By Charlotte Webster-
The UK Health Security Agency (UKHSA) is continuing to investigate and confirm cases of sudden onset hepatitis in children aged 10 and under that have been identified since January 2022.
Working alongside Public Health Scotland, Public Health Wales and the Public Health Agency, active investigations have identified a further 20 confirmed cases since the last update on 20 May, bringing the total number of cases in the UK to 222, as of 25 May.
AD: Capeesh Restaurant
The UKHSA said that of the confirmed cases, 158 are resident in England, 31 are in Scotland, 17 are in Wales and 16 are in Northern Ireland. The cases are predominantly in children under 5 years old who showed initial symptoms of gastroenteritis illness (diarrhoea and nausea) followed by the onset of jaundice.
As part of the investigation, a small number of children over the age of 10 are also being investigated. No children have died.
The UKRA stressed that there is no connection with the vaccine, as the majority of cases are under 5 years old and too young to have received the vaccine.
AD: Oysterian Sea Food Restaurant And Bar
However, the investigation suggests a strong association with adenovirus. Adenovirus is the most frequently detected virus in samples tested and a formal epidemiological study is underway.
Working closely with academic partners, additional research studies are also being undertaken to understand possible immune factors and the effect of recent or concurrent infections.
Dr Renu Bindra, Senior Medical Advisor and Incident Director at UKHSA, said:
”Our investigations continue to suggest an association with adenovirus, and we are exploring this link, along with other possible contributing factors including prior infections such as COVID-19.
”We are working with other countries who are also seeing new cases to share information and learn more about these infections.
The likelihood of children developing hepatitis remains extremely low. Maintaining normal hygiene measures, including making sure children regularly wash their hands properly, helps to reduce the spread of many common infections, including adenovirus.
We continue to remind everyone to be alert to the signs of hepatitis – particularly jaundice, look for a yellow tinge in the whites of the eyes – and contact your doctor if you are concerned.
Since the last update on 6 May, investigations have identified a further 34 confirmed cases, bringing the total number of UK cases to 197 as of 16 May. Of the cases to date, 11 have received a liver transplant. No cases resident in the UK have died.
Adnovirus
The investigation continues to suggest an association with adenovirus. Adenovirus is the most frequently detected virus in samples tested.
Adnovirus describes a group of DNA viruses first discovered in adenoid tissue, most of which cause respiratory diseases.
Amongst 197 UK cases, 170 have been tested for adenovirus of which 116 had adenovirus detected. In 31 cases where adenovirus was not detected, 13 had not had whole blood sample testing, and therefore it is not possible to definitively rule out adenovirus in these cases.
So far, SARS-CoV-2 has been detected in 15% of UK patients with available results, reflecting testing on or around the time of admission.
There is no evidence of any link to the coronavirus (COVID-19) vaccine. The majority of cases are under 5 years old and too young to have received the vaccine.
Following further investigation, there is no evidence linking dog ownership and cases of hepatitis in children.
Standard hygiene measures, including covering your nose and mouth when you cough and sneeze, thorough handwashing and making sure children wash their hands properly are vital in reducing the spread of many common infections, including adenovirus.
Jaundice and vomiting are the most common symptoms experienced by the children affected.
Dr Renu Bindra, Senior Medical Advisor at UKHSA, said:
‘It’s important that parents know the likelihood of their child developing hepatitis is extremely low. However, we continue to remind everyone to be alert to the signs of hepatitis – particularly jaundice, look for a yellow tinge in the whites of the eyes – and contact your doctor if you are concerned.
Our investigations continue to suggest that there is an association with adenovirus infection, but investigations continue to unpick the exact reason for the rise in cases.
The usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected. The cases are predominantly in children under 5 years old who showed initial symptoms of gastroenteritis illness (diarrhoea and nausea) followed by the onset of jaundice.
Active case finding investigations have identified a further 13 confirmed cases since the last update on 6 May, bringing the total number of cases in the UK to 176, as of 10 May. Of the confirmed cases, 128 are resident in England, 26 are in Scotland, 13 are in Wales and 9 are in Northern Ireland. No children have died. As part of the investigation, a small number of children over the age of 10 are also being investigated.
The investigation continues to suggest an association with adenovirus. Adenovirus is the most frequently detected virus in samples tested and a formal epidemiological study is continuing. Research studies of the immune system are also being undertaken to determine if changes in susceptibility or the effect of prior or concurrent infections could be contributing factors.
Normal hygiene measures, including thorough handwashing and making sure children wash their hands properly, help to reduce the spread of many common infections, including adenovirus.
Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said:
‘It’s important that parents know the likelihood of their child developing hepatitis is extremely low. We continue to remind everyone to be alert to the signs of hepatitis – particularly jaundice, look for a yellow tinge in the whites of the eyes – and contact your doctor if you are concerned.
Our investigations continue to suggest that there is an association with adenovirus and our studies are now testing this association rigorously.
We are working closely with the NHS and academic partners to actively investigate the role of other contributors, including prior SARS-CoV-2 and other infections.
Since the last update on 29 April, active case finding investigations have identified a further 18 confirmed cases, bringing the total number of UK cases to 163 as of 3 May. Of these children, 11 have received a liver transplant. None have died.
Jaundice and vomiting are the most common symptoms experienced by the children affected.
The investigation continues to suggest an association with adenovirus. Adenovirus is the most frequently detected virus in samples tested.
However, as it is not common to see hepatitis following adenovirus infection in previously well children, investigations are continuing into other factors which may be contributing. These include previous SARS-CoV-2 or another infection, a change in susceptibility possibly due to reduced exposure during the pandemic, or a change in the adenovirus genome itself.
These possibilities are being tested rapidly. The association with adenovirus is undergoing a formal epidemiological study.
Research studies of the immune system are being undertaken to determine if changes in susceptibility or the effect of prior infections could be contributing factors.
There is no evidence of any link to the coronavirus (COVID-19) vaccine. The majority of cases are under 5 years old, and are too young to have received the vaccine.
Normal hygiene measures, including thorough handwashing and making sure children wash their hands properly, help to reduce the spread of many common infections, including adenovirus.
Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said:
It’s important that parents know the likelihood of their child developing hepatitis is extremely low. However, we continue to remind everyone to be alert to the signs of hepatitis – particularly jaundice, look for a yellow tinge in the whites of the eyes – and contact your doctor if you are concerned.
Our investigations continue to suggest that there is an association with adenovirus and our studies are now testing this association rigorously.
We are also investigating other contributors, including prior SARS-CoV-2, and are working closely with the NHS and academic partners to understand the mechanism of liver injury in affected children.
AD: Heritage And Restaurant Lounge Bar