Eurosurv. Hepatitis of unknown aetiology in children – epidemiological overview of cases reported in Europe, 1 January to 16 June 2022

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• Adriana Romaní Vidal¹ , Aisling Vaughan² , Francesco Innocenti^1,3 , Soledad Colombe² , Lina Nerlander¹ , Natalia Rachwal¹ , Bruno Christian Ciancio¹ , Aikaterini Mougkou¹ , Carlos Carvalho¹ , Enrique Delgado¹ , Piers Mook² , Géraldine de Muylder⁴ , Michael Peeters⁵ , Tencho Tenev⁶ , Elitsa Golkocheva-Markova⁶ , Veronika Vorobieva Solholm Jensen⁷ , Anders Koch⁸ , Julie Figoni⁹ , Cécile Brouard⁹ , Georgia Nikolopoulou¹⁰ , Anastasia Zisouli¹⁰ , Niamh Murphy¹¹ , Annemarie Broderick¹² , Lital Goldberg¹³ , Rivka Rich¹³ , Lior Hecht Sagie¹³ , Maria Elena Tosti¹⁴ , Barbara Suligoi¹⁵ , Rosa Joosten¹⁶ , Roan Pijnacker¹⁶ , Ingvild Fjeldheim¹⁷ , Eli Heen¹⁷ , Małgorzata Stępień¹⁸ , Piotr Polański¹⁸ , Rui Tato Marinho¹⁹ , João Vieira Martins²⁰ , Carmen Varela²¹ , Ana Avellón²² , Emmi Andersson²³ , Marie Jansson Mörk²³ , Sema Mandal²⁴ , Conall Watson²⁴ , Laura Coughlan²⁴ , Meera Chand²⁵ , Claire Neill²⁶ , Declan T Bradley²⁷ , Kathy Li²⁸ , Maureen O’Leary²⁹ , Neil McInnes³⁰ , Christopher J Williams³¹ , Catherine Moore³¹ , Ardiana Gjini³¹ , Erika Duffell¹ , Richard Pebody²

Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18–3.74) and transplanted (OR = 3.36; 95% CI: 1.19–9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.31.2200483#html_fulltext