Report examining recent cases of hepatitis in Scotland published

On 14 April 2022, the Eurosurveillance journal published an article based on an ongoing investigation by Public Health Scotland (PHS) into the origin of recent severe hepatitis cases among young children in Scotland. 

As of 21 April 2022, PHS has identified 14 cases of severe hepatitis requiring admission to hospital in children aged between one and 10 years old, across six Scottish NHS health boards in Scotland, with most cases noted since March, although one child was admitted to hospital in early January 2022. 

Each year, around seven or eight cases of non-A to E hepatitis, without other underlying diagnoses, are detected in children in Scotland, therefore the increased number of cases in such a brief 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, while latest reports find detections have also been reported in four European countries and the US, which are being investigated by their own public health agencies. PHS is working closely with the UK Health Security Agency (UKHSA) and their devolved partners to coordinate the investigation. 

At present, all potential causes are being explored, though none has been found, but infection is more plausible based on available evidence. Some of the children were adenovirus PCR-positive and other childhood viruses, including SARS-CoV-2, have also been isolated. The Incident Management Team (IMT) is also looking into whether there are other infections or environmental causes. There is no connection between the COVID-19 vaccination and these cases, with the majority being 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, and while they do not 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. Parents are advised contact their GP or other healthcare professional if they notice signs of jaundice in their child, which can present as 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, hot temperature, loss of appetite and stomach pain. 

Source: PHS, 21 April 2022