Since the WHO Disease Outbreak News on Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland was published on 15 April 2022, there have been continuing further reports of cases of acute hepatitis in children of unknown origin.
The situation in Ireland
The HSE has confirmed that a child who was being treated for an acute form of hepatitis has died.
A second child who was also being treated for the same illness has received a liver transplant.
Six cases were reported last week and another seven cases of unexplained hepatitis in children are under investigation according to the HSE on 18/5/22
Both cases of acute hepatitis in children in Ireland are being linked to an unexplained acute hepatitis that is being reported in children worldwide.
What’s causing it?
The experts are working hard to identify a possible cause in the increased detection of these cases. Lab testing has shown that is not due to hepatitis type A, B, C, and E viruses (which are normally responsible) in these cases while Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and/or adenovirus have been detected in several cases.
While adenovirus (circulating high in the UK) is a possible cause, investigations are still underway to pinpoint the cause. Lab testing for additional infections, chemicals and toxins is ongoing for the identified cases. There does not seem to be a link between travel or vaccination with the illness.
Advice for parents on symptoms of hepatitis
Symptoms of hepatitis can 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
- dark urine
- pale, grey-coloured poo
- itchy skin
- yellowing of the eyes and skin (jaundice)
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.
Good respiratory and hand hygiene, including supervising hand washing in young children, can help to prevent adenovirus and other infections that can cause hepatitis. We are all experts at hand hygiene after the last two years!
Surveillance summary for those of you who like data – current on 19/5/22 and updates can be found by clicking the link to reference below.
This report provides an overview of the cases of hepatitis of unknown origin in children aged 16 years and below reported to ECDC and the WHO Regional Office for Europe through The European Surveillance System (TESSy) hosted at ECDC.
- As of 13 May 2022, 232 cases of acute hepatitis of unknown aetiology in children aged 16 years or below have been reported, of which 229 were classified as probable and three as epidemiologically linked, by 14 countries (Belgium (12), Cyprus (two), Denmark (six), Greece (two), Ireland (six), Italy (24), the Netherlands (six), Norway (five), Poland (one), Serbia (one), Slovenia (one), Spain (26), Sweden (nine), and the United Kingdom (131)).
- Of the 229 probable cases, 122 have recovered, while 18 remain under medical care.
- As severe hepatitis can take some time to develop after the onset of the first symptoms and as investigations take time, there may be a delay in the reporting of cases. The recent decrease in cases is therefore challenging to interpret.
- The majority (75.9%) of cases are <5 years of age.
- Of 143 cases with information, 22 (15.4%) were admitted to an intensive care unit. Of the 98 cases for which this information was available, 13 (13.3%) have received a liver transplant. There has been one death associated with this disease.
- Overall, 151 cases were tested for adenovirus by any specimen type, of which 90 (59.6%) tested positive. The positivity rate was the highest in whole blood specimens (68.9%).
- Of the 173 cases PCR tested for SARS-CoV-2, 20 (11.6%) tested positive. Serology results for SARS-CoV-2 were only available for 19 cases, of which 14 (73.7%) had a positive finding. Of the 56 cases with data on COVID-19 vaccination, 47 (83.9%) were unvaccinated.
I hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderBaba Insta page or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 012600262. I’m always happy to help!
Subscribe to the WonderBaba Podcast for lots of information and advice!