1887
Outbreaks Open Access
Like 0

Abstract

Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18–3.74) and transplanted (OR = 3.36; 95% CI: 1.19–9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2022.27.31.2200483
2022-08-04
2024-03-29
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.31.2200483
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/27/31/eurosurv-27-31-3.html?itemId=/content/10.2807/1560-7917.ES.2022.27.31.2200483&mimeType=html&fmt=ahah

References

  1. Braccio S, Irwin A, Riordan A, Shingadia D, Kelly DA, Bansal S, et al. Acute infectious hepatitis in hospitalised children: a British Paediatric Surveillance Unit study. Arch Dis Child. 2017;102(7):624-8.  https://doi.org/10.1136/archdischild-2016-311916  PMID: 28377449 
  2. Squires RH Jr, Shneider BL, Bucuvalas J, Alonso E, Sokol RJ, Narkewicz MR, et al. Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group. J Pediatr. 2006;148(5):652-8.  https://doi.org/10.1016/j.jpeds.2005.12.051  PMID: 16737880 
  3. Alonso EM, Horslen SP, Behrens EM, Doo E. Pediatric acute liver failure of undetermined cause: A research workshop. Hepatology. 2017;65(3):1026-37.  https://doi.org/10.1002/hep.28944  PMID: 27862115 
  4. Marsh K, Tayler R, Pollock L, Roy K, Lakha F, Ho A, et al. Investigation into cases of hepatitis of unknown aetiology among young children, Scotland, 1 January 2022 to 12 April 2022. Euro Surveill. 2022;27(15):2200318.  https://doi.org/10.2807/1560-7917.ES.2022.27.15.2200318  PMID: 35426362 
  5. World Health Organization (WHO). Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland. Geneva: WHO; 2022. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON368
  6. United Kingdom Health Security Agency (UKHSA). Increase in hepatitis (liver inflammation) cases in children – latest updates. London: UKHSA; 2022. Available from: https://www.gov.uk/government/news/increase-in-hepatitis-liver-inflammation-cases-in-children-under-investigation
  7. United Kingdom Health Security Agency (UKHSA). Investigation into acute hepatitis of unknown aetiology in children in England. Technical briefing 3. London: UKHSA; 2022. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1077027/acute-hepatitis-technical-briefing_3.pdf
  8. United Kingdom Health Security Agency (UKHSA). Investigation into acute hepatitis of unknown aetiology in children in England. Technical briefing. London: UKHSA; 2022. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1071198/acute-hepatitis-technical-briefing-1_4_.pdf
  9. United Kingdom Health Security Agency (UKHSA). Investigation into acute hepatitis of unknown aetiology in children in England. Technical briefing 2. London: UKHSA; 2022. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1073704/acute-hepatitis-technical-briefing-2.pdf
  10. de Kleine RH, Lexmond WS, Buescher G, Sturm E, Kelly D, Lohse AW, et al. Severe acute hepatitis and acute liver failure of unknown origin in children: a questionnaire-based study within 34 paediatric liver centres in 22 European countries and Israel, April 2022. Euro Surveill. 2022;27(19):2200369.  https://doi.org/10.2807/1560-7917.ES.2022.27.19.2200369  PMID: 35551705 
  11. van Beek J, Fraaij P, Giaquinto C, Shingadia D, Horby P, Indolfi G, et al. Case numbers of acute hepatitis of unknown aetiology among children in 24 countries up to 18 April 2022 compared to the previous 5 years. Euro Surveill. 2022;27(19):2200370.  https://doi.org/10.2807/1560-7917.ES.2022.27.19.2200370  PMID: 35551703 
  12. European Centre for Disease Prevention and Control (ECDC). Hepatitis of unknown origin - Reporting protocol 2022. Version 2.1. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/hepatitis-unknown-origin-reporting-protocol-2022
  13. European Centre for Disease Prevention and Control (ECDC), World Health Organization Regional Office for Europe (WHO/Europe). Hepatitis of unknown origin in children. Joint Epidemiological overview. Stockholm: ECDC; Copenhagen: WHO/Europe; 2022. Available from: https://www.ecdc.europa.eu/en/hepatitis/joint-weekly-hepatitis-unknown-origin-children-surveillance-bulletin
  14. European Centre for Disease Prevention and Control (ECDC). Guidance for diagnostic testing of cases with severe acute hepatitis of unknown aetiology in children. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/guidance-diagnostic-testing-cases-severe-acute-hepatitis-unknown-aetiology
  15. World Health Organization (WHO). Laboratory testing for severe cute hepatitis of unknown aetiology in children: interim guidance, 17 June 2022. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/who-unkhep-laboratory-2022.1
  16. World Health Organization (WHO). Suggested minimum variables for reporting cases of severe acute hepatitis of unknown aetiology in children: line list, 17 June 2022. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/WHO-UnkHep-Surveillance-Line_list-2022.1
  17. World Health Organization (WHO). The WHO Global Clinical Platform for severe acute hepatitis of unknown aetiology in children. Geneva: WHO; 2022. Available from: https://www.who.int/tools/global-clinical-platform/severe-acute-hepatitis-of-unknown-aetiology-in-children
  18. Somasekar S, Lee D, Rule J, Naccache SN, Stone M, Busch MP, et al. Viral surveillance in serum samples from patients with acute liver failure by metagenomic next-generation sequencing. Clin Infect Dis. 2017;65(9):1477-85.  https://doi.org/10.1093/cid/cix596  PMID: 29020199 
  19. Reicherz F, Xu RY, Abu-Raya B, Majdoubi A, Michalski C, Golding L, et al. Waning immunity against respiratory syncytial virus during the COVID-19 pandemic. J Infect Dis. 2022;jiac192.  https://doi.org/10.1093/infdis/jiac192  PMID: 35524952 
  20. Sanz-Muñoz I, Tamames-Gómez S, Castrodeza-Sanz J, Eiros-Bouza JM, de Lejarazu-Leonardo RO. Social distancing, lockdown and the wide use of mask; a magic solution or a double-edged sword for respiratory viruses epidemiology? Vaccines (Basel). 2021;9(6):595.  https://doi.org/10.3390/vaccines9060595  PMID: 34205119 
/content/10.2807/1560-7917.ES.2022.27.31.2200483
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error