Bulgaria Begins Testing for Mysterious Hepatitis in Children
Source：Novini BG
From：Taiwan Trade Center, Sofia
Update Time：2022/05/22
Bulgaria has begun tests for the presence of mysterious acute hepatitis in children, which has been found in several countries in Europe. This was reported by the National Center for Communicable and Parasitic Diseases (NCPB), cited by DarikNews.bg.
The Health Ministry has informed personal doctors, pediatricians, infectiousists and other medics about cases of acute hepatitis of unknown etiology recorded in a number of countries in children, including clinical conduct and laboratory results.
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In order to establish the etiological causative agent for each reported case, clinical samples should be sent to the NCPB for further laboratory and molecular biological studies on pathogens, the communication said.
History of mysterious hepatitis
On 5 April 2022, the UK reported to the World Health Organisation (WHO) an increase in cases of acute hepatitis with unexplained etiology in children under 10 from Scotland. By April 20, 2022, there were 111 cases reported from across the UK, the NCPB recalls.
Symptoms
These are cases of previously healthy children, aged 2 to 5 years, who were hospitalized due to the manifestation of symptoms of acute hepatitis – jaundice (74%), vomiting (73%), grayed stools (58%), diarrhea (49%), nausea (39%) and fever (29%); and severely inflated liver enzymes – ALT and AST (> 500 IU/L). No immunosuppression has been reported in any of the children. In some cases, gastrointestinal symptoms were present in the weeks before hospitalization. In total, complications requiring liver transplantation developed in 8 of all reported cases. In all other cases, the infection ended with a favorable outcome.
Microbiological studies conducted so far have found positive results with regard to adenovirus (75%), with the typing of the virus done in 11 cases and proven adenovirus type 41F. 16% of children in hospitalization tested positive for COVID-19 (past or present infection) with a small percentage of adenovirus co-infection detected. Due to the increased percentage of positive tests for adenovirus in children established by diagnostic laboratories for the same period of previous years, it is hypothesized that a suspected causative agent of acute hepatitis in children may be an adenovirus infection, the Center states. A similar trend has been established with regard to enerovirus, human mtadnevmovirus, rhinovirus and norovirus in children under 10 years, as well as respiratory sycitic virus.
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What we know about the disease
The disease is quite rare, and evidence of human-to-human transmission remains unclear, as a result of which the risk cannot be accurately assessed. Given the reported cases of acute hepatic insufficiency, the potential impact on the affected paediatric population is considered high. Therefore, on 8 April, the European Centre for Disease Control asked all EU/EEC countries to raise awareness of cases of severe acute hepatitis in children with unexplained etiology and to report any confirmed and possible cases.
Where the unknown hepatitis has been registered so far
So far, 12 EU countries have reported sporadic cases – Austria (2), Belgium (2), Denmark (6), France (2), Germany (1), Ireland (5), Italy (17), the Netherlands (4), Norway (2), Poland (1), Romania (1) and Spain (12), with a total of 5 children required liver transplantation.
Source: https://novini.bg/zdrave/bolesti/717062