Health officials believe it is highly likely that a virus which causes flu symptoms could be the cause of a vast spike in child hepatitis cases in the UK.
They say that the virus, known as adenovirus, could be the cause and are now investigating some 108 cases of sudden-onset hepatitis (or liver inflammation) in children since the start of the year.
According to a report by the BBC, officials are examining 79 confirmed cases in England, as well as 14 in Scotland and 15 across Wales and Northern Ireland. While the UK Health Security Agency (UKHSA) has said that eight children have received a liver transplant as a result.
Read more: Warning to parents after rise in scarlet fever and chickenpox cases across England
Most of the children said to be hospitalised so far are thought to be between the ages of one and five years old. The first sign of an unusual rise in young children with liver inflammation came in Scotland in late March. Globally, at least one death and 17 young people needing a liver transplant - according to the World Health Organisation. The condition has been found in 12 countries with 169 cases identified so far - 114 in the UK.
But how can you spot the signs and minimise the chance of infection?
What is hepatitis?
Hepatitis is a rather broad term used to describe inflammation of the liver, usually the result of a viral infection but also caused by exposure to some chemicals, drinking too much alcohol, drugs and even certain genetic disorders.
There are five main types of hepatitis caused by specific viruses, these are known as A, B, C, D and E. However, none of these so far appear to to have caused the liver inflammation seen in these children.
Some types of hepatitis can pass without any serious problems, but some can last for longer. You can find out more about hepatitis on the NHS website, here.
The cause behind this recent spike
UKHSA's chief medical advisor, Professor Susan Hopkins has said that officials were still looking at a range of possible factors behind the increase, however the "most likely" cause was believed to be adenovirus. This is a group of common viruses usually causing colds, vomiting and diarrhoea in children.
She told the BBC: ""Transplants in this age group are extremely rare so therefore we are concerned, and we want to understand why this is happening and what else we can do." She added that 77% of childhood hepatitis cases currently under investigation have tested positive for some form of adenovirus.
Scientists and clinicians are now investigating if there has been a change in the genetic makeup (genome) of the virus that might trigger liver inflammation more easily. While another possible explanation could be down to restrictions imposed during the pandemic leading to young children first being exposed to adenovirus at a slightly later point in their lives.
This then is said to lead to a "more vigorous" immune response. The UKHSA also says it is "keeping an open mind" and not ruling out other possible causes, such as Covid-19, other infections or even an environmental trigger, but it says that there is "no link" with the Covid-19 vaccine, as none of the aforementioned children had been vaccinated.
Symptoms and how to minimise chance of infection
Professor Hopkins advises parents to supervise a good level of hygiene and handwashing at home, saying: "The good things that we've learnt from reducing transmission of Covid will help us reduce the transmission of whatever is causing this as well."
The UKHSA has told parents and guardians to be on the lookout for the signs of hepatitis such as jaundice - a yellowing of the eyes and skin - and contact a GP if they are concerned.
Other symptoms of the liver condition include:
- dark urine
- itchy skin
- muscle pain
- loss of appetite
Elsewhere around the world, cases of childhood hepatitis have been detected in Denmark, Ireland, the Netherlands, Spain and even in the US - both the European Centre for Disease Control and Alabama's public health department have confirmed the cases, with at least two children needing liver transplants.
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