Since this year, the number of cases of hepatitis in children with unknown etiology has increased abnormally. At present, at least 460 such cases have been reported in the world, including 12 deaths and some cases have received liver transplantation. Health experts from many countries are actively investigating the cause of the disease. They believe that the existing evidence is not enough to "convict" the "most suspected" adenovirus, and point out that the abnormal increase of the disease may be related to a variety of factors. A total of 176 cases have been reported in the UK Since this year, the number of cases of hepatitis in children with unknown etiology has increased abnormally. At present, at least 460 such cases have been reported in the world, including 12 deaths. The UK is the first country to report relevant cases and the country with the largest number of cases at present. As of May 10, the cumulative number of children with hepatitis of unknown etiology in the UK has increased to 176. There have been nine cases in Sweden The Swedish public health bureau said on the 10th that so far there have been 9 cases of acute hepatitis in children with unknown etiology in Sweden. The Bureau urged medical staff to be vigilant against such suspected cases. A press release issued by the Public Health Bureau on the same day said that this is a rare disease. At present, the cause of infection of these nine cases is unclear. In addition to yellowing of skin and white eyes (jaundice), reported cases sometimes have symptoms such as vomiting, diarrhea, pale stool and nausea. These cases occurred between November last year and April this year. All 12 patients in Japan were under the age of 16 Japan's Ministry of health, labor and welfare announced on the 13th that there were 5 new cases of acute hepatitis in children with unknown etiology in Japan, reaching a total of 12 cases. All the 12 patients were under 16 years old and had no liver transplantation. One of them tested positive for novel coronavirus. Japan's Ministry of health, labor and welfare reported the country's first case of acute hepatitis in children of unknown etiology on April 25. South Korea reported its first suspected case this month South Korean health officials said on the 10th that South Korea found the first suspected case of hepatitis in children with unknown etiology, and the patient was also infected with novel coronavirus. The disease management agency under the Ministry of health and welfare of South Korea said on the same day that the suspected case was reported on the 1st of this month. The sex and age of the infected were not published. Adenovirus is difficult to "convict" Will Owen, a well-known virologist and professor of Virology at the University of Nottingham, pointed out in an exclusive interview with Xinhua news agency that although the number of cases of hepatitis in children with unknown etiology is not a relatively huge number worldwide, it is much more than expected by health experts, and the emergence of the disease is still "a very unusual event". In the investigation of the cause of disease, adenovirus is considered to be the "biggest suspect". Owen, who has long worked on hepatitis virus research, pointed out that the virus was found in about three-quarters of children. The UK health and safety agency pointed out that compared with the same period in previous years, the rate of adenovirus infection was higher than normal. Nevertheless, researchers believe that the existing evidence is not enough to "convict" adenovirus as the "culprit" of this hepatitis. They point out that hepatitis is not a common condition in children infected with adenovirus. Therefore, if adenovirus infection is indeed associated with this disease outbreak, it is necessary to explain why this infection has changed so much in 2022. "Although adenovirus infection is common in young children, adenovirus was not considered to be associated with any type of hepatitis before this year, let alone very severe hepatitis," Owen said Farid Jalali, an adult gastroenterologist and hepatologist in California, pointed out that adenovirus infection is very common in children. This virus can survive for months to years even in a few children with normal immunity, so adenovirus factors can also be related to this disease. Some investigators are asking parents about their children's diet and where they buy food. British health experts are also investigating the possibility that pet dogs may lead to an increase in cases of hepatitis in children. The latest report released by the British health and safety agency said that "a relatively high number (about 70%) of affected children had contact with pets. But so far, there is no hypothesis "convincing enough". Owen pointed out that the abnormal increase of hepatitis cases in children with unknown etiology compared with previous years may be caused by "multiple factors". The three views were accepted by more experts Although the "culprit" has not been determined, more and more researchers have accepted the following three views: First, these childhood hepatitis cases are not known to have hepatitis A to E. The five common hepatitis viruses were not detected in all case samples, the who said. Anders Lindbloom, a national epidemiologist at the Swedish public health bureau, pointed out that the investigation has ruled out known infections that may lead to liver inflammation, and there are other reasons to be ruled out, such as poisoning, autoimmune diseases or congenital diseases. Second, most experts believe that this hepatitis has nothing to do with the vaccination of new coronavirus. Who pointed out that since the vast majority of patients have not been vaccinated with NCV, it can be considered that hepatitis is not a side effect of NCV. Third, hygiene measures such as thorough hand washing can help reduce the spread of many common pathogens, including adenoviruses. The CDC recommends strengthening personal hygiene measures, such as washing hands frequently, covering your mouth and nose when coughing and sneezing, and avoiding rubbing your eyes and mouth and nose. The UK health and safety agency stressed that parents or guardians should be alert to hepatitis related symptoms such as jaundice. (Xinhua News Agency)