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Severe acute hepatitis of unknown aetiology in children-what is known?
Susan Khader1, Isabel Foster1, Andrew Dagens2
1GloPID-R, Pandemic Sciences Institute, University of Oxford, Oxford, UK.
Insights
Global investigations into severe acute hepatitis in children reveal challenges in detecting outbreaks in lower-resource settings. Enhancing diagnostic access is crucial for early detection and improved global health outcomes.
Area of Science:
- Global Health
- Infectious Disease Epidemiology
- Public Health Surveillance
Background:
- Clusters of severe acute hepatitis in children of unknown origin have been identified globally.
- The initial cases were predominantly reported in higher-income countries, prompting international collaboration.
Purpose of the Study:
- To assess the global capacity for coordinated response to emerging infectious diseases.
- To highlight challenges in detecting outbreaks in resource-limited settings.
- To emphasize the need for improved diagnostic access for global pathogen surveillance.
Main Methods:
- Review of ongoing investigations and data sharing among global health communities.
- Analysis of case notification patterns and geographical distribution.
- Assessment of diagnostic capabilities in different resource settings.
Main Results:
- The response to the hepatitis outbreak has tested global coordination capabilities.
- Detection of emerging cases is significantly limited in lower-resourced settings due to diagnostic access issues.
- Existing pathogen surveillance systems face challenges in generating integrated global data.
Conclusions:
- There is an urgent need to strengthen access to diagnostics, particularly in lower-resourced settings.
- Improved diagnostic capacity is essential for early detection of emerging diseases.
- Enhanced surveillance and diagnostics are critical for effective outbreak control and improved patient outcomes.
Abstract:
The ongoing investigations into clusters of children affected by severe acute hepatitis of unknown aetiology have put our global capacity for a coordinated, effective response to the test. The global health community have rapidly convened to share data and inform the response. In the UK, where most cases were initially identified, a coordinated public health and clinical research response was rapidly initiated. Since then, cases have been reported from other countries, predominantly from higher-income countries. While agencies are keeping an open mind to the cause, the working hypothesis and case notifications raise important questions about our capacity to detect emerging cases in lower-resourced settings with a recognised lack of access to diagnostics even for commonly circulating viruses such as hepatitis A. The limited capability to generate integrated global pathogen surveillance data is a challenge for the outbreak investigations, highlighting an urgent need to strengthen access to diagnostics, with a focus on lower-resourced settings, to improve the capacity to detect emerging diseases to inform care and to improve outcomes and outbreak control.
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