Children’s mysterious hepatitis, 228 reports and still not why

In just under a month, 228 cases of possible pediatric acute hepatitis of still unknown origin were reported to the world health authorities, and over 50 are currently under investigation. An escalation that is frightening because of the speed, gravity, global spread and above all because the cause is still a mystery. It was Tarik Jasarevic from the World Health Organization who took stock of the situation. “From the first report that arrived from the UK on 5 April to 1 May 2022, at least 228 probable cases from 20 countries have now been reported and there are over 50 currently under investigation. We therefore now have cases reported from five regions of the country. “WHO, the eastern Mediterranean, Europe, Pan-America and even the Southeast Asian and western Pacific region,” he explained.

In the last few hours, a case has also been reported in Argentina, it is an eight-year-old boy admitted to Rosario Pediatric Hospital. To date, one death has been confirmed worldwide by this disease, while four other deaths are being investigated. 18 minors have had a liver transplant.

What worries us is the difficulty in identifying the origin of the pathology. The tests for the viruses known to cause the disease have given negative results, the connection with Covid is excluded, the relationship to a specific territory or food is also excluded, because the cases have a dislocation that does not allow a type of this species. . In short, a mystery.

“Currently – reads the latest document published by the Institute of Health (April 29, ed) – none of the theories formulated about the origin have been confirmed through scientific evidence. In addition, every year in Italy, as in other countries, a certain number of hepatitis of unknown cause occur, and analyzes are under way to determine whether there is in fact a surplus. Preliminary hypotheses from the British investigation team suggested an infectious etiology or possible exposure to toxic substances. Detailed information collected through a questionnaire regarding food, drink, personal habits in the cases did not reveal common exposures. Toxicological studies are underway, but an infectious etiology appears to be more likely based on the epidemiological picture. Microbiological studies ruled out hepatitis A, B, C, D and E viruses in all cases. ‘Based on current studies – writes ECDC in its risk assessment of 28 April – the currently most plausible hypothesis is that a co-factor affecting children who have an adenovirus infection that would be mild under normal circumstances triggers a more severe infection or immune system. -mediated liver damage. Other causes are still under investigation and have not been ruled out ‘”.

The focus is on surveillance. For two reasons: because a timely diagnosis increases the chances of cure and cure and to get an exhaustive picture of the situation. In recent weeks, the warning “do not do as for Covid” – that is, do not underestimate the disease – sounds from one end of the globe to the other.

In Italy, due to the increase in pediatric cases of acute hepatitis (by decree of 27 April), a crisis unit was set up, which includes the Ministry of Health, the Higher Institute of Health, Regions, Agneas (Agency for Regional Health Services), Aifa (Italian Medicines Agency) ), Nas (anti-sophisticated carabinieri) and scientific societies. “In the awareness that the situation must be carefully monitored and supervised. A new ministerial circular is being defined, which aims to standardize and coordinate control and public health measures on national territory,” explained Andrea Costa, Minister of Health, in response. in the Social Affairs Committee on a parliamentary question presented by M5S.

The European Center for Disease Prevention and Control then developed a reporting protocol “to report national data from all countries and territories of the WHO European Region, including the 27 countries of the European Union (EU) and the other three countries of the European Economic Area. Area (SEE), at European level “.

Parents, according to the WHO, “should be aware of the symptoms of hepatitis, which is an acute onset of diarrhea, vomiting, abdominal pain and jaundice, where the skin and whites of the eyes turn yellow”, while “most children do not have a fever. “. To prevent children from getting sick, it is important to “take normal measures that help protect against common viruses,” such as hand washing and respiratory hygiene.

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