Mary Wilson
Well-known member
14/Apr/2022
https://doi.org/10.2807/1560-7917.ES.2022.27.15.2200318
Marsh Kimberly, Tayler Rachel, Pollock Louisa, Roy Kirsty, Lakha Fatim, Ho Antonia, Henderson David, Divala Titus, Currie Sandra, Yirrell David, Lockhart Michael, Rossi Maria K., Phin Nick.
On 31 March 2022, the Scottish National Health Service (NHS) Greater Glasgow and Clyde (GGC) Health Board alerted Public Health Scotland (PHS) to five children aged 3–5 years presenting to the Royal Hospital for Children, Glasgow with severe hepatitis of unknown aetiology within a 3-week period. The typical number of cases of hepatitis of unknown aetiology across Scotland would be fewer than four per year [1].
This paper describes the initial investigation into the first Scottish cases and aims to raise awareness of this severe illness of unknown aetiology among young children.
Early signal detection
Following the alert, PHS convened a multi-disciplinary team of experts from across Scotland to review clinical and epidemiological data from the first five children presenting to hospital with acute severe hepatitis of unknown origin. Clinical case review revealed vomiting in preceding weeks, jaundice, and exceptionally high levels of alanine aminotransferase (ALT) among children of a similar age. Most children presented with transaminases greater than 2,000 international units per litre (IU/L) where the normal range is 10 to 40 IU/L [2]. Initial screening for hepatitis viruses A, B, C, and E was negative, with one hepatitis E result pending. One child had insufficient sample material to test for hepatitis B. As an indicator of disease severity, three children were transferred to quaternary paediatric liver units in England to be evaluated for liver transplant, with one receiving a transplant.
In addition to the clinical case review, the number of children presenting acutely with abnormal liver function tests in March 2022 to the Royal Hospital for Children, Glasgow were compared with those in March 2019 as well as March 2020 and 2021. These data confirmed higher-than-expected numbers in 2022 among children under 5 years of age, but not older children. As noted above, the number presenting in March 2022 at the Royal Hospital for Children also exceeded the total number expected for the whole of Scotland over 1 year [1]. ...
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.15.2200318
https://doi.org/10.2807/1560-7917.ES.2022.27.15.2200318
Marsh Kimberly, Tayler Rachel, Pollock Louisa, Roy Kirsty, Lakha Fatim, Ho Antonia, Henderson David, Divala Titus, Currie Sandra, Yirrell David, Lockhart Michael, Rossi Maria K., Phin Nick.
On 31 March 2022, the Scottish National Health Service (NHS) Greater Glasgow and Clyde (GGC) Health Board alerted Public Health Scotland (PHS) to five children aged 3–5 years presenting to the Royal Hospital for Children, Glasgow with severe hepatitis of unknown aetiology within a 3-week period. The typical number of cases of hepatitis of unknown aetiology across Scotland would be fewer than four per year [1].
This paper describes the initial investigation into the first Scottish cases and aims to raise awareness of this severe illness of unknown aetiology among young children.
Early signal detection
Following the alert, PHS convened a multi-disciplinary team of experts from across Scotland to review clinical and epidemiological data from the first five children presenting to hospital with acute severe hepatitis of unknown origin. Clinical case review revealed vomiting in preceding weeks, jaundice, and exceptionally high levels of alanine aminotransferase (ALT) among children of a similar age. Most children presented with transaminases greater than 2,000 international units per litre (IU/L) where the normal range is 10 to 40 IU/L [2]. Initial screening for hepatitis viruses A, B, C, and E was negative, with one hepatitis E result pending. One child had insufficient sample material to test for hepatitis B. As an indicator of disease severity, three children were transferred to quaternary paediatric liver units in England to be evaluated for liver transplant, with one receiving a transplant.
In addition to the clinical case review, the number of children presenting acutely with abnormal liver function tests in March 2022 to the Royal Hospital for Children, Glasgow were compared with those in March 2019 as well as March 2020 and 2021. These data confirmed higher-than-expected numbers in 2022 among children under 5 years of age, but not older children. As noted above, the number presenting in March 2022 at the Royal Hospital for Children also exceeded the total number expected for the whole of Scotland over 1 year [1]. ...
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.15.2200318