Following the report shared by the United Kingdom relating to cases of severe acute hepatitis of unknown origin in young children, a standardized information feedback system involving a network of clinicians and laboratories has been set up. in France to detect a possible similar signal on the territory. An initial case definition for healthcare professionals was thus published on May 3, 2022. Today, based on the evolution of knowledge and after new exchanges with its network of partners (clinicians, biologists), Public Health France is adapting the case definition to improve its sensitivity and be able to identify less severe cases, and therefore potentially more numerous. In addition, the course of action has been updated to take this new case definition into account..
Cases of pediatric acute hepatitis: update on 07/26/2022 in France and abroad
In France :
Nine possible cases have been reported and one is being investigated by the medical teams in charge of patients, in conjunction with Public Health France. The occurrence of these cases is not unexpected and does not reflect, at this stage, an excess of cases in France.
The data on emergency visits for hepatitis of unknown etiology from the OSCOUR® network are stable and do not show an excess of cases. Analysis of PMSI data over the first 16 weeks of 2022 shows a number of hospital stays that remains within the usual values for the 2018-2021 period, regardless of the age group considered.
Internationally :
- As of June 30, 2022, 200 cases of acute hepatitis of unknown origin in children aged 16 or younger have been reported by 19 European countries.
- As of 4 July 2022, 263 cases of acute hepatitis of unknown etiology have been identified in children aged 10 years or younger at UK.
- As of July 8, 2022, a total of 1,010 probable cases have been reported from 35 countries in five WHO regionswithout it being possible at the moment to know if they represent an excess of cases or if it is about the usual number of cases in most countries.
This update will be updated in the event of a significant change in the situation in France.
A circuit for reporting possible cases in addition to syndromic surveillance
The formalized system for reporting and investigating possible cases, in conjunction with the Ministry of Health, relies on a network of clinicians and laboratories including the four liver transplant centers (Necker, Bicêtre, Marseille, Lyon ) and pediatric intensive care units. Its objective is to detect on the territory a possible signal similar to that observed in the United Kingdom.
The system is based on a new case definition developed in collaboration with hepato-pediatricians and the three National Reference Centers involved (viral hepatitis B/C/Delta, gastroenteritis viruses and respiratory infection viruses) . The action to be taken in the event of severe acute hepatitis in children under 18 has therefore been updated and disseminated by the Ministry of Health to the professionals concerned.
In addition, Public Health France continues to regularly analyze:
- emergency room visit data from the OSCOUR® network for a selection of diagnostic codes compatible with acute hepatitis of unknown etiology (notably excluding viral hepatitis A to E) in children under 18 in order to identify a possible increase unusual number of these cases over the recent period;
- hospitalization data (PMSI) to be able to detect a possible increase in the number of hospital stays compatible with acute hepatitis of unknown origin (data currently available until the end of January 2022).
