On April 15, 2022, the World Health Organization (WHO) issued for the first time an alert on cases of severe acute hepatitis of unknown cause in children, since then 448 suspected cases have been reported in the world, including Mexico.
In the country, according to health authorities, there are at least 21 suspected cases of childhood hepatitis severe acute illness of unknown cause, in states such as Nuevo León, Hidalgo, Mexico City, Durango, Sinaloa, San Luis Potosí and Coahuila, but for now no conclusive results have been reported, some have even been ruled out.
The issue in the country became more relevant when learning that this Wednesday the death of the first minor with a suspected case of hepatitis was reported. The death occurred in a 3-year-old boy, originally from Tulancingo, Hidalgo, it happened in the Hospital of the Racein Mexico City, where preparations were being made for a liver transplant.
What do we know so far about the disease?
To measure the problem and know what science tells us so far, The Economist spoke with Dr. Francisco Moreno, infectologist, internist and responsible for the coronavirus of the ABC Medical Center. He explains that this outbreak apparently started at the end of March in Scotland, with 11 cases. Although most cases are in Europe and Great Britain, cases have already begun to be documented in most parts of the world. “It is a hepatitis where the infectious agent has not been clearly identified.”
He said that this hepatitis is new and aggressive, because 10% of cases have required a liver transplant. But “until now, in the world there is a well-documented death from this cause, in the Mexican case the details that allow us to attribute it to this new form of hepatitis have not yet been determined.”
The undersecretary for Prevention and Health Promotion, Hugo López-Gatell, recently explained that “the analysis of the data suggests that it is not a rapidly spreading disease (…) The number of cases identified is very small, compared to with the enormous number of cases of hepatitis that occur every year for which a cause is known (…) It is not a pattern of spread and it does not seem to be a disease that has those characteristics.” He even mentioned that these cases were identified thanks to the fact that Mexico is in a search and study protocol to help understand the cause of this disease.
This strain is characterized by inflammation of the liver, which occurs abruptly, and does not belong to any of the existing types (A, B, C, D and E), and also progresses very quickly to severity. The symptoms are abdominal pain, nausea, vomiting, yellow color in the conjunctiva of the eyes, dark urine and white stools.
What is the origin?
Dr. Moreno explains that the possibility that it is an adenovirus 41 has been suggested, but of the 348 cases studied, only 80 were able to identify that virus. Another possibility that is being studied is that it be a sequel. “In children we have seen a form of presentation of Covid-19 and two or three weeks later they develop or present Pediatric Multisystem Inflammatory Syndrome (SIMP)”.
This is characterized by the fact that the organs become inflamed due to an immune response to Covid-19, “what is beginning to be suggested is that this phenomenon that we are seeing is in relation to an inflammatory process caused by Covid-19, however, until the date is a theory because it has not been actively demonstrated.
What we also know, he said, is that 80% of these children are under the age of five, an age group that has not been vaccinated against Covid-19. This is important because another theory speaks of a sequel to the vaccine, but they are children who have not been vaccinated, so this is ruled out.
recommendations
These lines of research have not yet given conclusive results that allow the identification of the origin of acute hepatitis, so the specialist is the following:
- There are many causes of hepatitis, not all children who have the disease at this time will have this problem.
- The pandemic has not disappeared, so it advises continuing with the preventive measures of using face masks in closed spaces, hand washing and distance.
- We lack information, therefore, other measures would be alarmist or unnecessary.
- What you have to do is be aware of a yellow tint in the eyes or skin of the little ones, immediately go to the doctor to be evaluated.
Moreno concludes that normally the viral hepatitis in children they are benign, it is very rare for a child to have fulminant or severe hepatitis, this is what has been contrasted with this new form. The Hepatitis Afor example, it is very common in childhood, it is acquired by contaminated food or water, even many patients do not even realize that they had it until some antibody test is done, so he asked not to be alarmed, to be patient and remember that today we have vaccines against hepatitis A and B.
kg