Hepatitis in young children – Alert in England and Scotland

Reports of about 60 cases of hepatitis in children under 10 years of age in England and a further 11 in Scotland have prompted UK public health bodies to issue alerts. Parents in the UK have been advised to look out for signs of hepatitis in young children.

Hepatitis symptoms include:

• dark urine
• pale, grey-coloured poo
• itchy skin
• yellowing of the eyes and skin (jaundice)
• muscle and joint pain
• a high temperature
• feeling and being sick
• feeling unusually tired all the time
• loss of appetite
• tummy pain

If further cases are identified quickly then public health staff will be able to build a better picture of what is happening and this may lead to identification of the cause for the unusually high numbers of cases of hepatitis.

If parents notice symptoms suggestive of hepatitis in young children they should contact a healthcare professional.

Dr Meera Chand, Director of Clinical and Emerging Infections, UK Health Security Agency said:

“We are working with partners to raise awareness among healthcare professionals, so that any further children who may be affected can be identified early and the appropriate tests carried out. This will also help us to build a better picture of what may be causing the cases.”

The usual cause for hepatitis in children is a viral infection. However, in the cases under investigation the common viruses (see below) that cause hepatitis have not been detected.

Dr Chand said: “Investigations for a wide range of potential causes are underway, including any possible links to infectious diseases.”

Acute infectious hepatitis

Acute infectious hepatitis is a rare cause of hospital admission in children.  According to a British Paediatric Surveillance Unit (BPSU) study the annual incidence is 0.52/100,000.

There are five viruses that can cause viral hepatitis. Hepatitis A and hepatitis B are the most common. The hepatitis A virus (HAV) is foodborne and can be spread through contaminated water, unwashed food and unwashed hands. It is usually mild, unlikely to damage the liver and resolves within a few months. The hepatitis B virus virus (HBV) is spread through contact with blood or body fluids. It can also be transmitted from mother to baby at birth. The hepatis C virus (HCV) is transmitted through infected blood. Both HBV and HCV can lead to liver cancer and cirrhosis.

More details of viral hepatitis in children can be found here.