Even the hypothesis, advanced by some researchers, that it is an adenovirus that causes hepatitis is considered unlikely. Continue the surveillance to understand better
On the causes of severe acute hepatitis in children of which, according to the latest data from theEcdc (the European Center for Disease Prevention and Control) were 190 cases reported worldwide, there is still no certainty. However the Higher Institute of Healthin a Close-up on the affair published today, tends to rule out a connection between disease and vaccination against Covid: Several considerations would lead to exclude it, the ISS experts write.
The considerations
On what basis does the ISS formulate its considerations?
The first is that in almost all cases in which the status is known, the affected children had not been vaccinated.
Not only. Even the hypothesisadvanced by some researcher, c
I have an adenovirus to cause hepatitis in itself unlikely, as this type of virus is not normally associated with liver disease. In any case the adenovirus contained in the anti Sars-Cov-2 adenoviral vector vaccines used in some countries (in Italy AstraZeneca and Janssen), genetically modified so as not to replicate in the cells of our body. Therefore, at the present state of knowledge, the phenomena of recombination between circulating Adenoviruses and vaccine strain do not seem biologically possible. These in fact presuppose the mixing of genes between viruses as they multiply, but this is not possible for the vector used for vaccination, they explain.
The first hypotheses: infection or intoxication
In the foreground, the ISS experts reconstruct what has happened so far. The initial hypotheses of the UK survey team
proposed an etiology (i.e. a cause ndr) infectious or possible exposure to toxic substances. Detailed information collected through a questionnaire relating to food, drink, personal habits of the cases did not reveal common exposures. Toxicological investigations are ongoing, but an infectious etiology appears to be more likely based on the epidemiological and clinical picture. Microbiological investigations excluded hepatitis A, B, C, D and E viruses in all cases. Among 13 reported cases from Scotland for which detailed testing information is available, three had confirmed SARS-CoV- infection, 5 were negative and 2 had SARS-CoV-2 infection three months earlier. Five cases had a positive test for adenovirus among 11 of the 13 cases for which data on this type of test was available.
The evolution from the first cases to today
In the report of the ISS we read:On April 5, 2022, the United Kingdom reported an increase in the number of hepatitis cases in previously healthy children under 10 years of age. On 12 April, the UK reported that, in addition to the cases reported in Scotland, around 61 cases under investigation had been identified in England, Wales and Northern Ireland, most between the ages of 2 and 5. On 14 April, Scotland reported 13 cases under investigation including two couples with epidemiological links. The clinical presentation of cases in the UK was severe acute hepatitis with increased transaminases (AST / ALT) above 500 IU / L and in many cases jaundice. In the previous weeks, some cases had presented gastrointestinal symptoms including abdominal pain, diarrhea and vomiting. The
most of the cases did not present fever.
Some cases have received specialist care in pediatric hepatology units and some of these have received liver transplantation. As of April 21, 2022, cases of acute hepatitis in children have been reported in Belgium, Denmark, France, Ireland, Holland, Romania, Spain, potentially in Sweden, on April 19 in Israel (12 cases) and on April 20 in Italy (4 cases). Most countries report a limited number of cases. The United Kingdom is an exception which, as of April 21, 2022, had identified over 100 children under the age of 10 with acute hepatitis in total 8 children received liver transplants.
Outside the EU
Outside the European Union, as of April 15, 9 cases of acute hepatitis among children aged 1 – 6 years with a positive test for adenovirus have been reported by the health authorities of the US state of Alabamasome of these had an adenovirus serotype 41 infection. At the moment – reports the ECDC in the latest bulletin updated on 23 April – there is no clear correlation between the reported cases. No clear epidemiological risk factors emerged between the cases, as well as no association with travel.
The action of the ISS
What does the ISS do? At the moment there are several activated structures. The “Integrated Epidemiological System of Acute Viral Hepatitis” (SEIEVA) the special surveillance of acute hepatitis, active in the ISS since 1985. SEIEVA supports and integrates the “Information System of Infectious and Diffusive Diseases” SIMID managed by the Ministry of Health, in order to promote the investigation and control of acute viral hepatitis at a local and national level.
The Italian network active in share sequencing data for SARS-CoV-2 strains of pediatric acute hepatitis cases n which such infection should be confirmed. This will allow you to better understand if SARS-CoV-2 infection is an accidental event, due to the high circulation of the virus in Europe, or if the etiological factor should be considered
of these forms of hepatitis, the experts conclude.
April 26, 2022 (change April 27, 2022 | 09:47)
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