São Paulo – The Ministry of Health said this Friday, 6th, that it monitors seven suspected cases of acute childhood hepatitis of unknown origin, three in Paraná, and four in Rio de Janeiro. The origin of the infection recorded in children is still unknown, but it is known that it can trigger a number of problems, including the need for a liver transplant, and that it can be fatal.
The folder also informed that the Centers for Strategic Information on Health Surveillance (CIEVS) monitor, together with the National Hospital Surveillance Network, any change in the epidemiological profile, as well as the detection of suspected cases of the disease, and guides health professionals and the Network National Surveillance, Alert and Response to Public Health Emergencies of the Unified Health System (VigiAR-SUS) that suspects are immediately notified.
On Thursday, 5th, the government of Argentina notified the confirmation of the first case of the disease in Latin America, in an eight-year-old boy. Then, Panama also confirmed a case in the country. Until then, only the United States and Europe had confirmed cases of the infection.
As of May 3, more than 200 cases have been recorded in 20 countries, according to the World Health Organization (WHO), the vast majority of them in the United Kingdom, the first country to report the disease. There have already been at least four deaths – one confirmed by British authorities and three by Indonesia.
According to the WHO, hepatitis is an inflammation that affects the liver caused by a variety of infectious viruses (viral hepatitis) and non-infectious agents. The infection can lead to a number of health problems, which can be fatal. The common viruses that cause acute viral hepatitis (hepatitis A, B, C, D, and E viruses) were not detected in any of these cases.
Although the syndrome affects patients up to 16 years of age, most cases are in the 2 to 5 year old range. The picture of European children is one of acute infection. Many have jaundice, which is sometimes preceded by gastrointestinal symptoms – including abdominal pain, diarrhea and vomiting -, especially in children up to 10 years of age. Most cases did not have fever.
In case of suspicion, blood tests (with initial experience that whole blood is more sensitive than serum), serum, urine, stool and respiratory samples, as well as liver biopsy samples (when available) are recommended. further characterization of the virus, including sequencing.
It is worth emphasizing that simple preventive measures for adenoviruses and other common infections involve regular hand washing and respiratory hygiene.
Experts believe that the causative agent of the disease is an adenovirus that is transmitted by contact or through the air. Although it is currently hypothesized as an underlying cause, it does not fully explain the severity of the clinical picture. Infection with adenovirus type 41, the type of adenovirus implicated, has not previously been associated with such a clinical presentation.
Adenoviruses are common pathogens – organisms that are capable of causing disease in a host – that usually cause self-limiting infections. They spread from person to person and most commonly cause respiratory illnesses, but depending on the type, they can also cause other illnesses such as gastroenteritis (inflammation of the stomach or intestines), conjunctivitis (pink eye) and cystitis (bladder infection).
According to the WHO, there are more than 50 immunologically distinct types of adenoviruses that can cause infections in humans. Adenovirus type 41 usually presents as diarrhea, vomiting, and fever, often accompanied by respiratory symptoms. The potential emergence of a new adenovirus is still being investigated. Another hypothesis is that there is some relationship with the new coronavirus. The possibility of being an adverse effect of the vaccine against covid-19, however, was ruled out, since most British patients had not taken the immunizer.