What experts say about hepatitis of unknown cause in children
Decoding Hepatitis of unknown cause in children
Doctor Nguyen Manh Cuong, Pediatric Specialist, 103 Military Hospital shared, on April 5, 2022, the UK informed WHO about 10 cases of severe acute hepatitis of unknown cause in young children. previously healthy (age: 11 months to 5 years). Time to manifest symptoms about 1-2 months before. These include jaundice, diarrhea, vomiting, and abdominal pain.
About 6 days later, 64 new cases were detected: Mainly in children under 10 years old, markedly elevated liver enzymes (ALT/AST), often accompanied by jaundice, gastrointestinal symptoms (nausea, defecation, etc.) . Some cases have liver transplant.
Tests to rule out known hepatitis (VG A, B, C, D, E) were performed and found that some people with hepatitis of unknown etiology had an adenovirus infection (doesn’t mean this is the cause). .
To date, a total of 169 cases of acute, severe hepatitis of unknown etiology have been reported in children aged 1 month to 16 years in 12 countries, including one death. Of the 169 reported cases, 85 were tested for Adenovirus, of which 74 were positive. Adenovirus type 41 was identified in 18 cases.
The clinical presentation among the identified cases corresponded to acute hepatitis with elevated transaminases, many of which presented with jaundice and gastrointestinal symptoms (including abdominal pain, diarrhea, and vomiting). and no fever. Hepatitis A, B, C, D, and E virus infection has not been identified in any of the affected children. Clinical outcomes to date have been very variable, with 10% requiring liver transplant.
Nguyen Thu Anh, Director of Woolcock Institute of Medical Research in Vietnam, leader of the F5 group, said that there are currently about 228 children in more than 20 countries suffering from acute hepatitis of unknown cause. Not including 50 cases under investigation. About 10% need a liver transplant. 5 deaths including 3 from Indo are not currently on this map. Case Fatality Rate is approximately 2%, not low at all. It is not clear how quickly the infection spreads, but it does not seem to be as fast as covid.
The first case was detected in the UK at the beginning of April 2022 (but the symptomatic case appeared in October 2021 in the US (Alabama), possibly due to the good diagnostic capacity of the hospital here, but not sure where the disease originated. from this country.
Cause: unknown. An adenovirus is currently suspected because it has been found in many children (but not all children have adenovirus). Liver biopsies in some children showed no signs of viral infection.
What do I need to know about the Adenovirus?
According to Dr. Dr. Nguyen Thu Anh, Adenovirus is spread through direct contact with respiratory droplets or surfaces contaminated with the virus. Some studies suggest that whole blood (instead of plasma) should be tested for adenovirus. However, it is not clear whether countries have investigated and tested contacts.
In addition, most children with hepatitis do not receive the Covid vaccine, so the vaccine is not the cause. And it is not clear which children are susceptible to the disease.
Symptoms of the disease: vomiting, diarrhea, abdominal pain, yellowing of the skin or eyes, elevated liver enzymes. Current treatment methods: cure symptoms, severe liver transplant.
Dr. Dr. Nguyen Thu Anh noted: The possibility of the virus entering Vietnam is very high and unavoidable. So what is currently possible is:
Doctors are alert to detect and report cases Update information in the world Parents monitor symptoms in children, especially jaundice, yellow eyes Maintain personal hygiene
What is adenovirus?
Adenovirus was first discovered in 1953 from amygdala, the glandular tissue was removed. Adenoviruses are viruses containing double-stranded DNA, the diameter of the virus is from 70 to 80 nm, without an outer envelope, the capsid has cuboidal symmetry and the viruses are polygonal in shape made up of 252 capsomeres.
Adenoviruses of the family Adenoviridae are divided into two main groups, one that causes disease in birds and one that causes disease in mammals. In the group that causes disease in mammals, including humans, 47 types of human adenovirus, some other animal species, and human adenovirus have been isolated, divided into 6 groups of symbols A-F based on on physiological, biochemical and molecular biological characteristics.
Adenovirus can survive and cause disease for a long time in the outdoor, at room temperature can survive for 30 days, 370C can live for 15 days, 40C they can live for many months, -200C can live for many years. Boiling water at 1000C, ultraviolet rays, chloramine easily destroy the virus, lose its virulence quickly and die at 56 degrees Celsius from 3 to 5 minutes. In addition, organic solvents such as ether and acetone do not kill viruses.
The source of Adenovirus infection is the patient who carries the virus during the course of the disease. The patient can be infected by direct contact between people through the respiratory tract; can be transmitted through mucous membranes by swimming or washing water contaminated with the virus in secretions from the eyes, nose, and feces of patients or by indirect contact with utensils of patients infected with adenoviruses. The disease can affect people of all ages. However, due to the virus that causes the disease, it will often be found in subjects with low resistance such as children, the elderly, people with chronic diseases …
Currently, there is no specific treatment for adenovirus disease. The main treatment is to treat symptoms, improve physical condition, if there is a superinfection, use antibiotics.
What is the pathogenicity of Adenovirus?
Adenovirus can cause disease in many different organs in the body such as the respiratory tract, digestive tract, eyes… in humans, especially children. Among the groups of viruses that cause disease, group B Adenoviruses are the most likely to cause disease and are the most common. After causing disease, the adenovirus can survive for many years in the amygdala.
Some diseases caused by adenovirus include:
1. Inflammation of the respiratory tract
Acute pharyngitis: This disease is common in infants and young children with symptoms such as fever, headache, swollen throat, cough and runny nose. This condition can last for days from 7 to 14 days and can spread quickly to become an epidemic. Diagnosis based on symptoms is often difficult to distinguish from other viral infections.
Pharyngitis conjunctivitis: Symptoms similar to pharyngitis caused by Adenovirus but with conjunctivitis manifests as red conjunctiva, usually painless, clear discharge. This condition is often contagious, especially in the summer, can be transmitted through respiratory droplets or children come into contact with the source of infection when swimming.
Acute respiratory infection: Manifestations of sore throat, sore throat, painful swollen lymph nodes, fever can be as high as 39 degrees Celsius, cough. The disease develops acutely, recovers quickly after 3-4 days, seen in both children and adults. The pathogenic types are 4, 7.
Pneumonia: Mainly caused by types 3, 4, 7 and 14, accounting for 10% of cases of acute pneumonia in young children. Symptoms appear suddenly with a high fever of 39 degrees Celsius, cough, runny nose and signs of damage to the lungs, these lesions can spread, leave sequelae and more seriously, can cause death. death. Adenovirus pneumonia has dangerous complications and can be fatal with a mortality rate of 8-10% when infected.
2. Eye conjunctivitis
Conjunctivitis, also known as pink eye, is a disease that often causes epidemics in the summer because it is easily spread through water in swimming pools. Manifestations of acute inflammatory disease of the corneal conjunctiva, red conjunctiva, maybe one or both sides, clear fluid, susceptible to bacterial superinfection if not controlled and promptly intervened.
3. Inflammatory bowel disease
Several types of Adenovirus, a common viral agent in acute non-bacterial gastroenteritis. Adenovirus gastroenteritis ranks 2nd after rotavirus in viral diarrhea in children. Patients present with diarrhea with a lot of water lasting about 7 days, accompanied by fever, vomiting, nausea, signs of respiratory infection and conjunctivitis. The virus causes disease in the gastrointestinal tract and is eliminated in feces, which is also the main source of infection for the community. Mainly caused by types 40, 41 and 31.
4. Other diseases
This virus can also be the cause of hemorrhagic cystitis in children, especially boys, in this case the virus is often found in the urine of the patient and the pathogenic types are type 11, 12. In the urethra, death There is also a virus and this is considered a sexually transmitted disease.
There are also some viral infections but no symptoms, called latent forms, which are an important source of infection in the community. The types that cause disease in humans, after being cured, patients have high and long-lasting immunity to Adenovirus with the same type of disease, but they do not have cross-immunity, so they can protect the cause of the disease due to different pathogens. other types.
This virus is very contagious to the community and especially, adenovirus can cause many dangerous complications from common symptoms, so when children have signs of suspected virus infection, they need to be monitored often. regular health status and as soon as there are abnormal signs, need to go to a medical facility for examination and treatment.
How to prevent disease caused by adenovirus?
Always ensure that there is enough clean water for daily use. Especially in the rainy season, it is necessary to use clean water that has been disinfected.
Maintain clean personal hygiene, do not share towels and regularly wash towels with soap, dry in the sun.
When taking care of an infected patient, do not share items with the sick person, especially towels and utensils that may be contaminated with the patient’s secretions such as bowls, spoons, cups, cups, beds… Disinfect the patient’s utensils during the disease phase.
The disease caused by adenovirus is very easy to spread by direct and indirect ways, so it is also easy to break out into an epidemic, so when you find yourself or those around you infected with Adenovirus, it is necessary to take reasonable precautions to avoid the disease. outbreak into an epidemic.
at Blogtuan.info – Source: Afamily.vn – Read the original article here
