Acute hepatitis in children: the European disease agency concerned

The cases are increasing, and the mystery remains. The European agency in charge of diseases classified Thursday as a “worrying public health event” the unexplained cases of acute hepatitis which have affected children for several weeks. A classification justified by “the etiology (the cause of the disease) unknown, the affected pediatric population and the potentially serious impact”.

“The disease is quite rare and evidence of human-to-human transmission remains unclear. Cases in the European Union are sporadic with an unclear trend,” notes the European Center for Disease Control and Prevention (ECDC), which also acknowledged that it was unable to accurately assess the risk. of this hepatitis.

Two cases in France

While the first cases of hepatitis were reported at the end of March in Scotland, the number of cases recorded worldwide currently stands at 191: 114 in the United Kingdom, 2 in France, 53 in eleven other European countries, 12 in the United States. , 12 in Israel and 1 in Japan.

The risk to children in Europe “cannot be estimated precisely”, according to the agency, which covers the 27 countries of the European Union as well as Norway, Iceland and Liechtenstein. “Nevertheless, considering the reported cases of acute liver failure, with cases requiring transplantation, the potential impact for the pediatric population is considered high. »

The disease is linked to adenoviruses

Affected children ranged in age from one month to 16 years old, but most were under 10 years old, and many under 5 years old. None had comorbidities. The main working hypothesis is that the disease, which remains unknown, would be linked to adenoviruses, fairly commonplace and known viruses, which generally cause respiratory, ocular and digestive symptoms.

“An adenovirus infection, which would be mild under normal circumstances, would trigger a more severe infection or immune-mediated liver injury,” according to this lead. Other causes, including toxic, “are still under investigation and have not been ruled out but are considered less plausible”, according to the ECDC, which recommends reinforcing good hygiene practices with the ” cleaning of hands and surfaces in places frequented by young children”.

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