Mystery continues over rise of liver inflammation among young children in the UK

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By Dave Kelly

The UK Heath Security Agency (UKHSA) published a detailed technical briefing on investigations into a rise in cases of sudden onset hepatitis (liver inflammation) in children.

UKHSA in investigating cases in children aged 10 and under that have occurred since January 2022. The usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected. The cases are predominantly in children under five years old who showed initial symptoms of gastroenteritis illness (diarrhoea and nausea) followed by the onset of jaundice.

Of the confirmed 81 cases, 10 children have received a liver transplant. A small number of children over the age of 10 are being investigated.

A spokesperson for UKHSA says there is no link to the coronavirus (covid-19) vaccine.

“None of the currently confirmed cases in under 10 year olds in the UK is known to have been vaccinated,” says the spokesperson.

“Information gathered through the investigations increasingly suggests that the rise in severe cases of hepatitis may be linked to adenovirus infection but other causes are still being actively investigated.

“Adenovirus was the most common pathogen detected in 40 of 53 (75%) confirmed cases tested. Sixteen per cent of cases were positive for SARS-CoV-2 at admission between January and April but there was a high background rate of COVID-19 during the investigation period, so this is not unexpected.”

Routine NHS and laboratory data show that common viruses circulating in children are currently higher than in previous years and there is a marked increase of adenovirus, particular in the 1 to 4 age group.

Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, says: “Information gathered through our investigations increasingly suggests that this rise in sudden onset hepatitis in children is linked to adenovirus infection. However, we are thoroughly investigating other potential causes.

“Parents and guardians should be alert to the signs of hepatitis (including jaundice) and to contact a healthcare professional if they are concerned. 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.

“Children experiencing symptoms of a gastrointestinal infection including vomiting and diarrhoea should stay at home and not return to school or nursery until 48 hours after the symptoms have stopped.”

Hepatitis symptoms include:

  • yellowing of the white part of the eyes or skin (jaundice)
  • dark urine
  • pale, grey-coloured faeces (poo)
  • itchy skin
  • muscle and joint pain
  • a high temperature
  • feeling and being sick
  • feeling unusually tired all the time
  • loss of appetite
  • tummy pain
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