On May 13, Ning Qin, director of the Department of Infectious Diseases of the National Medical Center for Major Public Health Events and Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, told the Science and Technology Daily reporter: In addition to the great harm, another important reason for the incident is that it occurred intensively in a short period of time. .In the past, this kind of unexplained childhood hepatitis was sporadic, and the number of cases was small, but this time, the number of cases reported in a short period of time is large, which may be caused by infectious diseases.
But what is puzzling is that if it is an infectious disease, there is no time-space intersection between children in different countries or regions, and theoretically they cannot infect each other.
There are many doubts, and many causes are “mismatched”
As of May 3, about 228 cases of acute hepatitis of unknown cause have been reported in 20 countries and regions around the world, of which at least 20 were liver transplants, accounting for about 8.8%, and 4 died.
“Children have common characteristics, such as jaundice and elevated transaminase indicators.” Professor Luo Xiaoping, director of the pediatrics department of Tongji Hospital, said that in such cases, the hospital will follow the routine procedures to screen for viral hepatitis and non-hepatotropic virus infection. , autoimmune hepatitis, metabolic liver disease, drug-induced infection, etc., according to the results to determine the cause.
WHO’s investigation of acute hepatitis of unknown cause ruled out hepatitis virus infection such as A, B, B, and B, so what is the cause?
Some scholars have speculated that it could be T-cell-dominated autoimmune hepatitis caused by the vaccination of the new crown mRNA vaccine?However, further investigation found that most of the children were not vaccinated with the new crown mRNA vaccine, and the possibility was ruled out.
Through molecular biological testing, it was found that there is a human adenovirus (HAdV) type 41 in the serum samples of some patients, and it has become the biggest “suspect” at present.
But the problem is, according to past experience, human adenovirus (HAdV) is not so destructive.
“People’s research on human adenovirus is relatively in-depth, from molecular structure to pathogenicity, to different tissue orientations and different toxicity.” Ning Qin said,Most human adenoviruses invade the respiratory tract, and a few cause gastroenteritis, conjunctivitis, and even rare cases of liver failure.
This is like a rabbit eating grass originally, because there are many dead mosquitoes and flies around, it is not justified to say that it is modified to eat insects.
Infection with a new variant of the new coronavirus may be one of the reasons
At present, the industry believes that in addition to human adenovirus (HAdV) infection, there are other possibilities, such as a new type of hepatotropic virus that has not yet been identified, a new variant HAdV, drugs, toxins or environmental exposure and other factors…Some analysts believe that infection with a new variant of the new coronavirus is also considered one of the possibilities.
“Although some cases tested positive for the new coronavirus and (or) HAdV, it is still necessary to carry out genetic identification of the virus to determine the relationship between the two.” Ning Qin said that whether it is a new virus requires further in-depth research Research.
In addition, it may be that during the new crown epidemic, the increased susceptibility of young children led to the increased virulence of the virus, and blood, serum, urine, stool and respiratory samples and even liver biopsy samples should be tested.
“In fact, it is still unclear whether unexplained hepatitis in various countries is caused by the same cause.”Ning Qin said that there is currently no evidence that the cases occurring in various places are caused by the same cause. Therefore, international exchanges and cooperation should be strengthened, such as the sharing of gene sequencing results in the international academic community, so that the mystery can be solved earlier.
No related cases have been found in my country, but we need to be vigilant
Similar cases have not been found or reported in my country, but due to their great harm and the possibility of infectious diseases, high vigilance is required.
The article “Highly Concerned about the Characteristics and Development Trends of Severe Acute Hepatitis in Children of Unexplained Cause in Many Countries” published in “Chinese Medical Journal” by Tongji Hospital’s Department of Infectious Diseases and Pediatrics emphasizes the above point of view.
“Fast and accurate identification of the cause is the basis for the diagnosis and treatment of emerging infectious diseases and epidemic prevention and control. The basis for the rapid identification of the cause is rapid discovery.” The article calls on physicians in pediatrics, infectious diseases and related departments to be highly vigilant about liver function of unknown causes For abnormal children and adult patients, carefully inquire about the contact history, the history of new coronavirus infection, etc.
There are many pathogen identification technologies at present, such as metagenomic sequencing technology, technologies based on antigen-antibody reaction, and biosensors, which can achieve rapid locking of pathogens.
Ning Qin reminded that patients with acute hepatitis of unknown cause who have been excluded from common pathogens should actively undergo metagenomic sequencing, and medical units should obtain blood or other body fluid samples after obtaining the patient’s consent for further identification of pathogens. Once a case is found, it should be actively reported to the disease control department.