Author Huang Zhiheng Pediatrics Huang Ge Huang Dr. Huang
recently, about Unexplained childhood hepatitis has become a hot issue, and many doctors and parents with children are discussing it.
According to WHO’s official website, as of April 21, multiple countries reported at least 169 cases of acute hepatitis of unknown origin, and adenovirus was found in at least 74 cases. As of April 21, 2022, 12 European and American countries have reported at least 169 cases of unexplained hepatitis in children aged 1-16 years. Adenovirus was detected in a considerable number of cases, and a small number of cases were combined with new coronavirus infection.
The UK was the first to report a significant increase in associated acute hepatitis cases, usually in healthy, young children. About 17 of the sick children (about 10%) required liver transplantation, and at least one death was reported.
Increasing information suggests that this disease may be associated with adenovirus infection span>
77% of cases in the UK were positive for adenovirus, and all nine cases in Alabama, USA, were positive for adenovirus. In immunocompromised individuals, hepatitis is a clear complication of adenovirus infection, but these children were otherwise healthy before the onset, so agencies are actively investigating other possible contributing factors, such as other infections (including COVID-19) ) or environmental factors.
Listen to the opinions of experts in Shanghai on children suffering from unexplained hepatitis in many countries
Common viruses that cause acute viral hepatitis ( HBV) was not detected in these cases. Based on currently available information, international travel or connections to other countries have not been identified as contributing factors.
The outbreak of adenovirus pneumonia in children in my country in 2019 is still fresh in my memory.
adenovirus
no Like the new coronavirus, adenovirus is a relatively old virus, and spring is the season when adenovirus is more active. An important cause of febrile diseases in young children, 5% to 10% of febrile diseases in infants and young children are caused by adenovirus. Adenoviruses cause multiple systemic lesions.
respiratory
adenovirus Infections most commonly cause upper respiratory tract syndromes, such as common cold symptoms, acute pharyngitis, etc.
It can also cause lower respiratory tract infections, such as bronchitis, pneumonia.
Gastrointestinal
Adenovirus can also cause diarrhea, such as adenovirus enteritis, which I see from time to time as a gastroenterologist Some children had abdominal pain and diarrhea, and stool tests found that it was an intestinal adenovirus infection.
Eyes
Adenoviruses also cause eye inflammation, such as adenovirus keratitis, adenovirus conjunctivitis.
Others: genitourinary, neurological and disseminated diseases.
Most adenovirus infections resolve on their own and may not require a doctor visit.
Treatment is generally supportive. Cidofovir is the most commonly used antiviral drug for the treatment of adenovirus infection, but has severe nephrotoxicity, so it is only used in severe cases.
Prevention
Adenovirus can be transmitted from person to person through droplets, fecal-oral route and exposure to pollutants , The best way to prevent adenovirus infection is to pay attention to hand hygiene and regular hygiene. Parents should educate their children to develop good hygiene habits.
When is hepatitis suspected in my child?
Children with the following signs and symptoms may have liver function tests, including:
1. Dark urine and/or pale stools
2. Jaundice
3. Itching
4. Arthralgia/muscle Pain
5. Fever
6. Nausea, vomiting, or abdominal pain
7. Drowsiness and/or loss of appetite
Adenovirus 41 typically presents with diarrhea, vomiting, and fever, often with respiratory symptoms. However, there is no report of adenovirus type 41 causing hepatitis in healthy children, because we have also found children infected with adenovirus type 41 in clinical practice, but the liver function is normal.
Whether adenovirus can cause hepatitis, and whether adenovirus has new mutations, etc., requires a scientific attitude. It is difficult to draw a clear conclusion at present. Follow-up findings such as pathology of children internationally are needed.
At present, for parents, there is no need to panic, the best way to prevent adenovirus infection is to pay attention to hand hygiene and regular hygiene, and preventing infection is the best way. important.
References: Lectures by Professor Zeng Mei, an expert in Shanghai Children’s Infectious Diseases, Baidu Encyclopedia, Physician News, Modern Parenting Encyclopedia, etc.
Source: The Paper