“Every so often we have cases of hepatitis with unknown causes, but what is striking about the current situation is that there are many cases in a short time and in the same geographical reference”, said the pediatrician and former president of the Argentine Society of Pediatrics (SAP) Omar Tabacco, about the increase in the world of a type of hepatitis acute of unknown origin from which yesterday the first case was detected in the country.
As explained by the specialist, hepatitis is an acute inflammation of the liver that can occur for three reasons: infectious causes, mainly viruses, toxic or metabolic causes. In childhood, the most common hepatitis is infectious and its symptoms are mainly gastrointestinal.
“At first there may be abdominal pain, a little temperature, loose stools and, in general, after 48 hours the patient develops what is called jaundice, which is the yellowish coloration of the skin and mucous membranes. This happens due to the deposit of a substance called bilirubin that the liver, being inflamed, cannot dump into the intestine. Jaundice is the most definite clinical feature of hepatitisTobacco said.
Along the same lines, the pediatrician and gastroenterologist Daniel D’Agostino said: “The characteristic of the adenovirus is that it presents itself as a very gastrointestinal virus. Patients start with abdominal pain, vomiting, nausea, diarrhea and/or fever, but in a very nonspecific way. Until then it can be any virus, but on the second or third day the jaundice begins. When the boy becomes more and more yellow and the inflammation increases, it is necessary to consult a hepatologist“, Held.
Yesterday the National Ministry of Health confirmed that an eight-year-old boy from Rosario is the first Argentine case of this type of hepatitis, which has its main outbreak in Great Britain.
“These cases, for which the World Health Organization (WHO) issued an alert on April 15, are mainly occurring in Great Britain. By that time they had detected 172 cases with a very aggressive evolution of the virus to the liver, in such a way that 10% required transplants without detecting any of the usual viruses in the generation of hepatitis or toxic or metabolic causes. In some of these patients, adenovirustypified as F41, and it is striking because it is usually a virus that produces milder respiratory or digestive symptoms and has no predilection for the liver”, Tobacco maintained.
Ángela Gentile, head of epidemiology at the Ricardo Gutiérrez Children’s Hospital, also pointed out that adenovirus 41 has been involved in some of the cases of acute hepatitis of unknown origin, but not in all. So, she said, we still can’t assume that all cases of hepatitis of unknown etiology are adenoviruses. “In Argentina all samples sent to the Malbrán Institute so far were negative for adenoviruscytomegalovirus and hepatitis A, B, C, D and E, which are the known viruses”, he explained.
Tobacco explained that prevention for the community focuses on digestive hygiene, respiratory hygiene and having complete vaccination schedules: “The viruses that can inflame the liver enter through the respiratory or digestive tract, so today prevention is, on the digestive side, frequent hand washing, proper handling of food and maintaining the cold chain of food. the food. And on the respiratory side, the same care we are taking for Covid: ventilation and use of a mask. And of course having a complete vaccination schedule”.
“We have to make handwashing a very clear routine. You have to wash them at least every two hours.. And the chinstrap is once again a very important element when there are respiratory symptoms. Washing bathrooms and kitchen utensils well and using boiled water are also essential precautions,” said D’Agostino, who is a member of SAP.
“It is very important for parents to be clear that children must have the complete vaccination schedule against hepatitis, both A and B,” Gentile summarized.
Tarik Jasarevic, a WHO spokesman, said that as of May 1, 228 cases were registered in 209 countries and that, at the same time, “another 50 are being investigated.” To these cases is now added that of Argentina.
In the country, hepatitis A and B viruses are the ones that can be prevented with vaccines. The vaccine against the B virus is already placed in the delivery room at the time of birth and the schedule is completed a year later. For virus A, the vaccine is placed at one year of life. “With this, fortunately, the incidence of hepatitis in childhood has significantly decreased. Before, we used to see many consultations for hepatitis diagnoses, but today it is a rarity thanks to the vaccines,” said Tabacco.