The cause of acute hepatitis in children is still unclear. This phenomenon has also affected Italy: In the latest update, the World Health Organization (WHO) reiterated that it continues to “work with countries to investigate the cause of hepatitis in children”. Every year there are cases of hepatitis that can not be explained by the “normal” viruses that cause them, but in some countries these reports have been higher than normal, which triggered the alarm. “So far, the five viruses that commonly cause hepatitis have not been detected in any of these cases,” the WHO reiterated.
Where are we with hepatitis in children
As reported TodayTo date, over 700 probable cases of hepatitis in children with unknown cause have been reported from 34 different countries. According to the latest WHO update “At least 38 of these children needed liver transplants and 10 died.” There are 112 other suspected cases still under investigation. Most of these cases come from Europe and 29 have been reported in Italy Per. On 31 May, 305 cases of acute hepatitis were reported in children aged 16 and under in the European region, of which 305 were classified as probable and none as epidemiological. related, from 17 countries: Austria (2), Belgium (14), Bulgaria (one), Cyprus (two), Denmark (seven), Greece (five), Ireland (eight), Italy (29), the Netherlands (14) ), Norway (five), Poland (three), Portugal (15), the Republic of Moldova (one), Serbia (one), Spain (34), Sweden (nine) and the United Kingdom (155).
In the latest update, 96.3% of cases in Italy had been hospitalized with a transplant. 55.6% of the cases are women, and most of the cases, 59.3% are younger than 5 years.
What do doctors say about hepatitis in children, and what is known so far, in order
The probable causes
The European Center for Disease Prevention and Control (ECDC) works closely with the countries involved, the WHO and other stakeholders to understand the causes of hepatitis. According to the latest rapid risk assessment from ECDC, the current main hypothesis is that a cofactor affecting young children with an adenovirus infection, which would be mild under normal circumstances, triggers a more serious infection or liver damage. Immune-mediated. Other etiologies (eg other infectious or toxic substances) are still under investigation and have not been ruled out but are considered less plausible. The disease is rare and signs of human-to-human transmission are still unclear.
However, it should be remembered that adenoviruses generally do not cause hepatitis, a rare complication commonly known among immunocompromised individuals. According to the Istituto Superiore di Sanità, the hypotheses currently at stake could be:
- The circulation of a new variant that causes severe hepatitis in children;
- A variant that is already normally in circulation and which affects younger children who are immunologically unprotected after a lower circulation of this type of virus during the pandemic. In particular, the adenovirus F41 strain appears to be the most likely cause.
Hepatitis in children, in Italy 26 hospitalized and a transplant
Symptoms of hepatitis in children
The clinical presentation of cases identified in the UK responds to severe acute hepatitis with high levels of liver enzymes (aspartate aminotransferase – AST or alanine aminotransferase – ALT greater than 500 IU / L) and symptoms include: jaundice, diarrhea, vomiting and abdominal pain. Some children were admitted to the pediatric hepatological unit and in some cases a liver transplant was required.
In general, viral hepatitis is an inflammation of the liver caused by a virus. The WHO says that the total number of deaths caused by viral hepatitis, including acute cases, cirrhosis and liver cancer, was around 1.1 million deaths globally in 2019. There are 5 different hepatitis viruses: hepatitis A, B, C, D and E. Hepatitis A and E is spread mainly through ingestion of contaminated food and water, and the disease is often endemic in countries with a lack of clean water and poor sanitation, but rarely becomes chronic. Hepatitis B is spread through contact with the blood or other body fluids of an infected person, and approximately 296 million people live with this infection. Hepatitis C is spread mainly through blood-to-blood contact, such as unsafe injection practices and inadequate sterilization of medical devices. Today, 58 million people live with the disease. Hepatitis D, on the other hand, is transmitted through contact with infected blood and occurs only in people who are already infected with hepatitis B.
In total, over 350 million people worldwide live with viral hepatitis. Over one million people lose their lives each year due to conditions related to acute hepatitis and chronic infections that cause liver cancer and cirrhosis. Chronic hepatitis B and C infections are the leading cause of liver cancer. Although there is an effective vaccine and treatment for hepatitis B and a cure for hepatitis C, few countries in the world are on track to meet the WHO goal of eliminating viral hepatitis by 2030.