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| The Centers for Disease Control and Prevention issued an alert on Thursday to physicians nationwide notifying them of a cluster of severe and unexplained hepatitis cases in otherwise healthy young children. |
| 美国疾病控制与预防中心周四向全国医生发出警告，通知他们一些健康的幼儿中出现了一批严重且无法解释的肝炎病例。 |
| Between October 2021 and February 2022, nine children between the ages of 1 and 6 in Alabama were admitted to the hospital with acute hepatitis; two required liver transplants. |
| 2021年10月至2022年2月，阿拉巴马州有九名一至六岁的儿童因急性肝炎入院；有两名儿童需要肝脏移植。 |
| Similar cases have also popped up in North Carolina, as well as in Europe. The U.K. Health Security Agency has reported more than 100 cases of sudden-onset hepatitis in children under 10 since January 2022, 10 of whom required liver transplants. |
| 类似的病例也出现在北卡罗来纳州和欧洲。自2022年1月以来，英国卫生安全局报告了100多例10岁以下儿童突发性肝炎病例，其中10例需要肝脏移植。 |
| Here’s what we know about these hepatitis cases, and what symptoms parents should watch for. |
| 以下是我们对这些肝炎病例的了解，以及父母应该注意的症状。 |
| What is hepatitis? |
| 什么是肝炎？ |
| Hepatitis is a broad term used to describe inflammation of the liver, an organ that carries out hundreds of essential functions every day, from aiding digestion to clearing toxins from the blood. When the liver is inflamed or damaged, it is unable to perform many of those tasks. |
| 肝炎是一个宽泛的术语，用来描述肝脏的炎症。肝脏每天承担数百项基本功能，从帮助消化到清除血液中的毒素。当肝脏发炎或受损时，许多任务就无法完成。 |
| “Acute” hepatitis refers to inflammation that comes on relatively quickly and does not last more than six months. It can be severe and lead to liver failure, as was the case with several children in Alabama. But hepatitis can also be relatively mild. It’s not uncommon for patients — particularly children — to have liver inflammation in the course of a simple, uncomplicated viral illness, explained Dr. Alexander Weymann, director of the Liver Center at Nationwide Children’s Hospital in Columbus, Ohio. |
| “急性”肝炎是指相对较快的炎症，持续时间不超过六个月。它可能会很严重，导致肝功能衰竭，阿拉巴马州的几个孩子就是如此。但肝炎也可能相对比较温和。俄亥俄州哥伦布市全国儿童医院肝脏中心主任亚历山大·魏曼博士解释说，在简单、不复杂的病毒性疾病过程中，患者——尤其是儿童——出现肝脏炎症并不罕见。 |
| What symptoms should parents watch for? |
| 父母应该注意哪些症状？ |
| Hepatitis symptoms are wide-ranging and overlap with many common illnesses. A child with hepatitis may experience fever (low-grade or more significant), fatigue, joint or muscle pain, loss of appetite or nausea, diarrhea and vomiting. |
| 肝炎症状广泛，并与许多常见疾病重叠。患有肝炎的儿童可能会出现发烧（低烧或更严重）、疲劳、关节或肌肉疼痛、食欲不振或恶心、腹泻和呕吐。 |
| Children may also have abdominal pain or tenderness, particularly in the right upper abdomen, which is where the liver is located, Dr. Weymann said, and it is important to seek urgent medical attention any time a child shows sign of severe pain when their abdomen is touched. Doctors may consider other possible causes of abdominal pain, like appendicitis. Some children may have darker urine, or pale or clay-colored stools. |
| 魏曼说，儿童也可能出现腹部疼痛或压痛，尤其是在右上腹，也就是肝脏所在的位置，因此，一旦触摸儿童的腹部出现剧烈疼痛，就必须立即寻求紧急医疗护理。医生可能会考虑腹痛的其他可能原因，如阑尾炎。一些孩子可能出现深色尿液，或苍白或粘土色的粪便。 |
| Jaundice, or yellowing of the skin and eyes, is a hallmark sign of hepatitis — although it is possible to have significant liver inflammation and show no signs of jaundice. |
| 黄疸，或皮肤和眼睛发黄，是肝炎的一个标志——然而一些明显的肝脏炎症也可能没有黄疸的迹象。 |
| “The first change is in the eyes: The white part begins to look yellow,” Dr. Weymann said. |
| “第一个变化发生在眼睛：眼白部分开始发黄，”魏曼说。 |
| He noted that it can be more difficult to detect jaundice in children who have darker skin, so parents should take even subtle changes in tone seriously. |
| 他指出，肤色较深的孩儿童可能更难发现黄疸，所以父母应该认真对待颜色的细微变化。 |
| “Typically, one won’t see ‘dramatic’ jaundice until the inflammation or dysfunction of the liver has progressed quite far already,” Dr. Weymann said. |
| “通常情况下，直到肝脏炎症或功能障碍发展到相当严重的程度，人们才会看到‘明显的’黄疸，”魏曼博士说。 |
| What is causing the recent hepatitis clusters? |
| 是什么导致了最近的肝炎集体暴发？ |
| Hepatitis can have many causes, from autoimmune disease to side effects of certain medications. Most often, it is caused by one of the five hepatitis viruses (hepatitis A, B, C, D and E). Depending on the type, viral hepatitis can spread through contact with blood and other bodily fluids or fecal matter, or by consuming raw or undercooked meats. But viral hepatitis has been ruled out in the recent pediatric clusters in the United States and abroad. |
| 患肝炎的原因有很多，从自身免疫性疾病到某些药物的副作用。通常，病毒性肝炎是由五种肝炎病毒（甲型、乙型、丙型、丁型和戊型肝炎）引起的。根据类型不同，病毒性肝炎可通过接触血液和其他体液或粪便传播，或食用生肉或未煮熟的肉类传播。但最近美国和国外暴发的儿童肝炎，已将病毒性原因排除。 |
| Instead, the C.D.C. suspects that the adenovirus is causing the current cases, though health officials caution that the investigation is ongoing. There are more than 50 types of adenoviruses, which tend to cause mild illness, such as colds and fevers, pink eye or vomiting and diarrhea. |
| 而疾病控制与预防中心怀疑是腺病毒所致，不过卫生官员提醒，调查仍在进行中。腺病毒有50多种，往往会引起轻微的疾病，如感冒和发烧、红眼病或呕吐和腹泻。 |
| In Alabama, all nine children tested positive for adenovirus. And of the five cases that were genetically sequenced, all had adenovirus type 41, which typically causes vomiting and diarrhea. A majority of the affected children in Britain, though not all, tested positive for adenovirus as well. |
| 在阿拉巴马州，所有九名儿童的腺病毒检测均呈阳性。在进行基因测序的五个病例中，所有人都携带41型腺病毒，这种病毒通常会导致呕吐和腹泻。在英国，大多数受感染的儿童，也被检测出腺病毒呈阳性，虽然不是全部。 |
| “It’s interesting that we’re really only seeing this in children less than 10 years, meaning that most people over 10 have immunity to adenovirus, and that may be why this hepatitis is showing up in young children,” said Dr. Jennifer Lighter, a pediatric infectious diseases specialist and hospital epidemiologist with N.Y.U. Langone Health in New York City. |
| “令人关注的是，我们只在10岁以下的儿童中看到这种情况，这意味着大多数10岁以上的人对腺病毒有免疫力，可能正因如此，这种肝炎只在幼儿当中出现，”纽约市纽约大学朗格尼健康中心的儿科传染病专家和医院流行病学家詹妮弗·莱特博士说。 |
| But doctors and health officials have known that adenovirus infection can cause liver inflammation. That’s not new. What is unusual is for otherwise healthy young children to become so suddenly ill, which is why public health officials are spreading the word and continuing to probe other possible underlying causes. |
| 但是医生和卫生官员已经知道腺病毒感染会导致肝脏炎症。这并不新鲜。不寻常的是，原本健康的儿童突然患病，这就是为什么公共卫生官员将这一消息广而告之，并继续调查其他可能的潜在原因。 |
| What can parents do? |
| 父母能做什么？ |
| Although health officials are not certain the adenovirus is causing the recent hepatitis clusters, parents can take steps to prevent transmission. Adenovirus spreads from person to person through respiratory droplets or through touching a surface with adenovirus on it. Children should be encouraged to wash their hands often and avoid touching their face and mouth to the extent it is possible — many of the same measures that help prevent the spread of Covid. |
| 虽然卫生官员不确定腺病毒是导致最近肝炎集体暴发的原因，但父母可以采取措施防止传播。腺病毒在人与人之间传播是通过呼吸道飞沫或接触带有腺病毒的表面。应该鼓励儿童经常洗手，尽可能避免触摸自己的脸和嘴——许多措施都和防止冠状病毒传播的措施一样。 |
| Parents should also remember that the C.D.C. alert is not a call for action or alarm. The overall risk of an otherwise healthy child suddenly developing severe hepatitis remains extremely low. Health officials simply want to alert pediatricians and other health care providers who may see young patients with hepatitis that they should now screen for adenovirus. |
| 家长们还应该记住，疾控中心的警报不是呼吁采取行动或发出警报。一个原本健康的儿童突然发展为严重肝炎的总体风险仍然极低。卫生官员只是想提醒儿科医生和其他可能看到年幼肝炎患者的卫生保健提供者，现在应该筛查腺病毒。 |
| Treatment varies based on the type of hepatitis that a child has. For some types of viral hepatitis, there are drugs that can suppress or eliminate the virus, Dr. Weymann said. But for the vast majority of cases — like when a child comes in with liver inflammation and adenovirus — doctors focus on preventing or managing complications. |
| 治疗方法因儿童所患肝炎的类型而异。魏曼说，对于某些类型的病毒性肝炎，有药物可以抑制或消除病毒。但对于绝大多数病例，比如同时患有肝脏炎症和腺病毒的孩子，医生关注的是预防及处理并发症。 |
| “That usually is sufficient, since the liver is really good at healing itself,” he added. |
| “这通常就足够了，因为肝脏的自愈能力真的很强，”他还说。 |
| If you have concerns about symptoms like lethargy, pain or changes in skin or eye tone, reach out to your child’s pediatrician for an immediate evaluation, said Dr. Mobeen Rathore, chief of infectious diseases and immunology at Wolfson Children’s Hospital in Jacksonville, Fla. |
| 佛罗里达州杰克逊维尔市沃尔夫森儿童医院传染病和免疫学主任莫贝·拉托尔说，如果孩子的嗜睡、疼痛、皮肤或眼睛颜色变化等症状令你担忧，请立即联系孩子的儿科医生进行评估。 |
| “Parents notice what their kids look like all the time. That’s what we do,” Dr. Rathore said. “I don’t believe that if a child’s skin color changes that a parent is going to say, ‘Oh, that’s OK, let’s wait and see what happens tomorrow.’” |
| “父母持续关注孩子的样子。这就是我们要做的，”拉托尔说。“我不相信，如果孩子的肤色发生了变化，父母会说，‘哦，没关系，我们再等等，看明天会怎么样。’” |
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