Health officials in Ireland have confirmed that the number of hepatitis cases in children has now risen to 13 cases.
Last month it was reported that one child died of acute hepatitis - and two others became so ill that they needed liver transplants as the mystery strain continues to puzzle experts.
Parents are being urged to watch out for symptoms of hepatitis in children, and to contact their GP if they suspect their child may be infected as the global outbreak continues to spread.
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All of the infections were in children aged between one and 12, and all have been hospitalised.
Almost 700 cases of the unexplained liver inflammation have been detected across 33 countries, according to the World Health Organisation.
In a statement on Wednesday, the Health Protection Surveillance Centre said: “Since March, 13 probable cases of children with hepatitis of unknown cause have been identified in Ireland and a small number of children are under investigation.
“This is more than would usually be expected over this period of time.
“The children affected have no links to the other children involved. To date no single virus has been identified in all cases. Investigations are currently ongoing to identify the cause of these illnesses.
“The common viruses that cause hepatitis (hepatitis viruses A, B, C, and E) have not been detected in any of the cases.
“Ireland is liaising closely with ECDC, UK and WHO colleagues in efforts to identify the cause of this illness.”
Hepatitis symptoms to look out for:
Parents are advised to go to their GP if their child develops symptoms of hepatitis. Symptoms of hepatitis can include:
- pale, grey-coloured poo
- dark urine
- yellowing of the eyes and skin (jaundice)
If their child has any of these three symptoms, they should contact their GP without delay. The GP will assess the child and refer on for further assessment as indicated.
Other symptoms include
- muscle and joint pain
- a high temperature
- feeling and being sick
- feeling unusually tired all the time
- a general sense of feeling unwell
- loss of appetite
- tummy pain
- itchy skin
A HSE spokeswoman said: "Parents are advised to go to their GP if their child develops symptoms of hepatitis. The GP will assess the child and refer on for further assessment as indicated.
"If your child is unwell with respiratory or diarrheal or hepatitis symptoms keep your child at home and do not send to crèche/preschool/school until they are better."
Read more: Mystery hepatitis strain kills three more children as Ireland confirms 'small number' of cases
Read more: Hepatitis signs to watch out for as mystery spike seen in children
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