Severity of cases of hepatitis of unknown origin in children considered ‘extremely unusual’

Cases of hepatitis of unknown origin in children have been reported in 20 European countries. While cases of hepatitis of unknown origin are reported every year, the severity of the cases seen this time is “Very strange”According to medical experts.

Cases of idiopathic hepatitis were reported first from the UK, where an increase in cases of acute idiopathic hepatitis was reported on 5 April.

As of 9 June 2022, 402 cases of acute hepatitis of unknown origin have been reported in children 16 years of age or younger across Europe. The vast majority appear in children aged five years or younger.

The UK has the highest rate, with 224 cases. In the European Union, Spain and Italy have recorded the highest number of cases, more than 30 each.

To date, 87 children have been admitted to the intensive care unit and 17 have received liver transplants. On May 12, Irish health authorities announced a hepatitis-related death of a child under 12 years old.

“The gravity of this situation is obviously very worrying, […] We wouldn’t normally see that kind of disease progression, that’s for sure.”Carrie James, Managing Director of Global Hepatitis Alliance.

While some cases of hepatitis of unknown origin are reported each year, Philippa Easterbrook, technical director of the Incident Management Team at WHO Headquarters, said at a summit on hepatitis, “In terms of how concerned we should be about this outbreak, this is the first time that such a large number of cases of severe acute hepatitis have been observed”.

Mrs. Watson refers to itSome of the cases developed liver failure, required transplantation, or caused death. The situation must be taken seriously. An important step at the moment is to understand its cause.”.

Long way to eradicate viral hepatitis in Europe

Although the United Nations aims to eliminate viral hepatitis by 2030, a report published on Wednesday (June 15) found that about a quarter of EU/EEA countries have no action plans or strategies for disease prevention and control.

The reason is still unknown

Speaking about the reasons for this spread, Mr. James said scholars “I didn’t really understand what exactly is going on. Which is really unfortunate.”.

Hepatitis is inflammation of the liver usually caused by a viral infection or excessive alcohol consumption. There are several common types, such as A, B, C, D, and E, all of which have varying levels of infection or cause, but these common A to E viruses were not detected in any of these cases.

“It could be a new virus, or just a form of liver disease caused by something else.”Mr. James said.

Several hypotheses are being studied to understand the cause of this hepatitis in these children. Adenovirus remains the prime suspect, as it was the virus most detected in samples tested in the UK.

“The main hypotheses that are currently held relate to the involvement of adenovirus, which may be related to a cofactor causing more severe infection or immune-mediated liver damage, or the fact that measures taken during the Covid-19 pandemic have resulted in decreased exposure to the youngest age groups and increased vulnerability. “According to a report by the European Center for Disease Control (ECDC).

A link to the Covid-19 vaccine is unlikely, as most cases have not been vaccinated.

The etiology of the disease and its transmission methods are still unknown. The cases do not appear to be related to each other, and very few have epidemiological relevance.

“Although the risk of spread cannot be accurately assessed, with some cases requiring liver transplantation, the potential impact on affected children is considered high.”says the ECDC report.

The possibility of hepatitis is still low

Separately, Sophia Makki, Incident Director at the UK Health Security Agency, said that “Children’s risk of hepatitis remains very low”.

She added that it is important to maintain regular hygiene procedures, “including making sure that children wash their hands regularly and properly, to reduce the spread of many common infections, including adenovirus”.

Symptoms reported to date, as described by the Centers for Disease Control and Prevention, include Marked elevation of transaminases, often accompanied by jaundice, and sometimes preceded by gastrointestinal symptoms, including vomiting, in children 16 years of age and older..

“We continue to remind everyone to be aware of signs of hepatitis, especially jaundice, which appears as a yellowish tinge to the white of the eye, and to contact their doctor if they have any concerns.”Mrs. Makki said.

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