Increase in acute hepatitis cases of unknown aetiology in children

UKHSA is working with the NHS and public health colleagues across the UK to investigate the potential cause of an unusually high number of acute hepatitis cases being seen in children from England, Scotland and Wales in the past few weeks. There is no known association with travel, and hepatitis viruses (A to E) have not been detected in these children.

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.

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