November 25, 2023 in Health news, News

Epidemiological update: Hepatitis of unknown aetiology in children

Since the first alert launched by the United Kingdom (UK) on 5 April 2022, probable cases of hepatitis of unknown aetiology in children have been reported from several countries worldwide. It is not yet clear whether the cases identified following the alert are part of a true increase compared to the baseline rate of hepatitis of unknown aetiology in children.

The aetiology and pathogenetic mechanisms of disease are still under investigation. A possible association with current adenovirus infection has been found in cases in the UK in particular but other hypotheses and possible co-factors are under investigation. Most cases continue to be reported as sporadic un-linked cases.

This report presents an update of probable cases identified in the European Union/European Economic Area (EU/EEA) and worldwide. Whereas cases detected in the EU/EEA have been reported according to the ECDC/WHO case definition, worldwide cases are collected through screening of official websites and media sources and therefore different case definitions could have been used.

Case definition used in EU/EEA:

  • Confirmed: N/A
  • Probable: A person presenting with an acute hepatitis (non-hepatitis viruses A, B, C, D and E*) with aspartate transaminase (AST) or alanine transaminase (ALT) over 500 IU/L, who is 16 years old or younger, since 1 October 2021.
  • Epi-linked: A person presenting with an acute hepatitis (non-hepatitis viruses A, B, C, D and E*) of any age who is a close contact of a probable case since 1 October 2021.

Cases of hepatitis with known aetiology such those due to specific infectious diseases, drug toxicity, and metabolic hereditary, or autoimmune disorders should not be reported under this protocol.

In EU/EEA countries, approximately 105 cases have been identified in 13 EU/EEA countries as of 10 May 2022.

The total number of cases reported worldwide is approximately 450, including 11 deaths reported from Indonesia, Palestine, and the United States.

Actions: On 28 April 2022, ECDC published a rapid risk assessment. ECDC has established reporting of case-based data for cases of acute hepatitis of unknown aetiology in The European Surveillance System (TESSy). The reporting protocol is available here, and countries are strongly encouraged to report cases to TESSy. A separate report based on the data reported in TESSy will be published shortly.

An EpiPulse item remains available to Member States (MS) to report updates on their investigations in order to inform and facilitate communication between MS and ECDC.

ECDC will continue to monitor this event through its epidemic intelligence activities.

Source: ECDC