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. 2023 Sep;28(38):2300171.
doi: 10.2807/1560-7917.ES.2023.28.38.2300171.

Task Force for a rapid response to an outbreak of severe acute hepatitis of unknown aetiology in children in Portugal in 2022

Berta Grau-Pujol  1   2   3 , João Vieira Martins  2 , Isabel Goncalves  4 , Fernanda Rodrigues  5   4 , Rita de Sousa  6 , Dina Oliveira  7 , Joana Bettencourt  8 , Diana Mendes  9 , Inês Mateus de Cunha  3 , Sara Pocinho  10 , Ana Firme  3 , Benvinda Estela Dos Santos  11 , André Peralta Santos  12   2 , Maria João Albuquerque  2 , Pedro Pinto-Leite  2 , Rui Tato Marinho  13   14 , Paula Vasconcelos  3
Affiliations

Task Force for a rapid response to an outbreak of severe acute hepatitis of unknown aetiology in children in Portugal in 2022

Berta Grau-Pujol et al. Euro Surveill. 2023 Sep.

Abstract

On 5 April 2022, the United Kingdom reported an increase of cases of severe acute hepatitis of unknown aetiology in children, several needing hospitalisation and some required liver transplant or died. Thereafter, 35 countries reported probable cases, almost half of them in Europe. Facing the alert, on 28 April, Portugal created a multidisciplinary Task Force (TF) for rapid detection of probable cases and response. The experts of the TF came from various disciplines: clinicians, laboratory experts, epidemiologists, public health experts and national and international communication. Moreover, Portugal adopted the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) case definition and recommendations. By 31 December 2022, 28 probable cases of severe acute hepatitis of unknown aetiology were reported: 16 male and 17 aged under 2 years. Of these cases, 23 were hospitalised but none required liver transplant or died. Adenovirus was detected from nine of 26 tested cases. No association was observed between adenovirus infection and hospital admission after adjusting for age, sex and region in a binomial regression model. The TF in Portugal may have contributed to increase awareness among clinicians, enabling early detection and prompt management of the outbreak.

Keywords: Europe; acute hepatitis unknown origin; adenovirus; cross-border threat; hospitalisation; liver transplant; outbreak response; paediatrics.

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Conflict of interest statement

Conflict of interest: BGP is a fellow of the ECDC Fellowship Programme, supported financially by the ECDC. The views and opinions expressed herein do not state or reflect those of the ECDC. The ECDC is not responsible for the data and information collation and analysis and cannot be held liable for conclusions or opinions drawn. All the other authors have no competing interests.

Figures

Figure 1
Figure 1
Description of the Task Force for hepatitis of unknown aetiology in children, Portugal, 2022
Figure 2
Figure 2
Date of symptom onset of probable cases of hepatitis of unknown aetiology, per region, Portugal, 2022
Figure 3
Figure 3
Symptoms of probable cases of hepatitis of unknown aetiology in children Portugal, 2022 (n = 28)
Figure 4
Figure 4
Microbiological analyses of samples from probable cases of hepatitis of unknown aetiology in children, Portugal, 2022 (n=28)
See this image and copyright information in PMC

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