National Health and Health Commission: Do not support unknown causes of severe acute hepatitis as infectious diseases

Data map. Xinhua News Agency

Cover news reporter Shao Meng

Since March 2022, many countries and regions around the world have reported the serious acute hepatitis in children, and severe cases have been relatively high, which has attracted widespread attention. The cause of the disease is unknown, and there are no relevant case reports in my country.

On June 16, the cover reporter learned from the National Health and Health Commission that in order to prepare for medical treatment in advance, the National Health and Health Commission organized the "Guidelines for the Diagnosis and Treatment of Severe Children for Children (Trial)" (referred to as the "Guide"), " The content includes epidemic overview, cause and pathogenesis, clinical manifestations, case definition and diagnosis, laboratory examination, imaging performance, treatment measures, and prevention and control measures.

Do not support it as a infectious disease

On March 31, 2022, the British Scottish region reported for the first time in the United Kingdom. Children had severe acute hepatitis for children, and their children were 3 to 5 years old. On April 5, 2022, Britain reported to the WHO (World Health Organization). The unknown cases of acute hepatitis in healthy children under the age of 10 increased. Children had vomiting, jaundice, and high aminoase.

As of May 20, 2022, the European monitoring system data shows that the disease can be seen in children at all ages, which are more common under 5 years of age; 14.1%of inpatient children need to live in severe care ward. On May 27, 2022, WHO announced that 33 countries reported 650 suspected cases, at least 38 cases of liver transplantation, and 9 deaths. There are no relevant case reports in my country.

The "Guide" pointed out that there is no obvious epidemiological correlation between various cases, and it does not support it as infectious diseases.

The association with gonadicine needs to be further clarified

The cause and pathogenesis of serious acute hepatitis in children are still studying.

At present, WHO believes that although the hypothesis of adenovirus infection as the cause of the cause has a certain rationality, adenovirus usually causes a mild and self -limiting digestive or respiratory infection of children with low age, which cannot fully explain the more serious clinical manifestations of the disease. Therefore, the correlation between the disease and the adenovirus needs to be further clarified. Most children have not been vaccinated with new coronal virus vaccines and do not support hypothesis related to the side effects of the new coronal virus vaccine.

Other pathogenic factors are still exploring. For example, during the popularity of new coronary pneumonia, the level of adenovirus is low, which increases children's susceptibility; new adenovirus occurs; adenovirus combined with new coronal virus infection; new coronal virus infection complications lead to super antigen media media Immune cells activated, which causes children's multi -system inflammatory syndrome. The exploration of other pathogens is also underway, and non -infectious factors also need to be eliminated.

Most manifestations of nausea, vomiting, diarrhea and other digestive tract symptoms

The "Guide" clearly states that the severe acute hepatitis for children is an acute onset, and mostly manifested as fatigue and poor, nausea, vomiting, diarrhea, abdominal pain and other digestive tract symptoms. Some children may have white stool, enlarged liver, fever and respiratory symptoms, and individual may have spleen enlargement. A small number of cases can progress in a short period of time to acute liver failure, and jaundice has performed aggravation and hepatic encephalopathy.

There are currently no diagnostic standards for diagnosis. Suspected cases and epidemiological associations must pay attention to eliminating hepatitis, common non -hepatitis virus infections (such as EB virus, giant cyt virus, etc.), autoimmune diseases, and genetic metabolic diseases.

In terms of the diagnosis of acute liver failure, the Guide emphasized that suspected cases or epidemiological associations meet the following three criteria:

1. The liver disease of acute attacks has no evidence of chronic liver disease;

2. Evidence of biochemical evidence of severe liver injury;

3. Abnormal coagulation that can not be corrected by vitamin K, and meets one of the following two: (1) The original time (PT) ≥15s or international standard ratio (INR) ≥1.5, accompanied by hepatic encephalopathy; (2) PT ≥ PT ≥ PT ≥ 20s or INR ≥ 2, accompanied by hepatic brain disease.

The "Guide" reminds to strengthen hand hygiene and pay attention to wearing masks and diet hygiene. In clinical work, medical personnel need to take standard prevention measures. Once a suspected case is found, report it in time as required.

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