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Infectious diseases in children
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4 results
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Hepatitis of unknown aetiology in children – epidemiological overview of cases reported in Europe, 1 January to 16 June 2022
Adriana Romaní Vidal , Aisling Vaughan , Francesco Innocenti , Soledad Colombe , Lina Nerlander , Natalia Rachwal , Bruno Christian Ciancio , Aikaterini Mougkou , Carlos Carvalho , Enrique Delgado , Piers Mook , Géraldine de Muylder , Michael Peeters , Tencho Tenev , Elitsa Golkocheva-Markova , Veronika Vorobieva Solholm Jensen , Anders Koch , Julie Figoni , Cécile Brouard , Georgia Nikolopoulou , Anastasia Zisouli , Niamh Murphy , Annemarie Broderick , Lital Goldberg , Rivka Rich , Lior Hecht Sagie , Maria Elena Tosti , Barbara Suligoi , Rosa Joosten , Roan Pijnacker , Ingvild Fjeldheim , Eli Heen , Małgorzata Stępień , Piotr Polański , Rui Tato Marinho , João Vieira Martins , Carmen Varela , Ana Avellón , Emmi Andersson , Marie Jansson Mörk , Sema Mandal , Conall Watson , Laura Coughlan , Meera Chand , Claire Neill , Declan T Bradley , Kathy Li , Maureen O’Leary , Neil McInnes , Christopher J Williams , Catherine Moore , Ardiana Gjini , Erika Duffell and Richard PebodyFollowing 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.
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Case numbers of acute hepatitis of unknown aetiology among children in 24 countries up to 18 April 2022 compared to the previous 5 years
An increase of acute hepatitis of unknown aetiology has been reported among children in multiple countries worldwide. With a rapid online survey among hospitals in and outside of Europe, we describe case numbers recorded from 1 January to 18 April 2022 vs the previous 5 years. Of 24 countries that responded, we identified 5/17 European and 1/7 non-European countries with an elevation in probable cases of unexplained acute hepatitis, and severe cases were elevated in five European countries.
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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
To detect potential concern about severe acute hepatitis in children, we conducted a survey among 50 ERN RARE-LIVER centres. By 26 April 2022, 34 centres, including 25 transplant centres, reported an estimated median of 3–5, 0–2 and 3–5 cases in 2021, 2020 and 2019 and a mean of 2 (range: 0–8) cases between January and April 2022 (mean in 10 large liver transplant centres: 3). Twelve centres reported suspicion of an increase, but no rise.
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Investigation into cases of hepatitis of unknown aetiology among young children, Scotland, 1 January 2022 to 12 April 2022
On 31 March 2022, Public Health Scotland was alerted to five children aged 3–5 years admitted to hospital with severe hepatitis of unknown aetiology. Retrospective investigation identified eight additional cases aged 10 years and younger since 1 January 2022. Two pairs of cases have epidemiological links. Common viral hepatitis causes were excluded in those with available results. Five children were adenovirus PCR-positive. Other childhood viruses, including SARS-CoV-2, have been isolated. Investigations are ongoing, with new cases still presenting.
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