On 5 April this year, the UK health department first informed WHO of 10 cases of severe acute hepatitis in children of unknown etiology detected in central Scotland, the earliest case developing symptoms in January 2022, and by 22 April 2022, the total number of cases of the disease in the UK had reached 108.
THE WHO reported hepatitis of unknown cause
But that's not the origin.
The U.S. Centers for Disease Control and Prevention (CDC) is releasing a Health Alert Network (HAN) to notify clinicians and public health authorities of children found and reported with hepatitis and adenovirus infection. In November 2021, clinicians at a large children's hospital in Alabama notified the CDC of five pediatric patients with severe liver damage, including three patients with acute liver failure, who also tested positive for adenovirus. All children were previously healthy. No one has COVID-19.
From October 2021 to February 2022, the hospital's case finding efforts identified 4 additional pediatric patients with hepatitis and adenovirus infections, with a total of 9 patients admitted to the hospital; all of whom were sequenced were found with adenovirus infections. In both patients, adenovirus in plasma samples was negative by quantitative polymerase chain reaction (qPCR), but both patients were positive when retested with whole blood (this is normal and may vary from source to sample). Two patients required liver transplants; no patients died.
Possible associations between hepatitis and adenovirus infection in children are currently being investigated.
Earlier this month, the UK reported cases of paediatric hepatitis in children who tested negative for hepatitis A, B, C, D and E, including some adenovirus infections.
What is more frightening is that people under 10 years of age, as a sick population, have the typical symptoms of hepatitis, jaundice, high liver enzymes, diarrhea, vomiting, abdominal pain and so on. Moreover, there have been reports of deaths and children in severe condition requiring liver transplantation.
You know, unless the congenital cause or the very typical hepatitis virus (A, B, C, D, E), it is difficult for children to develop such severe hepatitis.
The WHO reported the incident on its official website, and the US CDC issued a warning asking doctors across the United States to pay attention to unexplained childhood hepatitis.
Then on the 25th, Japan also reported a suspected case of hepatitis in children of unknown origin.
Many public health scientists and scientists wonder if there is a known cause that can explain this problem.
If not, we perform metagenomic testing by using patient samples and then correlate the results of these populations.
Simply put, it is 100 people, each of whom has a different pathogen in the sample, but coincidentally, everyone has a bad egg in the sample. Well, this villain is probably the culprit.
However, the big boy also said, called "very likely".
Because this is an exclusionary method, there is no causal inference, and it is not guaranteed.
For example, 77% of adenovirus samples are now tested positive for adenovirus, and some samples detect covid-19.
There have been many epidemiological studies of the new crown virus, and the large patient population around the world has no symptoms, and only some of the children with hepatitis have detected the new crown virus, so we have reason to believe that this has little to do with the new crown, at least, the new crown is not the main cause.
What about adenoviruses? More public health experts and scientists believe that adenovirus or its variants are the "most likely" trigger for this unexplained hepatitis.
You can understand that it is the "trigger", but it does not say that it all depends on the adenovirus.
The trigger is a contributing factor.
The beams of a house are not stable, and the 8-level wind blows for two days, and when it is over, the house collapses.
High winds are the trigger.
Adenovirus is not uncommon in children, but it mainly causes pneumonia, and if it is really hepatitis, it is a rare complication of viral infection.
However, we should pay more attention to why the beam is not stable!
At present, the research on etiology has not yet come out, and it is the first time to share with you.
Some experts say that it may be that during the new crown, the isolation measures have led to a decline in children's immunity to the virus, the house is not strong, and the adenovirus has an opportunity.
It's also not right.
Children's immunity needs to be exercised, and an overly clean environment is indeed not good for the maturity of children's immunity.
However, adenovirus infection is nothing new, so why did you choose liver this time?
I don't know, it's hard to say, the virus has evolved? Or is it a mixture of other genetic + environmental factors?
At least for now, it's hard to say.
What can be said is that we don't just worry, at the moment, you are all worried about a lot, if you are worried, you can use my message area as a platform, let's talk.