepatitis (hepatitis viruses A, B, C, D, and E) have not been detected in any of these cases. International travel or links to other countries based on currently available information have not been identified as a factor.
Adenovirus has been detected in at least 74 cases, and 18 of the cases with information on molecular testing have been identified as F-type 41. SARS-CoV-2 was identified in 20 tested cases. In addition, 19 people were detected with co-infection with SARS-CoV-2 and adenovirus.
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Adenovirus is currently one hypothesis as the root cause, but it does not fully explain the severity of the clinical picture. Infection with the adenovirus type involved, adenovirus type 41, has not previously been associated with such clinical manifestations. Adenovirus is usually a common pathogen that causes self-limited infections. They spread from person to person and most commonly cause respiratory illness, but depending on the type, gastroenteritis (inflammation of the stomach and intestines), conjunctivitis (pink eye), cystitis (cystitis), etc. It can also cause other illnesses. There are more than 50 immunologically different adenoviruses that can cause infections in humans. Adenovirus type 41 usually manifests as diarrhea, vomiting, fever and is often accompanied by respiratory symptoms. Although there are cases of hepatitis in immunocompromised children infected with adenovirus, adenovirus type 41 is not known to be the cause of hepatitis in otherwise healthy children.
Factors such as increased adenovirus susceptibility following decreased circulation levels of adenovirus during the COVID-19 pandemic, potential emergence of new adenovirus, and co-infection with SARS-CoV-2 need to be further investigated. The hypothesis associated with the side effects of the COVID-19 vaccine is currently unsupported, as the majority of affected children were not COVID-19 vaccinated. Other infectious and non-infectious descriptions should be excluded to fully assess and manage risk.
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