ESPID Approved Proposal for the 2021 Local Organizing Committee

ESPID are dfleighted to confirm the Local Organisers of the ESPID 2021 Geneva Annual Meeting have been approved to receive support for the follow project as per the terms and conditions of the LOC Grant:

Annual meeting (ESPID 2021) LOC Grant:
Paediatric Refugees from Ukraine in Switzerland: Evidence of current screening recommendations

Applicants
Nicole Ritz MD/PhD, Ulrich Heininger MD/Prof, Klara Posfay-Barbe MD/Prof

Background: By mid-2022 over 5 million Ukrainian refugees are registered in Europe of which over 55’000 have asked for asylum in Switzerland. Of those 40-50% are estimated to be children and adolescents. Transit, overcrowding, poor shelter, and vulnerability put refugees at risk for infectious diseases [1, 2]. Current consensus recommendations on medical care for Ukrainian refugee children were published recently [3]. These are mainly based on limited data and represent expert option. Accompanying research evaluating these recommendations and implementation is therefore required.  

Methods: The current recommendation include the following topics: Language, general paediatrics, vaccinations, screening for hepatitis C (HCV), tuberculosis (TB), human immunodeficiency (HIV) virus and mental health issues. In this project screening for HCV, TB, HIV and vaccinations will be evaluated.
Participating centers will include the University Children’s Hospital Basel and Geneva and the Childrens’ Hospital Lucerne. Further paediatricans, private practitioners and screening centers may also participate. All participating children and families will be approached by written informed consent in Ukrainian language. A minimal dataset will be collected epidemiological data and screening information from the selected topics. The study will include patients screened from August/September 2022 until end of December 2022.

Relevance: The findings will form the bases of updated recommendations and serve as a proof of concept on how research and quality assessment of refugee recommendations can be done.

References

1.            Brandenberger, J., et al., A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries - the 3C model. BMC Public Health, 2019. 19(1): p. 755.

2.            Brandenberger, J., et al., The global COVID-19 response must include refugees and migrants. Swiss Med Wkly, 2020. 150: p. w20263.

3.            Jaeger, F.N., et al., Paediatric refugees from Ukraine: guidance for health care providers. Swiss Med Wkly, 2022. 152(21-22).

The Impact of War in Ukraine on Children by Vera Chechenyeva

Warning - Please note this video may be triggering for those who have been impacted by violence or war crimes

Increase in acute hepatitis of unknown origin among children – United Kingdom

An increase in acute hepatitis cases in children during the past few weeks has been reported in the United Kingdom. In England, there are approximately 60 cases under investigation with most cases being 2 to 5 years old. Some cases progressed to acute liver failure and have required transfer to specialist children’s liver units. A small number of children have undergone liver transplantation. Based on reports from the specialist units, no child has died. In Scotland, 11 cases which required hospital admission were children aged between 1-5 years and are under investigation. Most of the cases in Scotland presented from March 2022 onwards. In Wales, there are currently no known cases under investigation, but a very small number of cases from early 2022 had similar clinical presentations. In Northern Ireland, there are currently no confirmed    cases reported.

The clinical syndrome in identified cases is of severe acute hepatitis with markedly elevated transaminases, often presenting with jaundice, sometimes preceded by gastrointestinal symptoms including vomiting as a prominent feature, in children up to the age of 16 years.

At present, the cause of hepatitis in these cases is unknown. The common viruses that can cause hepatitis (hepatitis viruses A, B, C, D and E) have not been detected in any of the cases. Some of the children hospitalised in England did test positive for SARS-CoV-2 and others for adenovirus. There is currently no clear connection between the reported cases. There is no known association with travel.

Investigations are underway across the UK to investigate the potential cause and information has been distributed to healthcare professionals and the general public to raise awareness.

ECDC and partners are sharing this information internationally to increase awareness among clinicians taking care of children and to assess and report whether there are any similar cases in other countries.

Clinicians are encouraged to report cases of acute hepatitis in children up to the age of 16 years with a serum transaminase >500 IU/L, in which hepatitis A to E has been excluded, to National Public Health Institutes.

Member States can share information about any such suspect cases in the ECDC EpiPulse platform to facilitate the investigation.

Sources: UK Government, UK Health Security Agency, Public Health Scotland, Public Health Wales, Public Health Agency Northern Ireland, Media

ESPID Members - HELP FOR UKRAINE CRISIS

Dear ESPID members,

By this statement we, as ESPID board, strongly sympathize with our colleagues from the Ukraine. Children are among the primary victims of armed conflicts and we call on all parties to the conflict in Ukraine to protect our colleagues, children and their families from further violence.

We wholeheartedly hope that all will stay safe the coming time that is filled with fear and uncertainty. 

We would like to reach out to the ESPID members from the Ukraine to see if we can offer help in any way. We would like to do whatever we can to support as much as possible in these extremely difficult times. A first request via pTBnet from Vera Chechenyeva (Kiev, Ukraine) to doctors from Poland, Romania, Moldova, Czech, Lithuanian, Latvia: could you, please, be so kind to send your contact data where our refugees can receive TB, ART or any pediatric help:

• Country
• City
• Name of Institution
• Address
• Contact Name
• Phone number (including country code please)
• Email
• support you can provide: TB Treatment, Antiretroviral Treatment, Common Pediatrician Help, Psychological, Social

 Please send your contact data to the ESPID secretariat: admin@espid.org and this will be forwarded on and shared with pTBnet.

 Please hold each other strongly and take care,

 The ESPID Board