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2022 年葡萄牙儿童不明病因严重急性肝炎疫情快速反应工作队。

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

机构信息

ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.

Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal.

出版信息

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

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.

摘要

2022 年 4 月 5 日,英国报告了几例病因不明的儿童严重急性肝炎病例增加,其中一些需要住院治疗,有些则需要进行肝移植或死亡。此后,35 个国家报告了可能的病例,其中近一半发生在欧洲。面对警报,4 月 28 日,葡萄牙成立了一个多学科工作队(TF),以快速发现可能的病例并做出反应。TF 的专家来自不同的学科:临床医生、实验室专家、流行病学家、公共卫生专家以及国家和国际沟通专家。此外,葡萄牙采用了欧洲疾病预防控制中心(ECDC)和世界卫生组织(WHO)的病例定义和建议。截至 2022 年 12 月 31 日,共报告了 28 例病因不明的严重急性肝炎疑似病例:16 名男性,17 名年龄在 2 岁以下。这些病例中,23 人住院,但无人需要肝移植或死亡。在 26 例检测病例中,有 9 例检测到腺病毒。在二项回归模型中,对年龄、性别和地区进行调整后,腺病毒感染与住院之间没有关联。葡萄牙的 TF 可能有助于提高临床医生的认识,从而能够早期发现和及时处理疫情。

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