The European Centre for Disease Prevention and Control has received information about an increase in cases of acute hepatitis in children in recent weeks in the United Kingdom (UK) and is sharing it internationally to raise awareness among doctors caring for children, in order to determine whether there are similar cases in other countries.
In England, there are approximately 60 cases under investigation, with most cases in children between 2 and 5 years old. Some cases progressed to acute liver failure and have required transfer to specialist children’s liver units. A small number of children have undergone liver transplantation.
In Scotland, 10 cases that required hospital admission were in children aged between 1 and 5 years of age and are under investigation. Most of the cases in Scotland presented from March 2022 onwards.
In Wales, there are currently no known cases under investigation, but a very small number of cases from early 2022 had similar clinical presentations.
In Northern Ireland, there are currently no confirmed cases reported.
The cause of hepatitis in these cases is not known at this time. The common viruses that can cause hepatitis (hepatitis A, B, C, D and E viruses) have not been detected in any of the cases. Some of the children hospitalised in England have tested positive for SARS-CoV-2 and others for adenovirus. At this stage there is no clear link between the reported cases. There is no known link to travel.
Investigations are ongoing across the UK to investigate the possible cause and information has been distributed to healthcare professionals and the public to raise awareness.
The clinical syndrome in the identified cases is that of severe acute hepatitis with markedly elevated transaminases, often presenting with jaundice, sometimes preceded by gastrointestinal symptoms including vomiting as a prominent feature, in children up to 16 years of age.
Physicians are encouraged to notify the National Institutes of Public Health of cases of acute hepatitis in children up to 16 years of age with a serum transaminase >500 IU/L, in whom hepatitis A to E has been excluded.
More information: European Centre for Disease Prevention and Control