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In response to the current outbreak of pediatric hepatitis possibly related to adenovirusthe Centers for Disease Control and Prevention (CDC) found that current data do not suggest an increase in cases of pediatric hepatitis or 40/41 adenovirus types from the time the outbreak began compared to pre-COVID-19 pandemic levels, according to a recent Morbidity. and Weekly Mortality Report.
“Data from four large 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 ecological analysis cannot conclusively confirm or refute a possible association between pediatric hepatitis and adenovirus, it provides a useful context for ongoing research.”
The CDC compared the data during the current period of the hepatitis outbreak from October 2021 to March 2022 with a reference line prior to the COVID-19 pandemic, because health care research behavior can having changed during 2020-21 in response to the pandemic.
Atlanta, Georgia, USA – August 28, 2011: Close-up of the entrance sign of the Centers for Disease Control and Prevention. Sign near Block 1700 Clifton Road in Atlanta, Georgia, on the Emory University campus. Vertical composition. (iStock)
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After pediatric cases of hepatitis began to be identified in the United States and the United Kingdom that did not have a clear etiology, the CDC issued a healthy warning in April 2022 to report additional cases.
They found that many of the reported cases also had positive test results for type 41 adenovirus, a virus known to cause gastroenteritis, but not known to cause hepatitis in children with an intact immune system, according to the agency.
“Because neither acute hepatitis of unknown etiology nor type 41 adenovirus is notifiable in the United States, it is unclear whether it has recently risen above historical levels,” the CDC said.
Thus, the agency analyzed data from four sources: the National Syndromic Surveillance Program (NSSP), the Premier Healthcare Database Special Release (PHD-SR), the Organ Transplant and Acquisition Network (OPTN), and Labcorp.
NSSP collects electronic health information from emergency departments in all U.S. states and the District of Columbia, which accounts for 71% of non-federal emergency rooms in the United States.
Pediatric cardiologist Ryan Serrano, on the right, talks to his patient, Richard Barnes, on the left, and his father Steve Barnes, during an examination on Thursday, March 11, 2021 at Riley for Children Hospital. The PHD-SR included records from approximately 1,000 hospitals, while pediatric liver transplant data were obtained from the national registry, which is managed by OPTN. (Fox News)
The PHD-SR included records from approximately 1,000 hospitals, while pediatric liver transplant data were obtained from the national registry, which is managed by OPTN.
Labcorp’s data included results for stool samples tested for adenovirus type 40/41, but could not distinguish whether the type was type 40 or 41, but the CDC noted that approximately 90% of all cases of adenovirus Adenoviruses detected in the US with gastroenteritis are type 41.
There were no significant differences in hepatitis-associated hospitalizations or pediatric emergency department visits during the outbreak period between October 2021 and March 2022 compared to before the COVID-19 pandemic.
There was also no significant increase in the number of monthly liver transplants or an increase in the percentage of positive specimens for adenovirus types 40/41 during October 2021-March 2022 compared to pre-pregnancy levels. pandemic.
But the UK reported an increase in adenovirus-positive stools among children aged 1 to 4 compared to pre-pandemic levels, but the agency noted that the data of the total number of specimens tested in the United Kingdom are not available, so the actual percentage of Adenovirus positive samples are unknown.
British Prime Minister Boris Johnson is leaving 10 Downing Street on his way to the House of Commons in London. The UK reported an increase in adenovirus-positive stools among children aged 1 to 4 compared to pre-pandemic levels, but the agency noted that data on Total copies tested in the UK are not available (AP / Alberto Pezzali)
The CDC reports that the data have limitations because the analysis assessed hepatitis trends indirectly through electronic health data because cases of hepatitis without a clear cause cannot be reported in the United States, so currently an exact baseline is unknown.
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They also point out that while liver transplants are “well documented,” there is a two- or three-month delay in reporting, so March 2022 data may not be reported.
In addition, because the COVID-19 pandemic likely altered health research behavior, pre-pandemic data is limited to 2017-2019, and it is unknown whether this data is an accurate baseline.
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The CDC also noted that the small sample size may make it difficult to determine small changes in incidence because cases of hepatitis are rare.
“Finally, these results are intended to provide an overview of trends in pediatric acute hepatitis of unspecified etiology and adenovirus types 40/41 in the United States and cannot be used to infer or disprove a causal link between these. two diseases “.