February 4, 2023

Health experts investigate 111 new UK cases as parents told ‘trust your instincts’

Parents are being advised to “trust your instincts” and to call for help if their child is unwell as health officials investigate a mystery strain of severe hepatitis which has been found in 111 young children in the UK.

Experts believe the rise in cases of sudden onset hepatitis, an inflammation of the liver, may be linked to adenovirus infection but other causes are still being actively investigated. Routine NHS and laboratory data show that common viruses circulating in children are currently higher than in previous years with a marked increase of adenovirus – a group of viruses that can affect different parts of your body depending on the type.

Adenovirus was detected in 75 per cent of hepatitis cases tested. Some 16 per cent of cases were positive for Covid-19 at admission between January and April but there was a high background rate of the virus during the investigation period, so officials said this is not unexpected.

The UKHSA, working with Public Health Scotland, Public Health Wales and the Public Health Agency, are continuing to investigate the cases in children aged 10 and under that have occurred since January. The usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected. The cases are predominantly in under-fives who showed initial symptoms of gastroenteritis illness – diarrhoea and nausea – followed by the onset of jaundice. Ten children have needed liver transplants.

Officials have been unable to identify the cause of the rise but said prior Covid-19 could be a factor – none of the 11 children had been vaccinated against the virus. Of the confirmed cases, 81 are resident in England, 14 are in Scotland, 11 are in Wales and 5 are in Northern Ireland. A small number of children over the age of 10 are also being investigated.

Increased susceptibility due to reduced exposure during the pandemic or a yet undiscovered coinfection or toxin are other potential cofactors being investigate. Alternatively, there may have been emergence of a novel adenovirus strain with altered characteristics, officials believe.

At least one child has died from the mystery strain of severe hepatitis which has now been reported in 12 countries, the World Health Organisation confirmed over the weekend. There have been no deaths in the UK.

Dr Meera Chand, director of clinical and emerging infections at UKHSA, said: “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.”