2022年兒童急性嚴重不明原因肝炎國際疫情概況與我國加強監測作為

Overview of the Global Outbreak of Acute Severe Hepatitis of Unknown Etiology in Children and Enhanced Surveillance Measures, Taiwan, 2022

2022年4月英國報告多起兒童急性嚴重不明原因肝炎病例，之後多國陸續發生類似疫情，截至同年7月全球35國累計報告1,010例疑似病例，46例需肝移植，22例死亡。依當時有限證據無法排除人傳人可能，WHO評估疫情風險為中等。為密切監測我國疫情狀況，於同年8月4日至12月31日進行加強監測，監測結果顯示我國共計14例極可能病例，逾八成為5歲以下兒童，年齡分布與歐盟國家類似。臨床症狀以發燒、腸胃道症狀等非特異性症狀為多，與日韓監測情形相似。adenovirus陽性率7%，約為WHO和英國報告陽性率（67.7%）的十分之一；無需肝移植治療或死亡病例。有鑑於國際間疫情趨緩且尚無發現特定致病風險因子，我國病例為零星散發之個案，亦無檢出主要病原體，故我國於2023年1月初終止加強監測，回歸通報第三類法定傳染病「急性病毒性肝炎未定型」及進行採檢送驗之常規監測模式，並持續關注國際疫情發展，以確保早期偵測及因應。

In April 2022, the United Kingdom reported multiple cases of acute hepatitis of unknown etiology in children, followed by similar outbreaks in other countries. By July, 1,010 probable cases had been reported across 35 countries, with 46 requiring liver transplants and 22 resulting in death. Given the limited evidence available at the time, the possibility of human-to-human transmission could not be ruled out, and the World Health Organization assessed the risk at the global level as moderate.
To monitor the situation in Taiwan, enhanced surveillance was conducted from August 4 to December 31, 2022. There were 14 probable cases identified, with over 80% occurring in children aged less than five years, a demographic distribution similar to that observed in European Union countries. Clinical symptoms were predominantly non-specific, such as fever and gastrointestinal symptoms, consistent with findings from Japan and South Korea. The adenovirus positivity rate in Taiwan was 7%, approximately one-tenth of the 67.7% reported by WHO and the UK. No cases in Taiwan required liver transplantation or resulted in death.
Given the global decline in cases, the lack of identifiable risk factors, and the sporadic nature of cases in Taiwan, with no major pathogens detected, enhanced surveillance was ended in early January 2023. Routine surveillance resumed under category III of notifiable diseases, ''Acute Viral Hepatitis, Unspecified,'' with continued specimen testing. Taiwan will also continue to monitor international developments to ensure early detection and response.