Outbreaks of pediatric hepatitis do not exceed pre-COVID-19 levels: CDC

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In response to the current The onset of hepatitis in children may be associated with adenovirusThe Centers for Disease Control and Prevention (CDC) does not recommend an increase in the incidence of pediatric hepatitis or adenovirus 40/41 since the onset of the epidemic, compared with the pre-pandemic level of COVID-19. and Weekly Report on Death.

“Data from four major administrative databases were analyzed to assess trends in pediatric hepatitis and the percentage of positive stool samples for adenovirus type 40/41,” the CDC said.

“While this environmental analysis may not conclusively confirm or rule out a potential link between pediatric hepatitis and adenovirus, it does provide a useful context for the ongoing study.”

The CDC compared the current epidemic period of hepatitis from October 2021 to March 2022 with the baseline figure before the COVID-19 pandemic, as health search behavior in response to the pandemic may change in 2020-21.

Atlanta, Georgia, USA – August 28, 2011: Entrance sign of the Centers for Disease Control and Prevention. The sign is located on the Emory University campus near the 1,700 block of Clifton Road in Atlanta, Georgia. Vertical composition.
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After pediatric cases of hepatitis began to be identified in the United States and the United Kingdom, with no clear etiology, the CDC issued a health advice in April 2022 to report additional cases.

According to the agency, they found that most of the reported cases caused gastroenteritis, but tested positive for adenovirus type 41, which causes hepatitis in children with impaired immune systems.

“As neither acute hepatitis of unknown etiology nor type 41 adenovirus has been reported in the United States, it is unknown that it has recently risen above historical levels,” the CDC said.

Thus, the agency analyzed data from four sources: the National Syndrome Surveillance Program (NSSP), the Prime Minister’s Database of Health (PHD-SR), the Organ Procurement and Transplantation Network (OPTN), and Labcorp.

NSSP collects e-health data from ambulance departments in each U.S. state and the District of Columbia, representing 71% of non-federal emergency rooms in the United States.

Pediatric cardiologist Ryan Serrano, right, talks to patient Richard Barnes, left and his father Steve Barnes during an exam at Riley Children’s Hospital on Thursday, March 11, 2021.  The PHD-SR contained records from approximately 1,000 hospitals, and pediatric liver transplant data were obtained from a national register administered by OPTN.

Pediatric cardiologist Ryan Serrano, right, talks to patient Richard Barnes, left and his father Steve Barnes during an exam at Riley Children’s Hospital on Thursday, March 11, 2021. The PHD-SR contained records from approximately 1,000 hospitals, and pediatric liver transplant data were obtained from a national register administered by OPTN.
(Fox News)

The PHD-SR contained records from approximately 1,000 hospitals, and pediatric liver transplant data were obtained from a national register administered by OPTN.

Labcorp data contained the results of fecal samples tested for 40/41 types of adenovirus, but could not tell if it was 40 or 41, but the CDC noted that approximately 90% of all cases of adenovirus detected in the U.S. were 41 types of adenovirus.

From October 2021 to March 2022, there was no significant difference compared to the COVID-19 pandemic among those admitted to the hepatitis or pediatric emergency department during the epidemic.

From October 2021 to March 2022, there was no significant increase in the number of monthly liver transplants or an increase in the percentage of positive samples for adenovirus strains 40/41 compared to the pre-pandemic level.

However, the UK reported an increase in the number of adenovirus-positive feces samples among children aged 1 to 4 years compared to pre-pandemic levels, but the agency noted that data on common samples tested in the UK were not available, so the true percentage of adenovirus-positive specimens was unknown.

The Prime Minister of the United Kingdom Boris Johnson is walking down 10 Downing Street in the House of Commons in London.  The UK said the number of adenovirus-positive stool samples among children aged 1-4 years had increased relative to pre-pandemic levels, but the agency said there were no data on common samples tested in the UK.

The Prime Minister of the United Kingdom Boris Johnson is walking down 10 Downing Street in the House of Commons in London. The UK said the number of adenovirus-positive stool samples among children aged 1-4 years had increased relative to pre-pandemic levels, but the agency said there were no data on common samples tested in the UK.
(AP / Alberto Pezzali)

There are limitations to the CDC data, as the analysis indirectly assesses the health trends of hepatitis through electronic data, as there are no reported cases of hepatitis in the United States, so the exact baseline is still unknown.

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They also have a two- to three-month delay in reporting, even though liver transplants are “well-documented,” so data for March 2022 may be less reported.

In addition, as the COVID-19 pandemic has changed health search behavior, pre-pandemic data are limited to 2017-2019 and it is unclear whether this information is an accurate database.

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The CDC also noted that the small size of the samples may make it difficult to detect small changes in the disease because cases of hepatitis are rare.

“Finally, these findings are intended to provide general information on the etiology and adenovirus type 40/41 pediatric acute hepatitis trends in the United States and cannot be used to conclude or rule out a causal link between these two diseases.”

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