Eurosurveillance has published a journal article based on Public Health Scotland (PHS) ongoing investigation into the origin of the recent severe hepatitis cases among young children.

So far, PHS has identified 13 cases of severe hepatitis requiring admission to hospital in children aged between one and 10 years old in six NHS Health Boards in Scotland.  Most cases have presented since March, although one child was admitted to hospital in early January 2022.  

Each year, typically around seven or eight cases of non A to E hepatitis (without other underlying diagnoses) are detected in children in Scotland. The number of cases in such a short time period, combined with the geographical spread and severity of illness is unusual and requires further investigation. Cases have also been detected in other parts of the UK, which are being investigated by their Public Health agencies.  PHS is working closely with UKHSA and their devolved partners to coordinate the investigation.

At present, there is no known cause. All potential causes are being explored but infection is considered to be more plausible based on available evidence. Five children were adenovirus PCR-positive and other childhood viruses, including SARS-CoV-2, have also been isolated. The Incident Management Team are also looking into whether there are other infections or environmental causes. There is no connection between the COVID-19 vaccination and these cases — the majority of cases are of an age too young to be vaccinated and none has received a first dose.

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.

Adenoviruses are commonly passed from person to person and by touching contaminated surfaces, as well as through the respiratory system.

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.

PHS continues to work with partners and other agencies across the UK to investigate these cases.

Dr Jim McMenamin, Head of Health Protection (Infection Services), Public Health Scotland said:

“Along with colleagues in other parts of the UK, several lines of investigation are ongoing. In a number of cases, adenovirus and SARS-CoV2 have been detected, so these links are currently being investigated.

“Parents should contact their GP or other healthcare professional if they notice signs of jaundice in their child. This can be a yellow tinge in the whites of their eyes or on their skin. Other symptoms include dark urine, pale grey coloured poo, itchy skin, muscle and joint pains, tiredness, feeling sick, a high temperature, loss of appetite and stomach pain.

 “I would also encourage parents and others taking care of young children to be vigilant about hand and general hygiene. We will issue further updates as the situation develops and we have more information.”

The report can be read here.

Last updated: 21 April 2022