#16,705
As expected, now that a case definition has been established and the word has gone out for clinicians to report suspected cases, we are seeing a jump in the number of children diagnosed with acute hepatitis of unknown origin around the world.
Yesterday Israel reported 12 cases, and Denmark reported 3. Today the UK adds 34 to their previous total (n=74), bringing their cases count to 108.
We are also aware of cases reported in Spain and the Netherlands, and 9 cases reported last week by the Alabama DOH here in the United States. A HAN advisory from the CDC is reportedly in the works, but has not yet been published.
While all potential causes - including toxic exposures - are still under review, a viral cause is high on the suspect list. COVID - which has been linked to some liver dysfunctions - is on that list, but increasingly an adenovirus is in the crosshairs.
Adenoviruses - of which there are many - are a common cause of (generally mild) respiratory or gastrointestinal illnesses in both adults and children. Serious illness can sometimes occur however, particularly in immunocompromised or medically fragile individual
A large percentage of identified cases have either tested positive for adenovirus infection - or reported common (gastrointestinal) adenovirus symptoms - prior to developing hepatitis.
Other possibilities include an (as yet) unidentified novel virus, or more likely, a genomic change to an existing virus.
Although parents are being asked to watch for symptoms, the number of cases remains small, and serious liver impairment remains rare. This from the UKHSA.
Increase in hepatitis (liver inflammation) cases in children under investigation
Regular updates by the UK Health Security Agency on the ongoing investigation into higher than usual rates of liver inflammation (hepatitis) in children across the UK.
From:UK Health Security Agency Last updated 21 April 2022 — See all updates
Latest
The UK Health Security Agency (UKHSA), Public Health Scotland, Public Health Wales and the Public Health Agency are continuing to investigate a rise in cases of sudden onset hepatitis (liver inflammation) in children aged 10 and under since January 2022, where the usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.
Our active case finding investigations have identified a further 34 cases since our last update, bringing the total number of cases to 108. All the children affected presented to health services between January 2022 and 12 April 2022.
Of the confirmed cases, 79 are in England, 14 are in Scotland and the remainder are in Wales and Northern Ireland.
Of these cases, 8 children have received a liver transplant.
There is no link to the coronavirus (COVID-19) vaccine. None of the currently confirmed cases in the UK is known to have been vaccinated.
The investigation, including information from patient samples and surveillance systems, continues to point towards a link to adenovirus infection. Seventy-seven per cent of cases tested were positive for adenovirus. However, as it is not usual to see this pattern of disease from adenovirus, we are actively investigating other possible contributing factors, such as another infection (including COVID-19) or an environmental cause.
We are also investigating whether there has been a change in the genome of the adenovirus. UKHSA is working with scientists and clinicians across the country to answer these questions as quickly as possible.
Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said:
We are working with the NHS and public health colleagues in Scotland, Wales and Northern Ireland to swiftly investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.
Information gathered through our investigations increasingly suggests that this is linked to adenovirus infection. However, we are thoroughly investigating other potential causes.
Normal hygiene measures such as thorough handwashing (including supervising children) and good thorough respiratory hygiene, help to reduce the spread of many common infections, including adenovirus.
We are also calling on parents and guardians, to be alert to the signs of hepatitis (including jaundice) and to contact a healthcare professional if they are concerned.
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
