Doctor answers all questions about “mysterious” acute hepatitis in children – Life Health

Acute hepatitis has symptoms of liver damage at different levels such as jaundice, yellow eyes, pale stools, destruction of liver cells…

Recently, there has been a lot of information about acute hepatitis of unknown cause in children. From the first cases recorded in October 2021, as of May 10, the World Health Organization (WHO) has reported 348 cases of the disease in 25 countries, an increase of 70 cases compared to May 10. with the organization’s report on May 6.

In Vietnam, so far, no cases have been recorded nationwide.

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Dr. BS Nguyen Pham Anh Hoa – Head of Hepatology Department, National Children’s Hospital answered questions about acute hepatitis.

What is acute hepatitis of unknown etiology?

Acute hepatitis is a condition in which the liver is newly damaged due to many causes such as viruses, bacteria, toxins, metabolic disorders, hemodynamic disorders, immune disorders or systemic diseases, leading to As a result, liver cells are destroyed. Most cases of acute hepatitis are reversible after eliminating the causative agent, a few are severe, resulting in irreversible liver failure and possibly death. Long-term progression can lead to chronic liver disease, cirrhosis…

According to WHO, acute hepatitis of unknown etiology in children has some common features as follows:

Age: between 0-16 years old. Young children get sick more often.

Have one or more symptoms such as fever, abdominal pain, vomiting, diarrhea, etc.

There are symptoms of liver damage at different levels such as jaundice, yellow eyes, pale stools, liver cell destruction (increased levels of liver enzymes in the blood).

No known common causes of liver injury were found.

Patients can recover after active supportive treatment, however, in some cases, severe progression causes irreversible liver failure, need for liver transplant and there have been cases of death.

Parents need to pay attention to monitor their children, if children have suspicious signs such as yellowing of the skin, eyes, pale stools, lethargy, etc., they need to take the child to a medical facility for an early diagnosis. and prompt treatment.

The emergence of a new virus variant or not?

Changes and immune responses of children after COVID-19 infection, as well as response to other common viruses.

According to WHO, 70% of patients in the hepatitis group of unknown etiology in the UK and 50% of cases in the US have been found to have adenovirus strain 41. This is a virus that has been discovered since 1953 with many strains and can cause disease in many organs. The most common lesions caused by Adenovirus are respiratory infections, conjunctivitis (pink eye), cystitis, meningitis… After Rotavirus, Adenovirus is the second cause of diseases in the gastrointestinal tract with symptoms in the stomach, intestines…. In young children, common digestive disorders caused by adenovirus include diarrhea, vomiting, and nausea. According to previous studies, evidence from antibody testing suggests that most children have had at least one adenovirus infection between the ages of 0 and 4 years. In the past, there have been isolated reports of a few pediatric patients with this virus causing liver damage in immunocompromised children.

Until now, there is not enough evidence to confirm that Adenovirus is the cause of disease in the group of children with acute hepatitis mentioned above, however, the recognition of the presence of Adenovirus in some pediatric patients needs to be further monitored and studied. next time.

Virus SARS-CoV-2 (causing COVID-19) is the cause of the disease?

To date, out of 348 cases, some children have tested positive for the SARS-CoV-2 virus. There are 10-18% of sick children with evidence of co-infection with SARS-CoV-2 virus and Adenovirus. The role of the SARS-CoV-2 virus in causing disease is not really clear and needs to be further studied.

Is the COVID-19 vaccine the cause of acute hepatitis?

Most of the sick children are young children who have not been vaccinated against COVID-19. Therefore, there is no association between the COVID-19 vaccine and acute hepatitis.

How is acute hepatitis of unknown cause treated?

Because the cause of the disease is unknown, there is no specific treatment. Treatment measures are mainly symptomatic and supportive treatment, including aggressive resuscitation measures for severe liver failure such as plasma exchange, continuous dialysis, etc., and possibly transplantation. emergency liver.

The goal is to provide early supportive treatment for children to limit the level of damage to the lowest level and enhance the ability to restore liver function and liver transplantation in case of decompensated liver failure.

Is there a possibility that the case of acute hepatitis will appear in Vietnam?

It is entirely possible that cases of acute hepatitis of unknown cause in Vietnam will occur. Currently, a number of Asian countries have reported cases such as Japan, Singapore, and Indonesia.

Notes for parents on prevention of acute hepatitis in children

Because to date, the cause of liver damage in this group of patients is still unknown, so it is not possible to recommend specific and active preventive measures. However, young parents should not be too alarmed. We need to be calm and attentive to be able to detect early symptoms of gastrointestinal disease and liver damage in children.

Children with symptoms of fever, abdominal pain, vomiting-nausea, diarrhea, fatigue, jaundice, conjunctivitis… should be examined at medical facilities.

While waiting for research results to confirm the cause of the disease in order to have specific measures, disease prevention should adhere to the following principles:

Practice good personal hygiene, wear a mask, wash hands often, especially before preparing food, before eating, after cleaning.

Fully immunize children according to the immunization schedule, including vaccines against hepatitis Bhepatitis A, COVID-19 vaccine when indicated.

Use clean food sources, ensure food hygiene and safety

Pay special attention to the prevention of diseases for children in schools and kindergartens by ensuring hygiene, using separate personal belongings (drinking cups, spoons, eating bowls, towels…).