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The hepatologist explains it in detail

A series of cases of severe acute hepatitis in children recently appeared in many countries. The number of cases and the number of countries where the disease is detected is increasing. Clinical symptoms in the initial stage are abdominal pain, diarrhea, vomiting… followed by the full-blown phase with severe hepatitis (very high liver enzymes), yellow eyes, and jaundice. 10% of cases required liver transplantation and 9 children died (3 deaths in Indonesia). Until now, scientists still do not know the exact cause of this disease.

On 15 April 2022, the World Health Organization (WHO) reported an outbreak of severe acute hepatitis of unknown cause in 74 children across the UK. Most recently, according to the WHO announcement on May 3, 2022 and the US Centers for Disease Control and Prevention (CDC) on May 6, 2022, the current number of suspected cases is more than 300 children. , recorded in at least 23 countries in Europe, the Americas, the Western Pacific and Southeast Asia.

According to TS.BS. Dinh The Trung, Hepatobiliary Specialist, Center for Endoscopy and Gastrointestinal Surgery, Tam Anh General Hospital, Ho Chi Minh Citythis mysterious hepatitis are cases of acute hepatitis in previously healthy children between the ages of 1 month and 16 years.

“In the context of limited information about the disease, parents are very concerned and worried about their children’s health. Therefore, it is very important to update accurate information about the mysterious hepatitis disease. important for the community,” said Dr. Trung.

What is acute hepatitis?

According to Dr. Trung, hepatitis is a condition in which liver cells are inflamed and destroyed. The liver is the “factory” that performs many important processes for the body such as synthesizing essential proteins, detoxifying… Therefore, liver damage can have serious, even dangerous consequences. live.

Hepatitis can be caused by viral infection (called viral hepatitis), by alcohol, by drugs or other chemicals, by some metabolic disorders, by immune system disorders… Hepatitis can be acute (disease). occurring within 6 months) or chronic (lasting more than 6 months).

The main viruses known to cause acute viral hepatitis in humans include hepatitis A, B, C, D, and E viruses. Most cases of acute hepatitis caused by these five viruses resolve completely on their own. Within a few months, only a small percentage (<1%) of the disease progresses to fulminant and possibly fatal hepatitis. Currently, viral hepatitis A, B and D can be effectively prevented with vaccines.

Theories about the cause of mysterious hepatitis in children

Adenovirus, especially adenovirus type 41, is suspected as the causative agent

By performing diagnostic tests, scientists have found that the recent mysterious childhood hepatitis is not caused by hepatitis A, B, C, D, E viruses and several other viruses that have been identified. known to cause hepatitis in humans (EBV, CMV…). Other causes of hepatitis (non-viral) related to food, toxins were also not found. Because the disease occurs at the same time in many countries, scientists still suspect it is a viral disease.

It is worth noting that adenovirus was detected in the majority of blood samples of infected children (according to a WHO report on April 23, 2022, out of a total of 169 children with mysterious hepatitis, 74 cases were positive for adenovirus, in which 18 cases were positive for adenovirus type 41). In addition, in the UK, where the number of mysterious hepatitis cases is reported the most, has also recently recorded a significant increase in cases of adenovirus infection in the community.

Therefore, adenovirus is currently the most suspected causative agent of mysterious hepatitis. This is only a question, further studies are needed to determine if adenovirus is the real cause of the recent episode of hepatitis.

Mysterious hepatitis in children confuses many parents: The hepatologist explains it in detail - Photo 1.

Adenovirus is now the suspected causative agent of the mysterious hepatitis. Photo: Shutterstock

Adenovirus is a virus containing double-stranded DNA, consisting of many different viral forms and capable of infecting different organs, most commonly the respiratory and digestive systems. Depending on the type of virus causing the disease, most of the clinical manifestations are mild illnesses such as colds, bronchitis, conjunctivitis, and gastroenteritis.

Adenovirus type 41 is a virus that causes gastroenteritis in children, with symptoms such as diarrhea, vomiting, and fever, often accompanied by respiratory symptoms. Although several cases of hepatitis due to adenovirus infection in immunocompromised children have been reported in the past, adenovirus type 41 has never been known to cause severe hepatitis in otherwise healthy children as has been the case in a series of cases. Mysterious liver in recent times.

Is mysterious hepatitis related to COVID-19 infection and COVID-19 vaccination?

According to a WHO report on April 23, 2022, out of a total of 169 cases of mysterious hepatitis, only 20 were found to be infected with COVID-19 (including 19 co-infections with COVID-19 and adenovirus). This shows that mysterious hepatitis is not related to COVID-19 infection.

Another suspicion was that the hepatitis was caused by the COVID-19 vaccine, but this has been ruled out because of the children with the mysterious hepatitis, the number of children who have received the COVID-19 vaccine is small (most sick children under 5 years old and not eligible for vaccination).

What should parents do?

The risk of mysterious hepatitis entering Vietnam is very high, but the frequency of children with hepatitis in our country recently has not increased abnormally and no cases of adenovirus have been recorded. Therefore, parents should monitor the disease situation and information from the Ministry of Health, should not be too confused and worried, Dr. Trung recommended.

The clinical presentation of occult hepatitis is generally similar to that of acute viral hepatitis caused by hepatitis A, B, C, D and E viruses (fatigue, anorexia, vomiting, abdominal pain within 3–10 days) the first day; then yellow eyes, jaundice, dark urine may appear, when yellow eyes and skin appear, the patient does not have fever).

Most children will make a full recovery on their own. Before the current situation, parents need to be aware of these symptoms and take their children to a specialized medical facility for examination as soon as there are suspicious symptoms, especially when there is yellowing of the eyes, skin, dark urine. appear.

Adenovirus is transmitted from person to person through the gastrointestinal tract (the stool of an infected person contains the virus), the respiratory tract (respiratory secretions when an infected person coughs or sneezes contain the virus), and through direct contact. (shaking hands) or indirectly (contacting a surface or object contaminated with the virus of an infected person, then bringing it to the eyes, nose and mouth without disinfecting hands).

Preventive measures for children include wearing masks, respiratory hygiene, washing hands often with soap or antiseptic solution (especially before eating, after going to the toilet, before touching the eyes, nose, mouth of children) himself) and eat and drink well. Children should avoid contact with people who are sick.

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