EODY: Three cases of children with acute hepatitis in Greece

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Three cases of children with acute hepatitiswhich meet the criteria of the “probable case” as defined by the World Health Organization, were identified in country us.

According to the relevant announcement of EODY, two of them, aged 14 months and 10 years, showed symptoms from the gastrointestinal tract (abdominal pain and vomiting) as well as fever, and the laboratory test showed an increase in liver enzymes (transaminases> 500 IU / ml). The other child, 18 months old, was asymptomatic and his transaminases were found to be increased> 500 IU / ml in a preventive laboratory test.

Test for viral hepatitis A-E was negative in all children. No EBV, CMV, adenovirus or SARS-CoV-2 virus was detected in any of the other laboratory tests. One was not hospitalized and both needed a few days of hospitalization. The children did not show any complications, did not receive special treatment and are in excellent general condition.

Clinicians are aware of this emerging situation, have been informed and are vigilant for the early detection of children up to 16 years old, who show signs and symptoms of hepatitis without a clear reason, and in such a case fill in and send to EODY a declaration form.

EODY closely monitors the development of the situation, is in systematic communication with the European public health bodies, the European Center for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) and has already informed all the health regions of the country. , the Panhellenic Medical Association, as well as scientific companies, whose members may face similar incidents. Instructions have also been sent for the collection and dispatch of samples to the Central Laboratory of Public Health, so that the necessary control can be performed immediately to identify the cause of the epidemic outbreak.

Epidemiology of acute hepatitis worldwide

In early April, an unusually high incidence of acute hepatitis was observed in children in the United Kingdom. No case of hepatitis virus infection (A to E) was documented and no correlation with travel, or exposure to toxic or environmental factors was found.

The clinical syndrome occurs in children up to 16 years of age, most often between 2 and 5 years of age, and includes severe acute hepatitis with markedly elevated transaminases, often with jaundice and gastrointestinal symptoms (vomiting as a predominant symptom), which preceded by jaundice.

Following the announcement of the incidents by Great Britain, similar incidents have been reported in 16 European countries as well as in the USA, Canada, Japan, Israel, Singapore. The total number of cases worldwide is extremely small. To date, about 300 cases have been reported, of which 163 have been reported by the United Kingdom. Although countries with suspected cases are being added, the number of cases per country does not appear to be increasing, suggesting that the spread is limited.

Most of the children needed hospitalization, some needed transfer to specialized pediatric hepatology units and a small percentage underwent liver transplants.

Hepatitis viruses (A to E) have been excluded from the laboratory test performed so far, while in several cases adenovirus and / or SARS-CoV-2 virus have been detected, but without being able to clarify the possible role of of these viruses in the pathogenesis of hepatitis showing the reported cases. Therefore, the underlying cause of this increase, from the beginning of 2022, remains currently unknown. Further laboratory investigations are underway into the identified cases, for additional infections, chemical agents and toxins.

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