The clinical syndrome in identified cases is of severe acute hepatitis with markedly elevated transaminases, often with jaundice, sometimes preceded by gastrointestinal symptoms including vomiting as a prominent feature, in children up to the age of 16 years. In England, there are approximately 60 cases under investigation with most cases being 2 to 5 years old. Some cases have required transfer to specialist children’s liver units and a small number of children have undergone liver transplantation. Based on reports from the specialist units, no child has died. The underlying cause of this increase in presentation since early 2022 currently remains unknown.
Clinicians are asked to be alert to this emerging situation, and to be vigilant to children presenting with signs and symptoms potentially attributable to hepatitis that may require liver function testing. These include:
- discolouration of urine (dark) and/or faeces (pale)
- jaundice
- pruritis
- arthralgia/myalgia
- pyrexia
- nausea, vomiting or abdominal pain
- lethargy and or loss of appetite
GPs should be alert to children presenting with symptoms compatible with acute hepatitis and seek advice from their local Trust.