世界衛(wèi)生組織調查兒童“神秘肝炎”，疑與新冠病毒有關
Colin Lodewick
2022-04-27
世界衛(wèi)生組織（World Health Organization）在上周末報告稱，兒童重癥肝炎病例呈持續(xù)增長的態(tài)勢，美國目前已經發(fā)現新病例。
世界衛(wèi)生組織于4月15日發(fā)布了第一份關于肝炎爆發(fā)的報告，當時的病例全部在英國。在該報告發(fā)布之際，一共發(fā)現了10例年齡在11個月至5歲之間的兒童病例。
具體病因尚未確定。截至上周，世界衛(wèi)生組織已經接到至少169例不明病因兒童急性肝炎報告，患者年齡在1個月到16歲之間。盡管病例仍然集中在英國，但西班牙、以色列、美國、丹麥、愛爾蘭、荷蘭、意大利、挪威、法國、羅馬尼亞和比利時也出現了新病例。根據世界衛(wèi)生組織的報告，至少有一例死亡。
所有報告病例均未檢測出甲、乙、丙、丁、戊這五種與急性病毒性肝炎相關的常見病毒。該報告稱，至少74個病例中檢出腺病毒。腺病毒是一種常見的病原體，通常會引起人體自限性感染。此外，有20個病例檢出新冠病毒。世界衛(wèi)生組織正在調查肝炎爆發(fā)與新冠病毒之間的關聯。
除急性肝炎和肝酶水平升高之外，報告病例的癥狀還包括腹痛、腹瀉、嘔吐和黃疸。腺病毒通常在人與人之間傳播，最常引起咳嗽、喉嚨痛和流鼻涕等呼吸道癥狀。根據具體類型，患者還可能出現胃腸炎、紅眼病和膀胱感染等癥狀。
根據世界衛(wèi)生組織的報告，可能感染人類的腺病毒有50多種。在經過分子檢測的兒童肝炎病例中，有18例確認感染41型腺病毒，而這種病毒以前從未跟嚴重肝炎密切關聯。它通常會引起腹瀉和嘔吐等癥狀。
“盡管一些肝炎病例是免疫力低下，并感染腺病毒的兒童，但41型腺病毒通常并不認為是免疫力正常兒童罹患肝炎的原因。”世界衛(wèi)生組織在其報告中指出。
世界衛(wèi)生組織表示，與肝炎爆發(fā)相關的高腺病毒感染率，可能僅僅是改善檢測手段使然。“目前的假設是，腺病毒是根本病因，但它并不能完全解釋臨床癥狀的嚴重性。”
世界衛(wèi)生組織指出，由于大多數兒童患者沒有接種過疫苗，那種認為這是疫苗副作用的假設還得不到支持。在美國，5歲以下兒童仍未獲準接種疫苗。
美國疾病控制和預防中心（U.S. Centers for Disease Control and Prevention）此前曾經將新冠病毒與兒童多系統(tǒng)炎癥綜合征（Multisystem Inflammatory Syndrome in Children）聯系起來。這種綜合征是一種以不同器官出現炎癥為特征的疾病。2020年下旬發(fā)表在學術期刊《肝臟病學》（Hepatology）上的一篇論文確定，肝炎是兒童多系統(tǒng)炎癥綜合征患兒的常見癥狀。
“受影響的國家和尚未報告病例的國家，目前都需要進一步確認更多的病例。”談到各國需要對肝炎爆發(fā)做出哪些適當的公共衛(wèi)生反應時，世界衛(wèi)生組織這樣說道。“無論是對于腺病毒，還是其他常見病毒感染，最常規(guī)的預防措施都是勤洗手，并保持呼吸道衛(wèi)生。”（財富中文網）
譯者：任文科
世界衛(wèi)生組織（World Health Organization）在上周末報告稱，兒童重癥肝炎病例呈持續(xù)增長的態(tài)勢，美國目前已經發(fā)現新病例。
世界衛(wèi)生組織于4月15日發(fā)布了第一份關于肝炎爆發(fā)的報告，當時的病例全部在英國。在該報告發(fā)布之際，一共發(fā)現了10例年齡在11個月至5歲之間的兒童病例。
具體病因尚未確定。截至上周，世界衛(wèi)生組織已經接到至少169例不明病因兒童急性肝炎報告，患者年齡在1個月到16歲之間。盡管病例仍然集中在英國，但西班牙、以色列、美國、丹麥、愛爾蘭、荷蘭、意大利、挪威、法國、羅馬尼亞和比利時也出現了新病例。根據世界衛(wèi)生組織的報告，至少有一例死亡。
所有報告病例均未檢測出甲、乙、丙、丁、戊這五種與急性病毒性肝炎相關的常見病毒。該報告稱，至少74個病例中檢出腺病毒。腺病毒是一種常見的病原體，通常會引起人體自限性感染。此外，有20個病例檢出新冠病毒。世界衛(wèi)生組織正在調查肝炎爆發(fā)與新冠病毒之間的關聯。
除急性肝炎和肝酶水平升高之外，報告病例的癥狀還包括腹痛、腹瀉、嘔吐和黃疸。腺病毒通常在人與人之間傳播，最常引起咳嗽、喉嚨痛和流鼻涕等呼吸道癥狀。根據具體類型，患者還可能出現胃腸炎、紅眼病和膀胱感染等癥狀。
根據世界衛(wèi)生組織的報告，可能感染人類的腺病毒有50多種。在經過分子檢測的兒童肝炎病例中，有18例確認感染41型腺病毒，而這種病毒以前從未跟嚴重肝炎密切關聯。它通常會引起腹瀉和嘔吐等癥狀。
“盡管一些肝炎病例是免疫力低下，并感染腺病毒的兒童，但41型腺病毒通常并不認為是免疫力正常兒童罹患肝炎的原因。”世界衛(wèi)生組織在其報告中指出。
世界衛(wèi)生組織表示，與肝炎爆發(fā)相關的高腺病毒感染率，可能僅僅是改善檢測手段使然。“目前的假設是，腺病毒是根本病因，但它并不能完全解釋臨床癥狀的嚴重性。”
世界衛(wèi)生組織指出，由于大多數兒童患者沒有接種過疫苗，那種認為這是疫苗副作用的假設還得不到支持。在美國，5歲以下兒童仍未獲準接種疫苗。
美國疾病控制和預防中心（U.S. Centers for Disease Control and Prevention）此前曾經將新冠病毒與兒童多系統(tǒng)炎癥綜合征（Multisystem Inflammatory Syndrome in Children）聯系起來。這種綜合征是一種以不同器官出現炎癥為特征的疾病。2020年下旬發(fā)表在學術期刊《肝臟病學》（Hepatology）上的一篇論文確定，肝炎是兒童多系統(tǒng)炎癥綜合征患兒的常見癥狀。
“受影響的國家和尚未報告病例的國家，目前都需要進一步確認更多的病例。”談到各國需要對肝炎爆發(fā)做出哪些適當的公共衛(wèi)生反應時，世界衛(wèi)生組織這樣說道。“無論是對于腺病毒，還是其他常見病毒感染，最常規(guī)的預防措施都是勤洗手，并保持呼吸道衛(wèi)生。”（財富中文網）
譯者：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.”
財富中文網所刊載內容之知識產權為財富媒體知識產權有限公司及/或相關權利人專屬所有或持有。未經許可，禁止進行轉載、摘編、復制及建立鏡像等任何使用。
