As of April 8, there have been 74 cases in the UK. Laboratory tests have ruled out hepatitis A, B, C, D or E. Further investigations are underway to understand the cause of these cases.
Given the increase in cases reported over the past month and the intensification of case search activities, more cases are likely to be reported in the coming days.
cases
On 5 April, the UK informed who of 10 cases in central Scotland in children aged between 11 months and five years who had been healthy before becoming ill.
Of the 10 cases, nine developed symptoms in March and one in January. Symptoms include jaundice, diarrhea, vomiting, and abdominal pain. All of these cases were detected during hospitalization.
As of April 8, further investigations across the UK had identified a total of 74 cases.
The illness
The clinical syndrome in confirmed cases is acute hepatitis with significantly elevated liver enzymes, often accompanied by jaundice and sometimes gastrointestinal symptoms.
Some cases required to transfer to specialist pediatric liver units and six children received liver transplants. As of 11 April, no deaths have been reported from these cases and one case of epidemiological relevance has been identified.
Unknown etiology
In these cases, laboratory testing has excluded hepatitis A, B, C, D, and E viruses, while sarS-COV-2 and/or adenoviruses, which cause COVID-19, have been detected in some cases. Increased adenovirus activity co-circulating with the Novel Coronavirus has recently been observed in the UK. Although the role of these viruses in pathogenesis remains unclear.
To date, no other epidemiological risk factors have been identified, including recent international travel.
Overall, the cause of these hepatitis cases remains unknown at this time, and active investigations are ongoing, while laboratory tests for other infections, chemicals, and toxins are being conducted in the identified cases.
Cases have also been reported in other countries
Following the UK notification, fewer than five confirmed or probable cases have been reported in Ireland, which is being further investigated.
In addition, Spain reported 3 confirmed cases of acute hepatitis of unknown etiology, aged 22 months to 13 years). Spanish health authorities are currently investigating the cases.
The risk assessment
Who notes that while some cases have tested positive for SARS-COV-2 and/or adenovirus, the virus should be genetically identified to determine any potential association between cases.
Meanwhile, while the potential role of adenovirus and/or SARS-COV-2 virus in the pathogenesis of these cases is a hypothesis, other infectious and non-infectious factors need to be fully investigated to properly assess and manage the risk.
advice
The organization stressed that cases in the UK had continued to rise over the past month as an extensive case search was carried out and that it was likely that more cases would be identified until the cause of the biological, chemical, or other pathogen was identified and appropriate control and prevention measures should be put in place accordingly.
Who strongly encourages the Member States to identify, investigate and report potential cases that meet the case definition.
Based on the information currently available, WHO does not recommend any restrictions on travel and/or trade with the UK or any other country where cases have been detected.
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