Health officials at the European Centre for Disease Control and Prevention (ECDC) said on April 26 that nearly 200 cases have been reported globally, including 140 in Europe, since the UK reported cases of unexplained childhood hepatitis earlier this month.
There are nearly 200 cases of hepatitis in children of unknown cause worldwide.
EcDC director Andrea Ammon said, "So far, there has been no link between these cases and no link to international travel, according to the Associated Press. ”
The unexplained disease is predominantly seen in previously healthy children, with cases reported in at least 12 countries in Europe, Asia and North America.
At least 12 countries have reported cases of unexplained hepatitis.
The following is the currently known information and unknown questions about the disease combed by the surging news.
How many cases have been reported in total in how many countries?
On 5 April, the UK was the first to report a significant increase in cases of severe acute unexplained hepatitis in previously healthy children under the age of 10, with a total of 74 cases.
The majority of current cases occur in the UK (114). Since then, 11 other countries, including Spain (13 cases), Israel (12 cases), the United States (12 cases), Denmark (6 cases), Ireland (less than 5 cases), the Netherlands (4 cases), Italy (4 cases), Norway (2 cases), France (2 cases), Romania (1 case), Belgium (1 case), etc., have also reported the unexplained case to WHO.
On 26 April, the Japanese government reported its first Asian case. On the 27th, Canada said it was investigating an unknown number of cases to determine whether they belonged to the above-mentioned cases of hepatitis of unknown cause.
In a statement on 15 April, WHO said: "Given the increase in reported cases over the past month and the intensification of case search activities, more cases are likely to be reported in the future." ”
In addition, considering that if some children do not develop severe symptoms, they may not be taken to the hospital for testing, the true number of cases may be higher.
Who is infected?
Affected children range from 1 month of age to 16 years of age, with the vast majority being children under 10 years of age. Who says a child has died and about 10 percent of severe cases require liver transplantation.
Many children develop gastrointestinal symptoms such as abdominal pain, diarrhea, and vomiting before they are diagnosed. Many people also suffer from jaundice, which is yellow in the skin and eyes, which can be caused by liver damage.
The occurrence of cases spans a wide range of time. Israel said the country's first case was detected in February 2021 and 12 cases were detected over the next 14 months, suggesting that this may not be an epidemic.
The earliest current cases in the US are in October 2021, and most cases in the UK are concentrated in January-April this year.
Unusual?
First, children are usually healthy before they get sick and are diagnosed.
The World Health Organization describes the hepatitis they develop as "severe and acute." This means that some children's livers have completely failed, which is extremely rare in healthy children.
Hepatitis is a liver infection characterized by acute liver failure, and in some severe cases, patients may need a transplant within a few days and, if left untreated, may die.
The most common cause of hepatitis is the virus, of which hepatitis A, B, C, D, and E are the key strains involved. These viruses vary in how they spread, geographically, symptoms (not everyone will develop symptoms), and severity, but they all cause hepatitis.
None of the above-mentioned common hepatitis viruses were detected in all affected child case tests.
Alcohol, certain drugs, and immune system disorders can also cause hepatitis. Sometimes, hepatitis can also be caused by unexplained causes. However, such severe cases of liver failure are particularly rare in children.
What is the cause?
Several investigations have been conducted into the underlying causes of mysterious hepatitis, but the cause has not yet been determined.
The adenovirus theory is by far the most likely explanation, but there is still a great deal of uncertainty as to whether this is an absolute pathogen of the disease.
Currently, adenovirus , a common virus , has been detected in more than 74 case samples that often cause symptoms such as colds, sore throats, fevers and diarrhea.
But WHO said in its latest report on cases that while adenovirus is currently a hypothesis of potential cause, "it does not fully explain the severity of the clinical situation". The strain of adenovirus found in many children, known as F41 adenovirus, has not been reported in previous cases of hepatitis in immunocompromised children infected with adenovirus, but no reports of hepatitis in healthy children.
Professor Deirdre Kelly, an expert in early childhood liver disease at the NHS Foundation at Birmingham Children's Hospital, who has worked with UKHSA to investigate these cases, told The Paper on April 26 that the most likely explanation for the preliminary investigation is that the disease is related to the long-term lockdown under the COVID-19 pandemic over the past two years – people have little exposure to the common adenovirus and no immunity, and recently with the reopening of society, adenovirus infections have soared, causing some children to have a serious reaction.
Is there a link to COVID-19 or vaccines?
The coronavirus has also been detected in 20 cases.
"After we ruled out all the possibilities, what all the cases we found had in common was that all the cases were infected with the new coronavirus about three and a half months before the infection appeared," Dr. Yael Mozer-Glassberg, head of the pediatric liver transplant department at Petatikwa Schneider Children's Medical Center in Israel, told the Israeli media Haaretz, "but I don't think it can be said that all of these cases are phenomena that appeared after the new crown virus infection." ”
Dr. Isaac Bogoch, an infectious disease expert at the University of Toronto, believes that the cause may ultimately be related to adenoviruses, the new crown virus, and some interaction between environmental exposures and viruses.
WHO said "the hypothesis related to the side effects of the COVID-19 vaccine is not currently supported" because most affected children are too young to be vaccinated.
What health advice do you have for parents?
There's no need to get into a panic, but it's worth being vigilant.
WHO recommends that normal hygiene measures, such as thorough handwashing (including supervising children), help reduce the spread of many common infections, including adenovirus.
If a child develops symptoms of a gastrointestinal infection, including vomiting and diarrhea, they should stay home until 48 hours after symptoms have stopped before returning to school or daycare.
Children may also have abdominal pain or tenderness, especially in the right upper quadrant, where the liver is located, and it is important to seek medical attention immediately when your child shows signs of severe abdominal pain.
In addition, jaundice, or yellowing of the skin and eyes, is a hallmark sign of hepatitis.
WHO has urged countries to remain vigilant about any unexplained cases of hepatitis in children and has said there is a need to thoroughly investigate other infectious and non-communicable causes.