A further 13 children with sudden hepatitis have been identified in the UK, bringing the total to 176, the UK Health Security Agency (UKHSA) has said.
Of the confirmed cases, 128 are in England, 26 in Scotland, 13 in Wales and nine in Northern Ireland. None of the children has died.
Health officials are continuing to investigate cases of sudden-onset hepatitis in children 10 years and younger identified since January 2022. The common viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.
The cases mainly occur in children under five years of age who showed initial symptoms of gastroenteritis (diarrhoea and nausea), followed by the onset of jaundice.
A small number of children over the age of 10 are also being examined as part of the study, the UKHSA said. The research continues to point to a link with adenovirus, the most commonly detected virus in the samples tested.
Increased susceptibility due to reduced exposure during the pandemic or as yet undiscovered co-infection or toxin are other possible cofactors under investigation. Alternatively, a new adenovirus strain may have emerged with altered characteristics, officials believe.
Normal hygiene measures, including thorough hand washing and ensuring that children wash their hands properly, help reduce the spread of common infections, including adenovirus.
dr. Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said: “It is important for parents to know that the chances of their child developing hepatitis are extremely low. We continue to remind everyone to be alert for the signs of hepatitis – especially jaundice, look out for a yellow tint in the whites of the eyes – and talk to your doctor if you are concerned.
“Our studies continue to suggest an association with adenovirus and our studies are now rigorously testing this association. We are working closely with the NHS and academic partners to actively investigate the role of other contributors, including previous SARS-CoV-2 and other infections.”
Cases have also been discovered in the US state of Alabama, as well as in Denmark, Ireland, the Netherlands, Spain and Israel.
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