The Infantile: We have a lot of seriously ill children now. Not only for hepatitis

The causes of many children falling ill with hepatitis are still unknown. One of the places in Poland where the youngest with this disease go is the Department of Infectious Diseases and Paediatrics at the Hospital. Stefan Żeromski in Krakow. Head of the department MD Lidia Stopyra says that nowadays there is an accumulation of various diseases, not only hepatitis. – It is not a question of children’s immunity dropped during the pandemic. Only before that, they had no contact with infections, explains Stopyra.

  1. Hepatitis of unknown origin is increasing in children
  2. At least a dozen or so cases have already been reported in Poland
  3. There is something wrong with WHO data (they say about five cases in Poland – ed.), Because from our department we reported 11 cases to the Sanepid – says Lidia Stopyra, head of the Department of Infectious Diseases and Paediatrics at the Hospital. Stefan Żeromski in Krakow.
  4. In our country, all children with hepatitis of unknown etiology had antibodies to SARS-CoV-2 – says the doctor
  5. We still don’t know what it’s caused by. Perhaps this is a complication of some medical condition. Some people argue that this is a complication of coronavirus infection, adds Stopyra
  6. More current information can be found on the Onet homepage.

Adrian Dąbek, Medonet: When I called earlier, you said that you have a lot of confusion in the ward, even “Saigon”. Does this apply to as yet unexplained hepatitis, or have other diseases coincided with it?

Dr Lidia Stopyra: We now have a lot of different infections and a lot of seriously ill children. We diagnose many children for pocovid complications, but various conditions appear. Children with hepatitis, which is loud now, we now have two. The others have already been checked out (the interview took place on Friday – ed).

Children from the voivodship come to your ward. Małopolska or also from other regions?

From a larger area than the province. We often have children from the province. Podkarpackie and Śląskie, but there are children from all over Poland.

According to WHO, there are currently only five cases of this hepatitis in Poland. It’s probably an understated number?

Something is wrong, because from our department we reported 11 cases to the Sanepid. Maybe there are some delays in reporting. On the other hand, there was one child from Poland on the ECDC website after we reported five cases only from my department.

How long does such a child’s hospitalization take on average?

Several days. In more severe cases, several days.

Are we still no closer to explaining the causes of these diseases?

There are several concepts, albeit mainly from abroad than from Poland. But hepatitis that could not be explained etiologically has always happened. The children were recovering, but we didn’t quite know what they were doing. Now there are actually more cases, but we also have greater vigilance, because when there are reports from the world about the need for liver transplantation and deaths in children, then our attention must be maximum. Diagnostics is more extensive, everything is carefully examined. We want to detect all cases as soon as possible. Fortunately, there were no serious illnesses, such as those referred to abroad.

It is said that the current increased incidence of infectious diseases is the result of a pandemic, i.e. increased prevention and lower exposure to various infections.

Children get sick when they come into contact with common bacteria and viruses for the first time. When kindergartens and schools were closed, and everyone was wearing masks, the children did not have the first contact they would otherwise have had. And when everything opened up, a lot of children who were susceptible to infections accumulated. So it’s not a question that their immunity has dropped. Only before that, they had no contact with infections. When a child is healthy, healthy people do not get sick, but when they go to kindergarten, they catch infections. And a similar mechanism worked during the lockdown. There was no opportunity for contact with other people, so the children did not get sick. And when they appear in the “normal” world, they get sick.

These various strange conditions we observe are also an effect of COVID-19. For example, we see a rash of autoimmune and other diseases. Everything is carefully researched.

And what other diseases dominate?

At this point, we have quite a few children with complications of smallpox. And there were many cases of smallpox, because it was also a droplet-transmitted disease, and during the lockdown there were definitely fewer cases of smallpox. There are pneumonia, neuroinfections, encephalitis.

How long will it take to return to “normal” regarding infectious diseases and the number of infections? Assuming, of course, that there won’t be another hard lockdown.

It should take about a year. More or less by analogy. When a three-year-old child goes to kindergarten, he gets various infections during the first year. After falling ill, it acquires some immunity and the next time it becomes ill, the course of the disease is milder. So it takes a few or a dozen months.

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I will come back to this hepatitis again. We already know roughly what the symptoms are and what parents should pay attention to. Can you introduce any preventive measures that can reduce the risk of developing the disease?

We can talk about preventive measures only when we know what this hepatitis is caused by, i.e. what the infectious agent, virus or bacterium is. And how does it transfer. If we know the path of infection, we will know how to break that path. We don’t know that yet. Perhaps this is a complication of some medical condition. Some people suggest that this is a complication of SARS-CoV-2 infection. In our country, all children with hepatitis of unknown etiology had antibodies to SARS-CoV-2. But many children have them, because many have passed the disease at some stage of the pandemic. So it’s hard to follow this tip unequivocally.

Acute hepatitis – symptoms

The symptoms of hepatitis in a child are characteristic, but they can be confused with symptoms of “ordinary” gastroenteritis, the common intestine or gastric flu.

Symptoms that may indicate your baby has hepatitis include:

  1. dark color of urine,
  2. a pale grayish stool
  3. itchy skin
  4. yellowing of the skin and eyes,
  5. muscle and joint pain,
  6. higher temperature,
  7. abdominal pain,
  8. loss of appetite
  9. severe fatigue.

If you notice these symptoms in your baby, whether or not he has been vaccinated against hepatitis, make an appointment with a pediatrician or general practitioner.

We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to one of the ways to deal with stress – the TRE method. What is it about? How does it release us from stress and trauma? Who is it intended for and who should definitely not use it? About this in the latest episode of our podcast.

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