Parents are being warned to look out for the symptoms of hepatitis after health experts revealed they are investigating more than 200 cases of the condition in children in the UK - and worldwide at least one child has died.
A further 25 cases of hepatitis have been confirmed in children aged 10 and under, the UK Health Security Agency (UKHSA) has said.
It brings the total number of cases across the UK to 222, as of Wednesday May 25.
Of the confirmed cases of sudden onset hepatitis, 158 are resident in England, 31 are in Scotland, 17 are in Wales and 16 are in Northern Ireland, the UKHSA said.
The cases are mainly in children under five, who showed initial symptoms of gastroenteritis illness (diarrhoea and nausea) followed by jaundice.
Health officials now say it is increasingly likely a virus, which causes flu-like symptoms, known as adenovirus, could be the cause, with eight children having received a liver transplant as a result.
England, Scotland, Wales and Northern Ireland have all seen a spike in cases since January.
There are several different types of the disease, which causes the liver to become inflamed.
This is what you need to know about hepatitis, how to spot the symptoms and everything we know so far about the new cases.
What is hepatitis, and what causes the disease?
Hepatitis is a term used to describe inflammation of the liver and can affect people of all ages.
In children, it is usually caused by a viral infection, but in adults it can also be the result of liver damage caused by drinking alcohol.
There are several different types of hepatitis.
Some types will pass without any serious problems, while others can be long-lasting and may cause scarring of the liver known as cirrhosis and could result in the loss of liver function and, in some cases, liver cancer.
Hepatitis may occur in children for a number of reasons, including common viral infections.
It is not known what type of hepatitis is associated with the new cases being investigated.
However, health officials say that the viruses that often cause the condition have not been detected in the children affected.
For more information on the different types of hepatitis that exist you can visit the NHS website.
What details are known about the new cases being investigated in the UK?
The UKHSA is investigating whether prior Covid infection is behind the surge, but said there was “no evidence” of the condition being linked to Covid vaccinations.
Scientists had also been looking into a link between the hepatitis cases and dogs, but ruled it out last week.
A more likely culprit is thought to be adenovirus, a common virus which causes infection.
Dr Renu Bindra, the UKHSA’s incident director, said parents should be “alert” to the symptoms of hepatitis.
Dr Bindra 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.
“We are working with other countries who are also seeing new cases to share information and learn more about these infections.
“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.”
What is known about the cases being investigated in the rest of the world?
The World Health Organisation (WHO) has also confirmed that multiple cases of hepatitis in children are being investigated in the rest of the world.
In a statement, released on 23 April, WHO said that at least 169 cases of acute hepatitis of unknown origin have been reported from 11 countries, including 13 in Spain, 12 in Israel, nine in the United States of America, six in Denmark, four in The Netherlands, four in Italy, two in Norway, two in France, one in Romania, and one in Belgium.
The children are aged one month to 16-years-old. Seventeen children worldwide have had a liver transplantation, including those in the UK, and at least one death has been reported.
What are the symptoms of hepatitis?
Hepatitis symptoms include:
- dark urine
- pale, grey-coloured poo
- itchy skin
- yellowing of the eyes and skin (jaundice)
- muscle and joint pain
- a high temperature
- feeling and being sick
- feeling unusually tired all the time
- loss of appetite
- tummy pain
The symptoms of the disease may first look like symptoms of other health problems.
If you are concerned about your child, please seek advice from your GP.
If you live in England, Scotland, or Wales you can call NHS 111 for advice.
What have health experts said about the rise in cases in the UK?
Health professionals are asking parents to be aware of the symptoms of hepatitis.
Doctor Meera Chand, Director of Clinical and Emerging Infections, said: “We are working with the NHS and public health colleagues in Scotland, Wales and Northern Ireland to swiftly investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.
“Information gathered through our investigations increasingly suggests that this is linked to adenovirus infection. However, we are thoroughly investigating other potential causes.
“Normal hygiene measures such as thorough handwashing (including supervising children) and good thorough respiratory hygiene, help to reduce the spread of many common infections, including adenovirus.
“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.”
How is hepatitis treated?
The treatment given to a child with hepatitis will depend on what type they have, what the cause of the disease is, what their symptoms are, and how severe the condition is.
The purpose of any course of treatment is to stop liver damage, or prevent any further damage, and alleviate symptoms.
Hepatitis sufferers of all ages may be given appropriate medicine to treat the virus and ease symptoms, such as itching.
They may also have blood tests to determine how severe their case of the disease is and if it is progressing.
In the most severe cases, a patient may have to stay in hospital while they are receiving treatment, and if a lot of damage has been done to the liver and it is no longer functioning properly then a liver transplant will need to be carried out.
How can I get a hepatitis vaccine for my child?
A hepatitis vaccine can provide babies, children and adults with protection against hepatitis B, one of the most common types of the virus.
It is recommended by the NHS that all babies have a vaccine against hepatitis B.
A 6-in-1 vaccine, which is offered to all babies when they are 8, 12 and 16 weeks of age, includes a vaccine against hepatitis B.
If you are an adult in need of a hepatitis vaccine, you can speak to your GP.
The hepatitis B vaccine is very effective, and about 9 in every 10 adults who have it develop protection against hepatitis B, according to NHS data published in 2021.
A vaccination for hepatitis A is available, but this is not routinely offered in the UK because the risk of infection from this type of the disease is low for most people.
The hepatitis A vaccine is only recommended for people at high risk. For more information, please visit the NHS website.