The World Health Organisation (WHO) has issued an update on severe acute hepatitis in children with the cause remaining unknown.
On April 5, 2022, WHO was notified of 10 cases of severe acute hepatitis of unknown cause in children under the age of 10 years, across central Scotland.
By April 8, 74 cases had been identified in the United Kingdom. On Tuesday, April 12, the Public Health Agency said there were fewer than five confirmed cases in Northern Ireland.
Read more: NI hepatitis cases being investigated as experts can't find source
Hepatitis viruses (A, B, C, E, and D where applicable) have been excluded after laboratory testing while further investigations are ongoing to understand the causes of these cases.
WHO say more cases are likely to be reported in the coming days.
Symptoms
On April 5, the International Health Regulations (IHR) National Focal Point (NFP) for the UK notified WHO of 10 cases of severe acute hepatitis of unknown cause in previously healthy young children aged from 11 months to five-years-old across central Scotland.
Of these 10 cases, nine had onset of symptoms in March 2022 while one case had an onset of symptoms in January 2022.
Symptoms included jaundice, diarrhoea, vomiting and abdominal pain. All 10 cases were detected when hospitalised.
As of 8 April 8, further investigations across the UK identified a total of 74 cases (including the 10 cases).
Talking about symptoms, a spokesperson said: "The clinical syndrome in identified cases is of acute hepatitis with markedly elevated liver enzymes, often with jaundice, sometimes preceded by gastrointestinal symptoms, in children principally up to 10 years old.
"Some cases have required transfer to specialist children’s liver units and six children have undergone liver transplantation. As of 11 April, no death has been reported among these cases and one epidemiologically linked case has been detected."
Cause being investigated
WHO said: "Overall, the aetiology of the current hepatitis cases is still considered unknown and remains under active investigation. Laboratory testing for additional infections, chemicals and toxins is underway for the identified cases.
"Following the notification from the UK, less than five cases (confirmed or possible) have been reported in Ireland, further investigations into these are ongoing.
"Additionally, three confirmed cases of acute hepatitis of unknown aetiology have been reported in children (age range 22-month-old to 13-year-old) in Spain. The national authorities are currently investigating these cases."
Public health response
Clinical and public health response has been implemented across the United Kingdom to coordinate case finding with investigation into the cause of illness in these cases.
Further investigations by the national authorities are ongoing to include more detailed exposure history, toxicology testing, and additional virological/microbiological tests.
Guidance has been issued to experts to support a thorough investigation of suspected cases.
Further investigations and a clinical and public health response to the cases reported are also being undertaken in Ireland and Spain.
WHO risk assessment
A spokesperson said: "The United Kingdom has reported a recent unexpected significant increase in cases of severe acute hepatitis of unknown aetiology in young children.
"Although the potential role of adenovirus and/or SARS-CoV-2 in the pathogenesis of these cases is one hypothesis, other infectious and non-infectious factors need to be fully investigated to properly assess and manage the risk."
Read more: NI children’s nurse on her pride on retirement after 40 years service
Read more: Belfast footballer issues Kinder warning after young son floored by salmonella
To get the latest breaking news straight to your inbox, sign up to our free newsletter.
