The U.K. Confirms Undefined Hepatitis Outbreak in Children

The UK Health Security Agency (UKHSA) today announced 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.

Of these recent hepatitis cases, 49 are in England, 13 are in Scotland, and 12 are in Wales and Northern Ireland.

The number of confirmed cases in such a short time, combined with the geographical spread, is unusual.

For example, Scotland generally reports about 7 or 8 non-A to E hepatitis cases in children annually.

The UKHSA confirmed as of April 12, 2022, the usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.

The clinical syndrome of currently identified cases is severe acute hepatitis with markedly elevated transaminases, sometimes preceded by gastrointestinal symptoms, in children up to 13 years.

Some cases have required transfer to specialist children’s liver units, and a small number of children have undergone liver transplantation.

Furthermore, none of the currently confirmed hepatitis cases in the UK has been COVID vaccinated. 

This means there is no link to COVID-19 vaccination.

Dr. Meera Chand, Director of Clinical and Emerging Infections at UKHSA, commented in a related press statement, “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.”

“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.”

Adenoviruses are a family of common viruses that usually cause mild illnesses, and most people recover without complications. While they don’t typically cause hepatitis, it is a known rare complication of the virus.

Adenoviruses are commonly passed from person to person through the respiratory route and by touching contaminated surfaces.

The most effective way to minimize the spread of adenoviruses is to practice good hand and respiratory hygiene and supervise thorough handwashing in younger children.

The UKHSA stated it is ‘working with partners, will continue to make the public aware of findings throughout the investigation.’

The U.S. CDC says hepatitis means inflammation of the liver and is often caused by a virus. The most common types of viral hepatitis are hepatitis A, B, and C.

And autoimmune hepatitis is a rare cause of long-term hepatitis in which the immune system attacks and damages the liver.

Since 2005, the epidemiology of viral hepatitis in the U.S. has changed substantially.

Decreases in hepatitis A incidence that occurred following the release of the hepatitis A vaccine in the late 1990s ended in 2016, when large person-to-person outbreaks of hepatitis A began in the ‘heartland’ states, such as Kentucky, Indiana, and West Virginia.

Hepatitis A accounts for over 100 million infections per year and tens of thousands of deaths, mainly due to fulminant liver failure, says the WHO.

And decreases in acute hepatitis B incidence that occurred after the release of the hepatitis B vaccine in the 1980s ceased in 2010. 

Also, in 2010, decreases in acute hepatitis C incidence that were first observed in the 1990s began to reverse. 

Rates of acute hepatitis C have most notably increased among people 20–49 years of age, American Indian/Alaska Native people, and non-Hispanic White people. 

The shift in acute hepatitis B and hepatitis C incidence is most evident in jurisdictions disproportionately affected by the opioid crisis.

The CDC recently released updated hepatitis vaccination schedules for children and adults.

The latest hepatitis vaccine news is posted at PrecisionVaccinations.com/Hepatitis.

PrecsionVaccinations publishes fact-checked research-based news.

Updates: EU/EEA Member States can share information about suspected cases on the ECDC EpiPulse platform to facilitate the investigation.