世界卫生组织调查儿童“神秘肝炎”，疑与新冠病毒有关
世界卫生组织（World Health Organization）在上周末报告称，儿童重症肝炎病例呈持续增长的态势，美国目前已经发现新病例。
世界卫生组织于4月15日发布了第一份关于肝炎爆发的报告，当时的病例全部在英国。在该报告发布之际，一共发现了10例年龄在11个月至5岁之间的儿童病例。
具体病因尚未确定。截至上周，世界卫生组织已经接到至少169例不明病因儿童急性肝炎报告，患者年龄在1个月到16岁之间。尽管病例仍然集中在英国，但西班牙、以色列、美国、丹麦、爱尔兰、荷兰、意大利、挪威、法国、罗马尼亚和比利时也出现了新病例。根据世界卫生组织的报告，至少有一例死亡。
所有报告病例均未检测出甲、乙、丙、丁、戊这五种与急性病毒性肝炎相关的常见病毒。该报告称，至少74个病例中检出腺病毒。腺病毒是一种常见的病原体，通常会引起人体自限性感染。此外，有20个病例检出新冠病毒。世界卫生组织正在调查肝炎爆发与新冠病毒之间的关联。
除急性肝炎和肝酶水平升高之外，报告病例的症状还包括腹痛、腹泻、呕吐和黄疸。腺病毒通常在人与人之间传播，最常引起咳嗽、喉咙痛和流鼻涕等呼吸道症状。根据具体类型，患者还可能出现胃肠炎、红眼病和膀胱感染等症状。
根据世界卫生组织的报告，可能感染人类的腺病毒有50多种。在经过分子检测的儿童肝炎病例中，有18例确认感染41型腺病毒，而这种病毒以前从未跟严重肝炎密切关联。它通常会引起腹泻和呕吐等症状。
“尽管一些肝炎病例是免疫力低下，并感染腺病毒的儿童，但41型腺病毒通常并不认为是免疫力正常儿童罹患肝炎的原因。”世界卫生组织在其报告中指出。
世界卫生组织表示，与肝炎爆发相关的高腺病毒感染率，可能仅仅是改善检测手段使然。“目前的假设是，腺病毒是根本病因，但它并不能完全解释临床症状的严重性。”
世界卫生组织指出，由于大多数儿童患者没有接种过疫苗，那种认为这是疫苗副作用的假设还得不到支持。在美国，5岁以下儿童仍未获准接种疫苗。
美国疾病控制和预防中心（U.S. Centers for Disease Control and Prevention）此前曾经将新冠病毒与儿童多系统炎症综合征（Multisystem Inflammatory Syndrome in Children）联系起来。这种综合征是一种以不同器官出现炎症为特征的疾病。2020年下旬发表在学术期刊《肝脏病学》（Hepatology）上的一篇论文确定，肝炎是儿童多系统炎症综合征患儿的常见症状。
“受影响的国家和尚未报告病例的国家，目前都需要进一步确认更多的病例。”谈到各国需要对肝炎爆发做出哪些适当的公共卫生反应时，世界卫生组织这样说道。“无论是对于腺病毒，还是其他常见病毒感染，最常规的预防措施都是勤洗手，并保持呼吸道卫生。”（财富中文网）
译者：任文科
世界卫生组织（World Health Organization）在上周末报告称，儿童重症肝炎病例呈持续增长的态势，美国目前已经发现新病例。
世界卫生组织于4月15日发布了第一份关于肝炎爆发的报告，当时的病例全部在英国。在该报告发布之际，一共发现了10例年龄在11个月至5岁之间的儿童病例。
具体病因尚未确定。截至上周，世界卫生组织已经接到至少169例不明病因儿童急性肝炎报告，患者年龄在1个月到16岁之间。尽管病例仍然集中在英国，但西班牙、以色列、美国、丹麦、爱尔兰、荷兰、意大利、挪威、法国、罗马尼亚和比利时也出现了新病例。根据世界卫生组织的报告，至少有一例死亡。
所有报告病例均未检测出甲、乙、丙、丁、戊这五种与急性病毒性肝炎相关的常见病毒。该报告称，至少74个病例中检出腺病毒。腺病毒是一种常见的病原体，通常会引起人体自限性感染。此外，有20个病例检出新冠病毒。世界卫生组织正在调查肝炎爆发与新冠病毒之间的关联。
除急性肝炎和肝酶水平升高之外，报告病例的症状还包括腹痛、腹泻、呕吐和黄疸。腺病毒通常在人与人之间传播，最常引起咳嗽、喉咙痛和流鼻涕等呼吸道症状。根据具体类型，患者还可能出现胃肠炎、红眼病和膀胱感染等症状。
根据世界卫生组织的报告，可能感染人类的腺病毒有50多种。在经过分子检测的儿童肝炎病例中，有18例确认感染41型腺病毒，而这种病毒以前从未跟严重肝炎密切关联。它通常会引起腹泻和呕吐等症状。
“尽管一些肝炎病例是免疫力低下，并感染腺病毒的儿童，但41型腺病毒通常并不认为是免疫力正常儿童罹患肝炎的原因。”世界卫生组织在其报告中指出。
世界卫生组织表示，与肝炎爆发相关的高腺病毒感染率，可能仅仅是改善检测手段使然。“目前的假设是，腺病毒是根本病因，但它并不能完全解释临床症状的严重性。”
世界卫生组织指出，由于大多数儿童患者没有接种过疫苗，那种认为这是疫苗副作用的假设还得不到支持。在美国，5岁以下儿童仍未获准接种疫苗。
美国疾病控制和预防中心（U.S. Centers for Disease Control and Prevention）此前曾经将新冠病毒与儿童多系统炎症综合征（Multisystem Inflammatory Syndrome in Children）联系起来。这种综合征是一种以不同器官出现炎症为特征的疾病。2020年下旬发表在学术期刊《肝脏病学》（Hepatology）上的一篇论文确定，肝炎是儿童多系统炎症综合征患儿的常见症状。
“受影响的国家和尚未报告病例的国家，目前都需要进一步确认更多的病例。”谈到各国需要对肝炎爆发做出哪些适当的公共卫生反应时，世界卫生组织这样说道。“无论是对于腺病毒，还是其他常见病毒感染，最常规的预防措施都是勤洗手，并保持呼吸道卫生。”（财富中文网）
译者：任文科
An outbreak of severe hepatitis in children has continued to grow, with new cases now identified in the U.S., the World Health Organization (WHO) reported this weekend.
The WHO published its first report on the outbreak on April 15, when cases were isolated in the United Kingdom. At the time of that report, there were a total of 10 cases in children between the ages of 11 months and 5 years old.
No cause has been identified as of yet. As of last week at least 169 cases of acute hepatitis, or liver inflammation, of unknown origin had been reported in children between the ages of 1 month and 16 years old. While still concentrated in the U.K., additional cases have appeared in Spain, Israel, the U.S., Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania, and Belgium. At least one death has been reported, according to the WHO.
The common viruses associated with acute viral hepatitis—hepatitis A, B, C, D, and E—have not been identified in any case. Adenovirus, a class of common viruses that typically cause self-limiting infections in humans, has been identified in at least 74 cases, according to the report. The WHO is also investigating connections between the outbreak and COVID, which was identified in 20 cases.
Beyond acute hepatitis and elevated levels of liver enzymes, symptoms in the reported cases have included abdominal pain, diarrhea, vomiting, and jaundice. Adenoviruses, which typically spread from person to person, most often cause respiratory symptoms like coughing, sore throat, and runny nose. Depending on the specific type, those affected can also develop gastroenteritis, pinkeye, and bladder infection, among other symptoms.
There are more than 50 adenovirus types that can infect humans, according to the WHO’s report. Of the cases that had access to molecular testing, 18 were identified as involving adenovirus type 41, which has never before been closely linked with severe hepatitis. It most often causes diarrhea and vomiting.
“While there have been case reports of hepatitis in immunocompromised children with adenovirus infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children,” said the WHO in its report.
The high incidence of adenovirus infections associated with the hepatitis outbreak could simply be due to better testing, according to the WHO. “While adenovirus is currently one hypothesis as the underlying cause, it does not fully explain the severity of the clinical picture,” said the WHO.
The WHO said that hypotheses relating to side effects of the vaccine are not supported, since most affected children had not been vaccinated. In the U.S. children under 5 are still not approved for the vaccine.
The U.S. Centers for Disease Control and Prevention (CDC) has previously linked COVID with Multisystem Inflammatory Syndrome in Children (MIS-C), a condition characterized by inflammation of different organs. A paper published in the scientific journal Hepatology in late 2020 identified hepatitis as a common symptom in children afflicted with MIS–C.
“Further work is required to identify additional cases, both in currently affected countries and elsewhere,” the WHO said in regard to proper public health response to the hepatitis outbreak. “Common prevention measures for adenovirus and other common infections involve regular hand washing and respiratory hygiene.”
