The words "children's unexplained acute hepatitis" have recently appeared frequently on the Internet hot list.
From the beginning of April to the present, 12 countries worldwide have reported cases of "unexplained acute hepatitis in children", totaling about 169 cases. The latest case report comes from Japan , where a child under the age of 16 was recently diagnosed and is now receiving treatment.
The reason is unknown, the threat is menacing, and it is really a bit scary.
On the one hand, its target age ranges from 1 month to 16 years old, and its condition is fierce. Of the currently confirmed cases, 17 have been severe enough to require a liver transplant, and 1 death has occurred;
On the other hand, from the progression of the disease to the present, experts have not found the "culprit" of this type of acute hepatitis. Even the "suspect" who is hard to lock in, the adenovirus, is also full of doubts...
The "suspect" locks the whole process
Hepatitis, a general term for liver inflammation, mainly refers to the impaired liver function caused by various causes, abnormal liver function indicators, and a series of symptoms of physical discomfort.
There are many causes of hepatitis. People are more familiar with hepatitis B, hepatitis C, etc., belong to viral hepatitis; like a series of symptoms caused by excessive alcohol consumption, it belongs to alcoholic hepatitis... Different causes of treatment are slightly different, so in clinical treatment, it is very important to find the cause.
Combined with public information, on April 5, the UK Health Security Agency officially informed the World Health Organization of the situation of "unexplained acute hepatitis in children": unexplained childhood hepatitis in Scotland, with 10 cases of severe acute hepatitis in just 3 months. Of these, 1 occurred in January and 9 in March.
Severe hepatitis in children is already rare. As for unexplained childhood hepatitis, the average annual number of cases in the UK is generally in single digits, and the annual data in Scotland is less than 4 cases... This time, there were nearly 10 cases in one month, which was obviously not right.
Because it is "unknown reason", after this briefing, experts have not given up the investigation of the cause.
After ruling out the more common viruses such as hepatitis A and hepatitis B, as well as various causes such as toxins, chemicals or pollutants, experts temporarily locked in a "suspect" - adenovirus.
About three-quarters of the cases currently reported in the UK have tested positive for the virus. A small percentage of people have also tested positive for COVID-19.
But will adenovirus really be the "real culprit" of this "unexplained acute pneumonia in children"?
The so-called "culprit" is full of doubts
The "adenovirus" that experts have temporarily targeted is not uncommon, referring to a particle without an envelope and a diameter of 70 to 90 nm. According to different characteristics, it can be divided into different categories. There are about 52 known classifications, including adenovirus type 41 detected in sick children in the United States.
Schematic diagram of the structure of the adenovirus
However, from the existing research on adenovirus, under normal circumstances, respiratory infections such as cough, nasal congestion, and fever are the most common symptoms after adenovirus infection. In addition, it is an eye infection, gastroenteritis, and hemorrhagic cystitis caused by adenovirus.
As for viral hepatitis, although there are also cases, many of them are concentrated in immunocompromised patients or organ transplant patients, and it is still relatively rare to directly cause children to be infected with viral hepatitis on a large scale.
On the other hand, experts currently speculate that the "unexplained acute hepatitis in children" is related to adenovirus, and its most direct data is that 77% of the 108 cases in the UNITED Kingdom have tested positive for adenovirus. But relying on this data alone, it is a bit premature to draw conclusions about this unexplained acute hepatitis. In particular, it is difficult to explain why the incidence of this type of hepatitis is much higher this year than in previous years.
At present, there are two relevant mainstream speculations: First, some experts believe that the long-term isolation caused by the new crown epidemic makes it difficult for children to contact this type of virus, and their resistance to it is naturally relatively low, and once infected, it may lead to more serious consequences; at the same time, some experts believe that there may be a certain mutation of adenovirus, which has led to this larger infection.
Dr. Zhang Wenhong also said, "If it is caused by a long period of covid-19 isolation, rather than a new virus that has not been discovered before, the follow-up effects of this unexplained hepatitis will gradually decline, but we also need to be vigilant against unknown pathogens, even if the probability of such a new infectious disease pandemic is not high."