Suspected cases of acute hepatitis in children are on the rise in Brazil – Nacional

So far, six cases have been reported in Rio de Janeiro, six in Sওo Paulo and two in Paran. (Photo: Pixabay / Disclosure)

The Ministry of Health has investigated, since last Friday (5/6), 16 suspected cases of severe acute hepatitis in children in the country, nine of which were reported only on Monday (5/9). State health departments are monitoring these cases.

The disease is rare in children

In contrast to chronic hepatitis, acute hepatitis is short-lived, according to infectious disease specialist Luana Araujo. “Hepatitis is an inflammation of the liver. In severe cases, the illness can last for weeks or up to six months. Different from chronic, which in many cases time is uncertain, “he explained.

He further explained that the disease is rare in children because the viruses responsible for infecting them usually affect the respiratory system, not the liver.

“In some cases, such as in immunosuppressed children, some viruses can infect other organs, including the liver. However, in general, this organ is not prone to these infectious agents in childhood, ”the doctor explained.

Also, Luana noted that the causes of hepatitis, which usually occurs in adults – such as A, B, C, D and E – are not common in the child population.

“Hepatitis A and B are prevented by vaccination, and this is reflected in the protection of children, as they are rare in diseases of this nature. “, He explained.

In light of the current situation, infectious experts warn that while the numbers are lower than on a global scale, the situation is getting worse, which is a concern for health agencies. “The feature that is attracting the most attention is the increase in cases, because, in the last 20 days, it has increased fivefold,” he warned.

According to Luana, since it is mild in most cases, some symptoms may go unnoticed. “However, one of the factors attracting the attention of the international community is the intensity ratio, which is much higher than expected. This is because 90% of children with suspected severe acute hepatitis need to be hospitalized, and within this hospitalization, 10% to 14% need a liver transplant, ”he added.

He says the group also has concerns about mortality. “The death rate is very high, reaching 3.1%. So, there is a sensitivity to perceiving these notifications, as there is a large proportion of severe cases, which may require implant or death, ”the infectologist emphasized.

Symptoms include, as well as common cases of hepatitis, gastrointestinal problems, such as vomiting, diarrhea and abdominal pain and changes in the sclera of the eye, which usually turn yellow. At the laboratory level, the amount of enzymes in the liver changes.

Luana explains that there is no specific treatment yet. “There is a constant search for the patient to bear the symptoms and stabilize them. That way, it can be avoided if the situation worsens, and if you need a liver transplant, the transplant network ecosystem is alert and working, “he said.

The frame may be related to COVID-19, not the vaccine

Even without identifying the cause, the infection specialist says there are already some guidelines.

“Initially, there was a high prevalence of adenovirus 41 in infected children. However, in cases where a liver biopsy was possible, there was nothing to do with the virus in these livers. In addition, it is a very common agent, responsible for causing colds, and therefore, not associated with the cause of hepatitis in healthy children, ”he said.

Luana explained that one of the hypotheses may be a complication caused by Covid-19, since, according to the clinical literature, the disease may alter liver enzymes. Therefore, severe acute hepatitis may cause late onset of the new coronavirus in these children.

“Some of these children had a history of acute covid and contact with patients, not necessarily with disease. So, we are talking about a weak population that has a lot of contact with the virus, ”he said.

“The fact that these children have not been vaccinated has nothing to do with the vaccine. And there is no link between adenovirus 41 and the similar adenovirus used in immunizers against COVID-19, which is used in most places, “he noted.

“Children who are eligible to be vaccinated need to be vaccinated, because immunizations, regardless of age group, reduce the risk of serious manifestations associated with COVID. We cannot condemn children because of the irresponsibility of adults. “, He said.

According to infectologists, it is important for parents to understand the benefits of vaccination. “It is the duty of those responsible to look after the life and safety of the child. She should be safe around, so in case of social interaction, if she can, wearing a mask is important. Also, to protect this vulnerable group, adults must be vaccinated, “he said.

Understand the case

The World Health Organization (WHO) has issued a warning in the United Kingdom on April 15 for pediatric fulminant hepatitis. Since then, several cases have been reported in more than 20 countries, including Spain, Denmark, Argentina, Israel, France, Italy, Norway, Romania and Belgium.

According to the latest balance published by the WHO, on the 1st of this month, at least 17 children have needed a liver transplant since the onset of the outbreak. Also, there are at least 26 reports of mysterious hepatitis and one death.

The organization is investigating the link between the event and adenovirus, which causes respiratory and gastrointestinal diseases. Subtype 41 of the disease can be gastroenteritis, which will trigger hepatitis.

However, the WHO investigates to analyze whether toxins, environmental agents, drugs may be related. It is also suspected that Kovid-19 may have caused the disease.

* Trainees under supervision

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