Xinhua News Agency reporter
More than 200 cases of childhood hepatitis of unknown etiology have recently been reported in more than 10 countries around the world, with at least one death, and some cases received liver transplantation. Relevant health departments and experts believe that childhood hepatitis of unknown etiology may be related to adenovirus, and common hygiene measures such as frequent hand washing can help prevent infection.
Multinational report
The bulletin released by the World Health Organization on April 23 shows that at least 169 cases of acute hepatitis of unknown etiology have been reported in children, the United Kingdom, Cases have been reported in the United States, Spain, Israel, Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania and Belgium. Patients ranged in age from 1 month to 16 years, 17 patients required liver transplantation, and at least 1 patient died. Many patients presented with abdominal pain, diarrhea, and vomiting, and most patients had no fever.
A report released by the European Centre for Disease Prevention and Control on April 28 states that as of April 27, 12 countries in the European Economic Area have reported cases of acute hepatitis of unknown etiology in children. In addition to the aforementioned European countries mentioned by WHO, it also includes Austria, Germany and Poland.
The British Health and Safety Authority issued a communiqué on April 29 saying that in the past four days, 34 new cases of childhood hepatitis of unknown etiology have been reported in the UK, bringing the cumulative number of cases to 145. Ten patients received liver transplants, and no patients died. Such cases mainly occur in children under the age of 5, and the symptoms of gastroenteritis such as diarrhea and nausea are initially present, followed by jaundice.
A report released by the Centers for Disease Control and Prevention on April 29 shows that between October 2021 and February 2022, nine cases of acute hepatitis of unknown etiology in children were reported in Alabama. Before admission, some children had symptoms such as vomiting, diarrhea, and upper respiratory tract infection; upon admission, some children had symptoms such as jaundice and hepatomegaly. Three pediatric patients developed acute liver failure, two of whom underwent liver transplantation. All nine child patients have recovered or are recovering.
The Cyprus Ministry of Health reported on April 28 two cases of acute hepatitis of unknown etiology in children, aged 5 and 4, who developed symptoms in November last year and March this year.
The Japanese Ministry of Health, Labour and Welfare announced that as of April 28, 3 cases of childhood hepatitis of unknown etiology had been found in Japan.
Searching for the cause
Studies suggest that adenovirus infection may be associated with increased hepatitis cases in children. There are dozens of known adenoviruses, many of which are associated with cold symptoms such as fever and sore throat. Because many of the above-mentioned childhood hepatitis cases have symptoms that are not typical of adenovirus infection, experts are still investigating other possible causes.
The five common hepatitis viruses A, B, C, D and E were not detected in any of the cases, WHO said. One type of adenovirus was detected in at least 74 cases, of which adenovirus type 41 was detected in 18 cases; the new coronavirus was detected in 20 cases; and both adenovirus and new coronavirus were detected in 19 cases. Adenovirus is a hypothetical cause of these cases. Since the vast majority of childhood hepatitis patients with unknown etiology have not been vaccinated against COVID-19, it can be considered that their hepatitis is not a side effect of vaccination against COVID-19.
The U.S. Centers for Disease Control and Prevention stated that none of the nine patients reported in Alabama had a history of new crown infection, and adenovirus was detected in their blood samples, so these hepatitis cases may be caused by adenovirus. Adenovirus is thought to be a cause of hepatitis infection in immunocompromised children, but its effect on liver damage in healthy children is still under investigation. Adenovirus type 41 was detected in all five of the patients’ samples when they were genetically sequenced, the center said. Adenovirus type 41 is a common cause of acute gastroenteritis in children, usually with diarrhea, vomiting, fever, and respiratory symptoms.
UK Health Safety said it is still investigating whether the increase in childhood hepatitis cases of unknown etiology is related to increased susceptibility to the virus due to reduced exposure to the virus during the Covid-19 pandemic. The adenovirus genome has changed. Will Owen, professor of virology at the University of Nottingham, UK, said adenovirus infection was a possibility, but it had not been proven. There are few case reports of adenovirus infection associated with hepatitis in immunocompetent children or adults in the global literature.
Preventive measures
WHO believes that to prevent recently reported acute hepatitis in children, it is imperative to identify the cause, and recommends frequent handwashing and respiratory hygiene Measures to prevent common viral infections such as adenovirus.
Parents and guardians should be on the lookout for signs of hepatitis in children, including jaundice, and hygiene measures such as hand washing can help reduce Many infections including adenovirus.
The European Center for Disease Control and Prevention believes that due to unknown pathogens and unclear signs of human-to-human transmission, cases in the European Economic Area are in a state of “sporadic with unknown trend”, so it is impossible to accurately estimate at this stage. Health risks of a disease to the European population of children. The center recommends enhanced surveillance and hygiene measures to prevent the disease from continuing to spread. (Note-taking writer: Li Wen; participating reporters: Tan Jingjing, Guo Shuang, Hua Yi)