Unexplained childhood hepatitis swept through 20 countries, and the General Administration of Customs urgently deployed! What should ordinary people pay attention to?

As of 1 May, at least 228 cases of unexplained childhood acute severe hepatitis and 50 suspected cases have been reported in 20 countries worldwide. In this regard, on May 9, the General Administration of Customs made a deployment, the national customs need to strengthen quarantine inspection of inbound passengers from countries /regions with case reports, and carry out medical screening of passengers with relevant symptoms in accordance with the prescribed procedures.

Customs:

Strengthen quarantine inspections for inbound passengers from countries/regions with reported cases

On May 9, in response to the successive reports of unexplained cases of acute severe hepatitis in children from many countries around the world, the General Administration of Customs made arrangements for health quarantine at customs ports across the country to prevent the epidemic from being introduced to the mainland.

The General Administration of Customs requires customs throughout the country to strengthen quarantine inspection work such as health declaration, body temperature monitoring, medical inspection and other quarantine inspections for inbound passengers from countries/regions with case reports, and to carry out medical screening in accordance with the prescribed procedures for passengers with abdominal pain, diarrhea, vomiting and jaundice who voluntarily declare or are found at the scene. After medical investigation, passengers suspected of having acute severe hepatitis of children of unknown cause should be transferred to designated medical institutions for further diagnosis and treatment in a timely manner, and follow-up should be done.

Customs reminds that the symptoms of acute severe hepatitis in children of unknown cause include jaundice and gastrointestinal symptoms, such as vomiting and diarrhea, abdominal pain, etc. If there are symptoms of discomfort during the entry and exit, the attendants on the transportation should be informed in a timely and truthful manner, and cooperate with self-protection. Passengers entering and leaving the country, especially children, who have gastrointestinal symptoms and jaundice, should report to the Customs in time so that they can obtain diagnosis and treatment as soon as possible. WHO recommends that thorough handwashing, including supervising children, can help reduce the spread of many common infections.

Which countries globally have hepatitis in children with an unknown cause found?

20 countries reported 228 cases

According to the World Health Organization, as of 1 May, at least 228 cases of unexplained childhood acute severe hepatitis and 50 suspected cases have been reported from 20 countries around the world. Including the United Kingdom, the United States, Spain, Israel, Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania, Belgium, Austria, Germany, Poland, Cyprus, Japan, Singapore, Indonesia, Argentina and so on. Among them, the epidemic in The European region has spread to 14 countries, and the spread trend is obvious, and cases have also been found in countries in the Americas, the Western Pacific and Southeast Asia. The age distribution of cases is mainly from 1 to 16 years. Seventeen patients required liver transplantation and at least one died. Many patients present with abdominal pain, diarrhea, and vomiting, and most do not have fever.

Are there cases on the mainland?

No related cases have been detected on the mainland

On May 7, the National Health Commission responded: At present, no relevant cases have been found in the mainland, and health administrative departments and medical institutions at all levels are paying close attention to and continuously monitoring the relevant situation.

What are the symptoms?

Be vigilant in these situations

On May 7, the National Health Commission reminded that the common characteristics of children with this acute hepatitis are:

Age 1 month to 16 years old, mostly under 10 years old;

jaundice, nausea, abdominal pain, fatigue, drowsiness, and gastrointestinal symptoms (including diarrhea and vomiting), and most children are fever-free;

Laboratory liver biochemical tests for transaminases (AST or ALT) are markedly elevated.

If the child shows the above symptoms, parents should be vigilant and go to the hospital in time. It is recommended to check liver biochemical indicators and do related etiological tests such as blood, urine, feces, and respiratory samples to further determine whether the child has acute hepatitis and possible causes.

What is the cause?

May be associated with adenovirus infection

Studies have shown that the above cases of hepatitis in children may be associated with adenovirus infection. But because the symptoms of many of these cases are not typical of adenovirus infection, experts are still investigating other possible causes.

WHO said the five common hepatitis viruses A, B, C, D and E were not detected in samples from all cases. One adenovirus was detected in at least 74 cases, of which type 41 was detected in 18 cases. Adenovirus is a hypothetical cause of these cases.

The U.S. Centers for Disease Control and Prevention said adenovirus is thought to be one of the causes of hepatitis infection in immunocompromised children, but its effects on liver damage in healthy children are still under investigation.

What is an adenovirus?

There are dozens of known adenoviruses, many of which are associated with cold symptoms such as fever and sore throat. Adenovirus type 41 is a common cause of acute gastroenteritis in children, with diarrhoea, vomiting, fever, and respiratory symptoms in infected people.

Is it related to COVID-19 vaccination?

The related assumptions are not currently supported

A recent world health organization survey showed that because the vast majority of children with acute hepatitis of unknown cause have not been vaccinated against the new crown virus, the assumptions related to the new crown virus vaccine are not currently supported.

What do you think?

Prepare early and be vigilant

On April 29, the "Huashan Infection" WeChat public account published an article introducing the development of hepatitis in children of unknown causes in the United Kingdom and other places and its possible causes. The article pointed out that there is an imported risk of hepatitis in unexplained children, and China should prepare for this early.

Zhang Wenhong, director of the National Center for Infectious Disease Medicine and director of the Department of Infectious Diseases at Huashan Hospital affiliated to Fudan University, said that the unexplained hepatitis that WHO is concerned about this time has the characteristics of cluster incidence, and the incidence rate has exceeded that of previous years. In this case, it makes sense to consider the risk of infectious diseases.

Why are so many cases of severe hepatitis this year, and only in children? At present, it is speculated that it is a long period of new crown isolation, children have not been exposed to this virus for a long time, and sudden contact will produce more serious immune damage, which is consistent with the phenomenon that emerging infectious diseases tend to be heavier in the early stages of disease outbreaks.

Zhang Wenhong said that we also need to be vigilant against unknown pathogens, even if the probability of such an emerging infectious disease pandemic is not high.

How to prevent it?

Cut off droplet contact and fecal-oral transmission routes

Wash your hands frequently and maintain respiratory hygiene

WHO believes that it is imperative to determine the cause of the disease and recommends measures such as frequent hand washing and respiratory hygiene to prevent common viral infections such as adenovirus.

The National Health Commission pointed out that there are many causes of acute hepatitis in children, and the main route of infection is through the digestive tract and blood. Some of the children with acute hepatitis of unknown cause reported abroad tested positive for adenovirus. At present, the main preventive measures are to avoid children from going to public places with crowded people and no air circulation, cut off droplet contact and fecal-oral transmission routes, ensure adequate sleep and nutrition for children, regularly wash children's clothes and frequently contacted items, wash their hands frequently, wear masks, maintain social distancing, such as children with jaundice, digestive tract symptoms and other hepatitis diseases need to seek medical treatment in time.

At present, the experience accumulated in the prevention and control of the new crown pneumonia epidemic in the mainland and the improvement of the public's awareness of health protection have considerable benefits for the prevention of acute hepatitis in children of unknown cause.

Xiaoxiang Morning News comprehensive report