The new coronary pneumonia epidemic has not yet ended, and another hepatitis is emerging due to unknown reasons.
Comprehensive World Health Organization (referred to as " WHO ") and the European Center for Disease Control and Prevention reported that nearly 200 cases of hepatitis in children with unknown causes have occurred in at least 12 countries around the world, which has attracted attention and concern from many countries.
WHO said that although adenovirus is a hypothesis that the underlying cause is currently, it does not fully explain the severity of the clinical situation. In addition, the assumptions related to the side effects of the COVID-19 vaccine are not currently supported, because most affected children are not vaccinated because they are too young.
At present, WHO, the European Center for Disease Control and Prevention and medical experts from many countries around the world are studying the causes of their diseases and discussing response measures and solutions.
How many cases of hepatitis in children with unknown causes have been found so far?
On April 5, 2022, the UK reported to the WHO for the first time that the number of children suffering from severe acute unknown hepatitis in the UK has increased significantly. After April 8, similar cases began to appear in , Ireland, , Spain and other places in Europe.
WHO mentioned the above situation in a briefing on April 15 and provided the latest overview of unknown hepatitis cases in the briefing on April 23.
WHO data shows that as of April 21, at least 169 children in 12 countries have been infected with this unknown hepatitis, including 11 European countries and 1 American country. On April 26, the European Center for Disease Control and Prevention released higher estimates, with nearly 200 such cases worldwide.
htmlOn April 26, the Japan Times and other Japanese media reported that Japan had the first suspected case in Asia. On April 27, according to reports from Canadian media such as CBC, Canada is investigating unknown cases to determine whether they belong to the above-mentioned cases of hepatitis due to unknown reasons.Why is hepatitis of unknown cause worrying?
Military hepatitis in children is not unheard of. Why is the unknown case of hepatitis caused concern? Many foreign media reported that one of the reasons is that such unknown hepatitis can have serious symptoms.
The WHO notice on April 23 pointed out that patients with hepatitis due to unknown reasons are between 1 month and 16 years old. Their symptoms include a significant increase in liver enzyme , accompanied by jaundice , and sometimes gastrointestinal symptoms such as diarrhea, vomiting and abdominal pain. Most cases do not have fever symptoms.
Before being diagnosed with hepatitis of unknown causes, children are usually healthy, but after illness, they may be so severe that they need a liver transplant or even die. In its April 23 briefing, WHO mentioned that among the cases of unknown hepatitis, 17 required liver transplantation and at least one death.
"This is absolutely unusual. The reason I say that is because it is fulminant hepatitis, which basically means that these children's livers have completely failed, which is extremely rare in childhood, putting us all on high alert," said Asha Bowen, a researcher at the Telethon Kids Institute, a medical researcher at Australia.
According to CNN (CNN), Wisconsin, USA, is investigating whether several unknown hepatitis cases are related to such unknown hepatitis, with one death. The report said that if the cause of this death is confirmed to be related to such unknown hepatitis, it would be the first death in the United States related to such unknown hepatitis.
Another reason people are concerned about is that current studies show that most of these hepatitis patients are children and are not related to the common virus that causes hepatitis.
On November 6, 2020, in Shanghai, the medical device and medical health exhibition area of the CIIE, GlaxoSmithKline exhibited a recombinant hepatitis B vaccine. Data photo/IC photo
The most common cause of hepatitis is infection, among which Hepatitis A, B, C, D and E Hepatitis are typical viral hepatitis , but all affected children did not detect the common hepatitis virus mentioned above.
Alcohol , certain drugs and Hydrome immune system disease can also cause hepatitis. Sometimes, hepatitis can also be caused by unknown reasons. However, this severe case of liver failure is particularly rare in children.
"Although there are still a small number of cases of such unknown hepatitis at present, the majority of patients are children, which is the most worrying. At the same time, its severity is also worrying," said Maria Butty, president of the European Association for Liver Research.
Hepatitis is related to adenovirus due to unknown reasons?
At present, the cause of such cases of childhood hepatitis is still undeterminable, and adenovirus infection with is the most likely explanation so far.
Adenovirus is a common type of virus that spreads between people and usually causes a series of mild illnesses, including colds, vomiting and diarrhea. A report from the British " Daily Telegraph " pointed out that in rare cases, adenovirus can cause hepatitis.
In its latest notification on cases, the WHO said that at least 74 cases had adenovirus detected. A survey from the UK showed that information from patient samples and surveillance systems points the unknown cause of hepatitis to adenovirus infection, and 77% of the tested cases were adenovirus positive.
British Health Security Agency Chief Medical Consultant Susan Hopkins said British health officials are still studying a range of possible factors that lead to an increase in cases of hepatitis due to unknown reasons, but the "most likely" cause is infection with adenovirus.
In a briefing on April 25, the UK Health and Safety Agency also raised other possibilities for infection with adenovirus, such as the presence of a co-infection that has not been found yet, and it may also be that a new adenovirus strain with altered characteristics has appeared.
The US health department also holds a similar view. The Centers for Disease Control and Prevention said in an April 21 statement that based on what is currently understood, adenovirus may be the cause, but researchers are still learning more about it.
However, the WHO said that although adenovirus is a hypothesis that the underlying cause is currently, it does not fully explain the severity of the clinical situation. Although there have been cases of hepatitis in children with low immune function infected with adenovirus, no reports of hepatitis in healthy children have been found.
WHO expert on hepatitis Philippa Eastbrook believes that although about 74 cases tested have detected adenovirus, the serious symptoms of adenovirus causing such hepatitis are unusual.
In addition, some research institutes do not agree with the saying that adenovirus infection is the cause of this type of hepatitis.
On April 26, local time, the Italian Institute of Higher Health released a research report on the recent occurrence of unidentified causes of children with hepatitis in Europe, the United States and other countries. The report believes that some researchers have proposed that the possibility of hepatitis caused by adenovirus is extremely low.
Unexplained hepatitis is related to COVID-19 ?
In the notice on April 23, the WHO also pointed out that the new coronavirus was detected in 20 cases.
Some people believe that unknown hepatitis is caused by the side effects of the new crown vaccine, and this statement has been excluded by some current studies.
WHO said that "the assumptions related to the side effects of the COVID-19 vaccine are not supported at present" because most affected children are not vaccinated because they are too young. The British Health and Safety Agency and the Italian Institute of Higher Health also stated that this unknown hepatitis has nothing to do with the side effects of the new crown vaccine.
There are also opinions that unknown hepatitis is related to the prevention and control measures of the new crown. In response, the UK Health Safety Agency said in its April 25 briefing that there may be a cofactor that causes normal adenovirus to show more serious clinical symptoms in children. For example, during the COVID-19 prevention and control period, children are less exposed to adenovirus, and as the COVID-19 prevention measures are relaxed, children become more susceptible to infection.
Related research is underway on whether hepatitis due to unknown causes is related to the new coronavirus.
Take Israeli as an example. So far, Israel has found 12 cases that meet the WHO's definition of currently unknown children with hepatitis.
"After we ruled out all possibilities, we found that all cases have commonalities that are infectious of the new coronavirus about three and a half months before the onset of unknown hepatitis," Dr. Yel Moze Glasberg, head of the pediatric liver transplant department at Petatich Waschneid Children's Medical Center in Israel, told the Israeli media "Haretz", "But I don't think it's said that all these cases are phenomena that only occur after the new coronavirus is infected." Andrea Amon, director of the European Center for Disease Control and Prevention, said at a briefing on April 25, "We do not want so-called anchoring bias. If we only focus on the possible cause of the new coronavirus, we will miss other causes."
There are other possibilities for such unknown hepatitis. The UK Health Security Agency said hepatitis of unknown cause may also be related to age. Infants have milder symptoms after contracting the virus, but as they age, these children who have been infected with the virus have more severe reactions.
What are the precautions for children with unknown causes?
WHO recommends that normal sanitation measures, such as thorough hand washing (including supervising children's hand washing) can help reduce the spread of many common viral infections, including adenovirus. The WHO has urged countries to remain vigilant about any unexplained cases of childhood hepatitis and said the need to thoroughly investigate other infectious and non-communicable causes.
Experts from the UK Health Safety Agency and the U.S. Centers for Disease Control and Prevention all recommend that parents and guardians be alert to children with symptoms of hepatitis. In addition, maintaining good hand and respiratory hygiene and supervising young children to thoroughly wash their hands can help reduce the spread of adenovirus.
Australian infectious disease expert Professor Peter Collignon believes that the best protection for families with children in the short term is to keep them away from other sick people and maintain good hygiene habits.
In addition, it is rumored that there were cases of hepatitis in children due to unknown reasons in Beijing. After verification by the Beijing Municipal Health Commission, this is false information. In response to the relevant case information reported recently abroad, in order to prevent the situation and to ensure the health and life safety of children in the capital area to the greatest extent possible, the Beijing Municipal Health Commission issued the "Notice on Strengthening the Treatment of Hepatitis Cases of Unknown Children", with the purpose of reminding relevant medical institutions to be alert. If such cases occur, the causes should be identified as soon as possible and treatment should be strengthened.
Beijing News reporter Zhu Yuehong
Editor Zhang Lei Proofreading Li Lijun
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