Unusual Hepatitis Cases Surge in the UK

sick child
Source: Freepik

The UK Health Security Agency (UKHSA) is investigating a sudden rise in cases of unusual hepatitis in children under 10.

In a recent press release, the UK Health Security Agency (UKHSA) reported that since January a total of 74 children have undergone hospitalization due to hepatitis. Out of these, 49 cases occurred in England, 13 in Scotland, and 12 in Wales and Northern Ireland. Health officials have also issued warnings to parents to remain on the lookout for signs and symptoms of hepatitis such as a yellow discolouration of the skin.

While hepatitis is a fairly common condition, what makes the recent surge unusual is the lack of a possible cause. Doctors and scientists have failed to detect the usual viral suspects (hepatitis A to E) that commonly cause liver inflammation. Therefore, they are investigating a wide range of possible causes including COVID-19 infection, COVID-19 vaccines, adenoviruses, and various other factors.  

According to Dr. Meera Chand at UKHSA, the health agency is currently investigating adenovirus infection as a potential cause of hepatitis in children. However, other causes are also under investigation, including environmental factors.

We are working swiftly with the NHS and public health colleagues in Scotland, Wales and Northern Ireland to investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.

Dr. Meera Chand, Director of Clinical and Emerging Infections at UKHSA

She further stressed the importance of proper hygiene such as handwashing and wearing a mask to prevent the transmission of disease. Moreover, UKHSA advised parents and guardians to contact a doctor in case of concerns about a possible infection.

Public Health Scotland Issues Warning to Parents

Typically, Scotland sees seven to eight non-viral hepatitis cases in children, per year. However, the recent surge has caused 11 children between one and five years of age to undergo hospitalization in the country. According to Public Health Scotland, since March, doctors across hospitals in Lanarkshire, Glasgow, Tayside and Fife have reported an increase in hepatitis cases. While the cause remains unclear, Public Health Scotland has excluded the common hepatitis viruses A to E.

At the moment, health officials in Scotland have not yet found any common link between the 11 cases. They are currently working closely with UKHSA to further investigate the disease and identify the risk factors.

For now, Dr. Nicholas Phin at PHS has advised parents to watch out for signs and symptoms of hepatitis among their children. The most common of which is a yellow discolouration of the skin and the whites of the eyes also called jaundice.

If you have a child who is showing signs of jaundice, where the skin has a yellow tinge and is most easily seen in the whites of the eyes, then parents should contact their GP or other health care professional.

Dr. Nicholas Phin, of Public Health Scotland

What is Hepatitis?

Hepatitis, or inflammation of the liver, is most commonly caused by Hepatitis A, B, C, D, and E viruses. Other infectious causes include parasites such as malarial Plasmodium, Trypanosoma cruzi and Entamoeba histolytica; bacteria such as E. coli, Klebsiella, and campylobacter species are also known to cause hepatitis. However, there are also many non-infectious causes such as heavy alcohol use, certain supplements and medications, metabolic diseases, autoimmune disorders, and genetic factors.

Symptoms of hepatitis can range from mild fever and jaundice to more severe liver failure. Hepatitis C mostly leads to a chronic infection that results in scarring of the liver (cirrhosis), abdominal swelling, weight loss, and many other life-threatening complications. While most cases of acute hepatitis are self-resolving, chronic cases often require extensive treatment. Moreover, in severe cases, liver transplants might be necessary.

Both Hepatitis A and B have a vaccine available against them which are part of routine immunizations in children.

Are Adenoviruses to Blame?

It is not yet clear what is causing the surge in hepatitis cases among children in the UK and Scotland. Since some of the children tested positive for adenovirus and COVID, doctors are suspecting them as possible suspects.

Adenoviruses are a group of viruses that can cause a wide range of illnesses with mild to severe symptoms. These viruses are easily spread via close contact, respiratory droplets, or touching an object or surface contaminated with adenoviruses. Symptoms include a cold-like illness, pneumonia, diarrhoea and vomiting. However, in rare cases, it can also cause hepatitis as a complication of the infection, especially in immunocompromised individuals.

Since none of the affected children in the UK had received a COVID-19 vaccine, doctors have ruled it out as a possible cause. On the other hand, SARS-CoV-2 has also caused rare cases of hepatitis in the past. Therefore, scientists are continuing to investigate both adenovirus and SARS-CoV-2 as potential causes of the unusual hepatitis cases.

While they await further results from their investigations, UK health officials have advised parents to watch out for the following signs and symptoms of hepatitis:

  • yellowing of the eyes and skin (jaundice)
  • dark urine and pale stool
  • itchy skin (pruritus)
  • muscle and joint pain
  • a high temperature
  • feeling and being sick
  • lethargic
  • loss of appetite
  • stomachache

Source: UK Health Security Agency


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