The UK Health Security Agency (UKHSA) reported that public health doctors and scientists at the UK’s public health agencies are continuing to investigate 74 cases of hepatitis (liver inflammation) in children since January 2022, where the usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.
Of the confirmed cases, 49 are in England, 13 are in Scotland and the remainder are in Wales and Northern Ireland.
One of a number of potential causes under investigation is that a group of viruses called adenoviruses may be causing the illnesses. However, other possible causes are also being actively investigated, including coronavirus (COVID-19), other infections or environmental causes.
According to the UKHSA, there is no link to the COVID-19 vaccine. None of the currently confirmed cases in the UK has been vaccinated.
Adenoviruses are a family of common viruses that usually cause a range of mild illnesses and most people recover without complications. They can cause a range of symptoms, including colds, vomiting and diarrhoea. While they don’t typically cause hepatitis, it is a known rare complication of the virus.
The most effective way to minimise the spread of adenoviruses is to practice good hand and respiratory hygiene and supervise thorough handwashing in younger children.
Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said:
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.
One of the possible causes that we are investigating is that this is linked to adenovirus infection. However, we are thoroughly investigating other potential causes.
Normal hygiene measures such as good handwashing – including supervising children – and respiratory hygiene, help to reduce the spread of many of the infections that we are investigating.
We are also calling on parents and guardians, to be alert to the signs of hepatitis – including jaundice – and to contact a healthcare professional if they are concerned.
The issue also extends beyond the UK as it was reported the Alabama Department of Public Health (ADPH) in the USA, in collaboration with pediatric healthcare providers including hospitals who treat children and the Centers for Disease Control and Prevention (CDC), has been investigating an increase in hepatitis in young children. To date, nine children less than 10 years old have been identified as positive for adenovirus and two have required liver transplants. The affected children were from throughout the state of Alabama, and an epidemiological linkage among them has not been determined. None of these children has had any underlying health conditions of note.
Adenoviruses are common viruses that typically cause a mild, self-limiting flu-like or gastrointestinal illness. Rarely, in otherwise healthy individuals, do these viruses cause an illness so severe that they need to be hospitalized and may die.
According to ADPH, adenoviruses are usually spread from an infected person to others through:
Close personal contact, such as touching or shaking handsThe air by coughing and sneezingTouching an object or surface with adenoviruses on it, then touching your mouth, nose or eyes before washing your handsContact with stool, for example, during diaper changing
Adenoviruses are often resistant to common disinfectants and can remain infectious for long periods of time on surfaces and objects. Basic steps individuals can take to protect themselves from getting sick are as follows:
Wash your hands often with soap and water for at least 20 seconds, and help young children do the same.Avoid touching your eyes, nose or mouth with unwashed hands.Avoid close contact with people who are sick.
UKHSA and ADPH, working with partners, will continue to make the public aware of findings throughout the course of the investigation.
(Source: ADPH and UKHSA)