d. Who is being mentioned/affected in this article?
e. How did it happen?
f. Why did it happen?
Extracted text: Three cases of childhood hepatitis of unknown origin detected in Spain In the United Kingdom, around 70 acute cases of this disease are being investigated, whose origin is unknown The Ministry of Health of the Community of Madrid is investigating three isolated cases of children infected with severe acute hepatitis of unknown origin. The patients, whose ages are between two and seven years, come from Madrid, Aragon and Castilla-La Mancha, and have required admission to a Madrid hospital. One of them has required liver transplantation and all three have evolved favorably. The European Centre for Disease Control (ECDC) had warned on Wednesday of the increase in acute cases of hepatitis in children that has been occurring for a few weeks in the United Kingdom and sounded the alarm for European specialists to be attentive to possible cases. The affected Castilian-Manchego patient is a child from Valdepeñas who was admitted to the Hospital of Ciudad Real and has been transferred to the Hospital La Paz in Madrid. He is 22 months old and has developed acute hepatitis after presenting gastrointestinal symptoms, as El Pais advanced and sources from the Junta de Castilla-La Mancha have confirmed to EL MUNDO. The first research at the international level indicates that this disease is not related to covid-19 vaccination or cases of infection. "The Health Alerts and Emergencies Coordination Centre has not reported an unusual increase in cases of acute childhood hepatitis nationwide comparable to that of the United Kingdom since January. It is expected that in the coming days and due to the media coverage and the level of surveillance, isolated cases will be reported in different çenters, which until now would square with the usual frequency, "says Cristina Molera Busoms, coordinator of the Hepatology Working Group of the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP). Sources from the Ministry of Health indicate that "a communication has been made to the Autonomous Communities and Cities through the Alert Presentation and the Public Health Commission and to the scientific societies of Pediatrics and hospital management to carry out an observation and active search for possible cases". Instructions have been given, especially to paediatric intensive care units, to be able to identify possible cases even retrospectively since last January. According to ECDC data, around 60 cases are currently being investigated in England, most of which have been detected in children aged between two and five years. Of these, some cases have led to liver failure and have required hospitalization. Without indicating the amount, the European body indicates that a small number of affected people have had to undergo a liver transplant.Scotland, the statement continues, 10 cases of hepatitis have been reported in children between the ages of one and five who have required hospital admission. Most of these cases have detected since March. In Wales there are currently no reported cases, although some cases detected in early 2022 share clinical signs. 22
Extracted text: In Wales there are currently no reported cases, although some cases detected in early 2022 share clinical signs. "So far, the cause of these cases of hepatitis is unknown," say the ECDC, which clarify that none of the viruses that usually cause hepatitis (A, B, C, D and E) has been detected in those affected. "A-E viruses are the main viruses that cause liver inflammation; they are the so-called hepatotropics, that is, they only cause hepatitis. But there are many viruses that can also occur with hepatitis, which can also associate symptoms that translate the involvement of other organs. The causes are multiple, vary with age and not all are of infectious origin. There are toxic, autoimmune, metabolic, genetic causes, etc.", clarifies Molera Busoms. Some of the children hospitalized in England tested positive for SARS-CoV-2 and others for adenovirus, but so far no clear connections have been made with the disease nor is the onset of symptoms associated with circumstances such as travel. The ECDC has made public the alert to warn doctors throughout Europe of the existence of these strange cases, so that they are attentive to possible similar pictures in their consultations. The cases detected presented acute hepatitis, with a marked elevation of transaminases, often accompanied by jaundice and sometimes gastrointestinal symptoms, such as vomiting. Cases have been detected in children up to 13 years of age. "The symptoms of hepatitis are usually nonspecific (asthenia, abdominal pain, nausea and / or vomiting, diarhea), but there are also more characteristic signs, such as jaundice (yellowing of the skin and mucous membranes), coluria (dark coloration of the urine), acolia (stools with little pigmentation) and / or pruritus (skin itching). They can also occur asymptomatically," adds the SEGHNP specialist. "Although the exact frequency is unknown, we can say that acute liver failure uncommon in pediatrics. In Spain, 5 to 19% of paediatric liver transplants are performed due to acute liver failure," he adds. The British Health Agency has published a guide for paediatricians that includes how to examine potential cases. Hepatitis is an inflammation in the liver that affects the functions of this organ that is essential for functions such as the purification of many substances in the body or the treatment of nutrients absorbed by the body. The most common cause is infectious, and within this, virus infection. The main preventive measure to avoid virus infections is frequent hand washing, covering coughing with the inside of the elbow and using tissues.