WikiProjectMed:Community pump

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Welcome to the Pump

The Community Pub is the place to ask questions. To start a new topic, click the "Add topic" tab, so that it gets added at the bottom of the page, and sign your post by appending four tildes (~~~~) }}

Pull up a chair and join in the conversation!
useful link outbreaks, etc

Welcome

Starting this page as an area for general discussion about all things Wiki Project Med. Doc James (talk · contribs · email) 15:37, 20 April 2022 (UTC)

awesome 😊--Ozzie10aaaa (talk) 20:39, 20 April 2022 (UTC)
(: Sj (talk) 19:00, 21 April 2022 (UTC)

Reliable sources for vaccines?

I'm compiling discussions about RS for vaccines and COVID-19 (as specific modern example), so that we can have a vax-specific Perennial Sources list that tracks when different sources were discussed + classified. If you've worked on related issues, or have a source in mind that you've found useful [or deceptive and worth flagging], please see the related project page:

m:Reliable sources/vaccines. Sj (talk) 19:00, 21 April 2022 (UTC)
Looks great @Sj:... Feel free to use my vaccine library if any use. Whispyhistory (talk) 07:05, 22 April 2022 (UTC)
Thanks Whispy! I've updated the table and moved it here: Wikipedia:Vaccine_safety/Reference_sources. Feel free to comment there if you have improvements to the schema or contents you'd like. Sj (talk) 23:39, 20 June 2022 (UTC)

Another wave ?

  • "Fourth wave scare! Omicron now dominant variant in Delhi: Here are some serious side-effects caused by this virus". MSN. Retrieved 23 April 2022.--Ozzie10aaaa (talk) 13:18, 23 April 2022 (UTC)
    Thanks @Ozzie10aaaa:... also outbreak of hepatitis (many have adenovirus infection but link uncertain) if you know of any sources. Whispyhistory (talk) 16:29, 23 April 2022 (UTC)
Arnold, Amber; MacMahon, Eithne (1 December 2021). "Adenovirus infections". Medicine. 49 (12): 790–793. doi:10.1016/j.mpmed.2021.09.013. ISSN 1357-3039. Retrieved 23 April 2022...maybe? --Ozzie10aaaa (talk) 16:44, 23 April 2022 (UTC)
Thank you for looking. It's good and I added it. Will look more tomorrow. Images are difficult for that article.Whispyhistory (talk) 18:01, 23 April 2022 (UTC)
@Whispyhistory: I noticed that your new edit [1] indicated a slight correction, maybe this update below (text/or links) may be of use to you...Ozzie--Ozzie10aaaa (talk) 21:25, 28 April 2022 (UTC)
Thanks @Ozzie10aaaa:... interesting, will keep an eye on it. I hadn't seen these links before. Whispyhistory (talk) 05:41, 29 April 2022 (UTC)
additional links/text

A ProMED-mail post http://www.promedmail.org ProMED-mail is a program of the International Society for Infectious Diseases http://www.isid.org

In this update: [1] USA (Wisconsin): alert [2] Japan [3] Cyprus

[1] USA (Wisconsin): alert Date: Wed 27 Apr 2022 3:30 PM CDT Source: Wisconsin Department of Health Services [edited] https://content.govdelivery.com/accounts/WIDHS/bulletins/3154f31


Wisconsin DHS Health alert no. 42: Recommendations for adenovirus testing and reporting of children with acute hepatitis of unknown etiology


Summary


The Wisconsin Department of Health Services (DHS) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and public health authorities of a recent increase in cases of acute hepatitis and adenovirus infection in children.

From November 2021 to February 2022, clinicians at a large children's hospital in Alabama identified 9 pediatric patients with significant liver injury, including 3 with acute liver failure, who also tested positive for adenovirus. All children were previously healthy. All 5 of the 9 specimens that were sequenced had adenovirus type 41 infection identified. 2 patients required liver transplant; no patients died. Since being notified of this adenovirus-associated hepatitis cluster, DHS is now investigating at least 4 similar cases among children in Wisconsin. This includes 2 children who had severe outcomes, 1 liver transplant, and 1 fatality.

Background


A possible association between pediatric hepatitis and adenovirus infection in children who tested negative for hepatitis viruses A, B, C, D, and E is currently under investigation worldwide. This Health Alert serves to notify American clinicians who may encounter pediatric patients with hepatitis of unknown etiology to consider adenovirus testing and to elicit reporting of such cases to state public health authorities and to the CDC. Nucleic acid amplification testing (NAAT, e.g., PCR) is preferred for adenovirus detection and may be performed on respiratory specimens, stool, rectal swabs, or blood.

CDC issued an official Health Advisory describing a cluster of cases in Alabama and provided recommendations for testing and reporting on 21 Apr 2022. The WHO has also published a Disease Outbreak News report on 23 Apr 2022 describing 169 cases of acute hepatitis of unknown etiology, of these, adenovirus had been detected in at least 74 cases.

Clinical


Hepatitis is inflammation of the liver that can be caused by viral infections, alcohol use, toxins, medications, and certain other medical conditions. In the USA, the most common causes of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C viruses. Signs and symptoms of hepatitis include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice. Treatment of hepatitis depends on the underlying etiology. Adenoviruses are double-stranded DNA viruses that spread by close personal contact, respiratory droplets, and fomites. There are more than 50 types of immunologically distinct adenoviruses that can cause infections in humans. Adenoviruses most commonly cause respiratory illness. However, some adenovirus types can cause other illnesses, such as gastroenteritis, conjunctivitis, cystitis, and, less commonly, neurological disease.

There is no specific treatment for adenovirus infections. Adenovirus type 41 commonly causes pediatric acute gastroenteritis, which typically presents as diarrhea, vomiting, and fever; it can often be accompanied by respiratory symptoms. While there have been case reports of hepatitis in immunocompromised children with adenovirus type 41 infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children.

Recommendations


Clinicians should consider adenovirus testing in pediatric patients with hepatitis of unknown etiology. NAAT (e.g., PCR) is preferable and may be done on respiratory specimens, stool or rectal swabs, or blood. Anecdotal reports suggest that testing whole blood by PCR may be more sensitive than testing plasma by PCR; therefore, testing of whole blood could be considered in those without an etiology who tested negative for adenovirus in plasma samples. If patients are still under medical care or have residual specimens available, please save and freeze specimens for possible additional testing and contact DHS at 608-267-9003.

Clinical criteria for case reporting


- Children under age 16, presenting with hepatitis of unknown etiology (with or without any adenovirus testing results) since 1 Jan 2021, AND elevated liver function tests (that is, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >500 U/L). - Suspect cases should be reported to public health electronically via the Wisconsin Electronic Disease Surveillance System (WEDSS) and selecting "hepatitis unknown" as the disease type, or by contacting DHS at 608-267-9003.

-- Communicated by: Ryan Westergaard, MD, PhD, MPH Chief Medical Officer and State Epidemiologist Bureau of Communicable Diseases Division of Public Health Wisconsin Department of Health Services

[ProMED map of Wisconsin, United States: https://promedmail.org/promed-post?place=8702896,250]

[2] Japan Date: Thu 28 Apr 2022 Source: NHK [in Japanese, machine trans., edited] https://www3.nhk.or.jp/news/html/20220428/k10013604651000.html


Regarding hepatitis of unknown cause, which has been mainly in young children in Europe and the USA, the Ministry of Health, Labor and Welfare has revealed that 2 new children under the age of 16 have been hospitalized with similar symptoms in Japan. There are now 3 patients with unexplained severe hepatitis confirmed in Japan.

According to the WHO, there have been a series of reports of acute hepatitis in 12 countries, including the UK and the USA, mainly in children under the age of 10, with at least 169 cases reported as of 21 Apr 2022, one died.

The Ministry of Health, Labor and Welfare announced on 25 Apr 2022 that a patient with a possible cause of hepatitis of unknown cause was confirmed for the 1st time, and the number of patients confirmed in Japan is now 3. The relationship between these 3 children has not been clarified. The Ministry of Health, Labor and Welfare is requesting local governments nationwide to report any patients with similar symptoms and is collecting information on the situation overseas.

Ryo Sumazaki, Honorary Director of Ibaraki Prefectural Children's Hospital, a pediatric doctor who is familiar with liver diseases in children, said, "Mild hepatitis generally occurs in children, but cases requiring liver transplantation or liver failure are rare. However, it is still unclear whether the same thing as in Europe and the USA, which has been reported one after another, will occur in Japan. In children, hepatitis A to E does not [generally] apply, and acute hepatitis of unknown cause often occurs. It is necessary for the country and experts to carefully investigate whether the number of cases is increasing, but at this point, generally, parents do not have to worry excessively.

Also, regarding the fact that adenovirus is detected in many children with acute hepatitis in Europe and the USA, he said "Adenovirus itself is a common virus, so even if it is detected in a patient, it cannot be immediately determined that it is the cause. However, adenovirus often spreads not only through the air but also by contact infection, so I want you to wash your hands thoroughly."

-- Communicated by: ProMED

[ProMED map of Japan: https://promedmail.org/promed-post?place=8702896,156]

[3] Cyprus Date: Thu 28 Apr 2022 Source: In-Cyprus [edited] https://in-cyprus.philenews.com/cyprus-reports-case-of-acute-hepatitis/


A case of acute hepatitis of unknown origin has to do with a girl 4.5 years old and has already been reported to the relevant European bodies by the Makarios Children's Hospital.

The chief of the pediatrics division at Makarios hospital, Avraam Elia, said that a young child was diagnosed back in February [2022] with acute hepatitis of unexplained origin, as cases emerge across the world. He noted that the case had been reported as unexplained hepatitis. "Lab work that was done on the child yielded no correlation with a cause of hepatitis," Elia said.

-- Communicated by: ProMED

[ProMED map of Cyprus: https://promedmail.org/promed-post?place=8702896,82

More cases of severe hepatocellular injury in children are being reported with many reported on a review of previous cases. Cases apparently fitting the clinical case definition have come from at least 12 European countries, the USA (now 5 states), Japan (now 3 cases), and Cyprus (1 case) to this point and are likely to increase.

Adenovirus serotype 41, one of the so-called enteric adenoviruses, has been found in some of the cases, but the virus has not been known previously to cause hepatitis in the immunologically normal host. Whether the finding of adenovirus serotype 41 is an epiphenomenon or the virus is etiologic here is not yet known. No information has yet been forthcoming on evidence that the virus was found in liver tissue or not, whether a whole genomic analysis of the virus has been compared to older adenovirus serotype 41 and the specific pathology of the affected liver has not been reported. If the virus is the cause, has the agent acquired additional virulence factors, or is a cofactor involved (virus or toxin)? Are certain children genetically more susceptible for the more severe disease?

To this point, no evidence for household clusters has been reported, which one might expect if a foodborne toxin or transmissible agent was involved. Additionally, it would be interesting to know if any asymptomatic aminotransferase elevations were looked for in household contacts. The cases recognized as severe could be the "tip of the iceberg," as we saw with paralytic poliomyelitis when only a small percentage of infections resulted in the classical asymmetrical flaccid paralysis of polio. Additionally, it is not clear whether all these cases are related to the same cause. Also, most of the newer reported cases do not specifically say that the case fits the proposed case definition. - Mod.LL]

[See Also: Hepatitis, undefined - Global: children, USA, Japan, Canada http://promedmail.org/post/20220427.8702884 Hepatitis, undefined - USA, Europe (07): children, aflatoxin hypothesis, 2021-22 http://promedmail.org/post/20220426.8702860 Hepatitis, undefined - USA, Europe (06): USA, children, poss adenovirus 2021-22 http://promedmail.org/post/20220426.8702848 Hepatitis, undefined - USA, Europe (05): UKHSA,children, poss adenovirus 2021-22 http://promedmail.org/post/20220425.8702847 Hepatitis, undefined - USA, Europe (04): WHO, children, poss adenovirus, 2021-22 http://promedmail.org/post/20220424.8702811 Hepatitis, undefined - USA, Europe (03): CDC, children, poss adenovirus, 2021-22 http://promedmail.org/post/20220421.8702752 Hepatitis, undefined - USA, Europe (02): Israel, children, possible adenovirus, 2021-22 http://promedmail.org/post/20220420.8702720 Hepatitis, undefined - USA, Europe: children, possible adenovirus, RFI http://promedmail.org/post/20220415.8702636 Hepatitis, undefined - UK: children, RFI http://promedmail.org/post/20220406.8702449 2021


Non-viral hepatitis - USA (02): bottled water, fatal, recall http://promedmail.org/post/20210523.8377404 Non-viral hepatitis - USA: (NV) bottled water susp http://promedmail.org/post/20210429.8334840] .................................................ll/mj

ProMED makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. The reader assumes all risks in using information posted or archived by ProMED. ISID and its associated service providers shall not be held responsible for errors or omissions or held liable for any damages incurred as a result of use or reliance upon posted or archived material.

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Visit ProMED's website at https://www.promedmail.org/. Submit all items for posting via the ProMED website at https://promedmail.org/submitinfo/. If you have any questions or need support, please contact us via the ProMED website at https://promedmail.org/support/. You may subscribe/unsubscribe at https://isid.org/promedmail-subscribe/.

Upload Wizard

We now have the upload wizard working over at NC Commons... Should make things easier :-) Doc James (talk · contribs · email) 17:36, 29 April 2022 (UTC)

Doc James, it does[2], thank you--Ozzie10aaaa (talk) 20:55, 29 April 2022 (UTC)