We've a bit of a medical mystery this morning.
Health authorities in the UK and Scotland are reporting higher rates of hepatitis (etiology unknown) among children under the age of 10. The UK has recorded roughly 60 cases, while Scotland reports 11 children hospitalized with `non A-E' hepatitis.
While some childhood viral infections are known to produce liver inflammation, none of the `usual suspects' has been detected. That, combined with the unusually high number of cases, has prompted public health investigations in both countries.
Parents are being advised to be alert to the signs of hepatitis in their children (jaundice, dark urine, fever, etc.) and to seek medical care immediately. Two reports from UKHSA and Public Health Scotland.
Increase in hepatitis (liver inflammation) cases in children under investigation
The UK Health Security Agency (UKHSA) has recently detected higher than usual rates of liver inflammation (hepatitis) in children. Similar cases are being assessed in Scotland.
From:UK Health Security Agency
Published 6 April 2022
Hepatitis is a condition that affects the liver and may occur for a number of reasons, including several viral infections common in children. However, in the cases under investigation the common viruses that cause hepatitis have not been detected.
UKHSA is working swiftly with the NHS and public health colleagues across the UK to investigate the potential cause. In England, there are approximately 60 cases under investigation in children under 10.
Dr Meera Chand, Director of Clinical and Emerging Infections, said:
Investigations for a wide range of potential causes are underway, including any possible links to infectious diseases.
We are working with partners to raise awareness among healthcare professionals, so that any further children who may be affected can be identified early and the appropriate tests carried out. This will also help us to build a better picture of what may be causing the cases.
We are also reminding parents to be aware of the symptoms of jaundice – including skin with a yellow tinge which is most easily seen in the whites of the eyes – and to contact a healthcare professional if they have concerns.
Hepatitis symptoms include:
- dark urine
- pale, grey-coloured poo
- itchy skin
- yellowing of the eyes and skin (jaundice)
- muscle and joint pain
- a high temperature
- feeling and being sick
- feeling unusually tired all the time
- loss of appetite
- tummy pain
And this report from Scotland.
Cases of non A to E Hepatitis
First published on 06 April 2022
Health protection
Public Heath Scotland (PHS) is investigating the cause of a small number of cases of hepatitis (liver inflammation) in young children across the central belt of Scotland.
We are aware of 11 cases of hepatitis requiring admission to hospital that have been identified in children aged between 1 and 5 years old in four NHS Health Board areas in Scotland (Lanarkshire, Tayside, GGC and Fife). Most cases have presented from March. The hepatitis viruses commonly associated with this condition have been excluded.
Each year around 7 or 8 cases of non A to E hepatitis (without other underlying diagnoses) are detected in children in Scotland. The number of cases in such a short period of time, combined with the geographical spread and severity of illness, in some cases, is unusual and requires further investigation.
As yet, there is no clear connection between the cases.
At present, there is no clear cause. All potential causes are being explored but infection is considered to be a more probable source this time.
Investigations are still in the early stages and work is ongoing with partners and other agencies across the UK to investigate these cases.
Dr Nicholas Phin, Director of Public Health for Public Health Scotland said;
“If you have a child who is showing signs of jaundice, where the skin has a yellow tinge and is most easily seen in the whites of the eyes, then parents should contact their GP or other Health Care professional.
"We are continuing to investigate these cases and will provide further updates as and when they are available.”
Given the wide geographic spread of this outbreak, and no obvious connection among the children involved, a viral cause has to be near the top of the suspect list. But what that virus might be, isn't known.
There are some on social media who are pointing their finger at their favorite villain; the COVID vaccine. But that appears highly unlikely - given the majority of cases reported have been among children under the age of 5 - who are ineligible to receive the vaccine.
We have seen cases of hepatitis linked to COVID infection (see CDC What to Know About Liver Disease and COVID-19), but they have usually been mild, particularly among those without severe COVID or a history of liver problems.
While a COVID link is certainly possible, without supporting data, it is just speculation.
Hopefully, we'll get some definitive answers sooner rather than later.
