Cases of acute hepatitis of unknown origin

Subject: Cases of acute hepatitis of unknown origin

Several organisations for the control of infectious diseases, such as the European Centre for Disease Prevention and Control (ECDC) have reported almost 200 cases (140 in Europe) of acute hepatitis of unknown origin in children up to 16 years of age. The WHO reported that 17 victims needed a liver transplant, and that at least one death had been recorded.

None of the common hepatitis viruses (A, B, C, D and E) which cause acute viral hepatitis were detected in these cases. Adenoviruses are being considered among the possible causes of infection. Moreover, on 12 April, the ECDC reported that there had been cases in Europe, and claimed that there was no clear link between the cases or any link to travel.

With this and the lessons learnt from the pandemic in mind:

1. Is the Commission monitoring the evolution of these cases? If so, what information does the Commission have?

2. Are precautionary measures being taken to prepare for a potential spike in cases across the EU and the rest of the world?

Answer given by Ms Kyriakides on behalf of the European Commission

(7 July 2022)

The Commission is following closely the increase in severe acute hepatitis cases of unknown aetiology in children in the United Kingdom and several European Union/European Economic Area (EU/EEA) countries.

Together with involved countries, the World Health Organisation and other stakeholders, the European Centre for Disease Prevention and Control (ECDC) is monitoring the situation and provides updates to the Commission. Situation updates are also publicly available on a specific ECDC website (1).

The Commission’s activities in relation to the increase of severe acute hepatitis cases of unknown aetiology in children currently aim at preventing infections by knowing more about what causes them.

The Commission is continuously discussing with Member States the situation and coordinating the EU response in the Health Security Committee.

In its Risk Assessment of 28 April 2022 (2), ECDC called on EU/EEA countries to establish surveillance at national level, including appropriate testing, and quickly report cases to the European Surveillance System (3).

Moreover, different European clinical research networks, several of which receive Horizon 2020 funding (e.g. the European Clinical Research Alliance on Infectious Diseases (ECRAID) (4), Penta (5)), swiftly reacted by setting up a rapid survey to assess the extent and geographical distribution of the outbreak (6).

⋅1∙ https://www.ecdc.europa.eu/en/increase-severe-acute-hepatitis-cases-unknown-aetiology-children

⋅2∙ https://www.ecdc.europa.eu/en/publications-data/increase-severe-acute-hepatitis-cases-unknown-aetiology-children

⋅3∙ In accordance with Article 6 of Decision 1082/2013/EU on serious cross-border threats to health and repealing Decision No 2119/98/EC (OJ L 293, 5.11.2013, p. 1)

on epidemiological surveillance of communicable diseases and related special health issues (such as antimicrobial resistance). Hepatitis is included in the list of notifiable diseases subject to epidemiological surveillance. Decision 1082/2013/EU is currently under revision. The proposed Regulation of the European Parliament and of the Council on serious cross-border threats to health and repealing Decision No 1082/2013/EU, will, once adopted, strengthen preparedness and response, inter alia, through a Union preparedness plan, a system of regular assessments of national preparedness plans and improved, continued surveillance of communicable diseases.

⋅4∙ https://www.ecraid.eu/ ; projects ECRAID-Plan (Grant Agreement No 825715; https://cordis.europa.eu/project/id/825715), ECRAID-Base (Grant Agreement No

965313, https://cordis.europa.eu/project/id/965313), ECRAID-Prime (Grant Agreement No 101046109, https://www.ecraid.eu/ecraid-prime); total EU contribution EUR 42.9 million

⋅5∙ https://penta-id.org/ ; beneficiary of a total EU contribution of EUR 8.0 million in 8 Horizon 2020 projects (i.e. Grant Agreements No 734857, 777554, 825579,

825715, 965313, 965328, 101003589, 101016167) and 2 Horizon Europe projects (i.e. Grant Agreements No 101046118, 101057036). ⋅6∙ https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.19.2200370