Hepatitis cases of unknown cause being investigated among Irish children

In the UK children have undergone liver transplantation after contracting condition

Parents are advised to be aware of symptoms of hepatitis and to go to their GP if their child develops jaundice. Photograph: iStock
Parents are advised to be aware of symptoms of hepatitis and to go to their GP if their child develops jaundice. Photograph: iStock

A small number of cases of hepatitis of unknown cause have been identified among children in Ireland over the past six weeks.

The Health Service Executive confirmed the number of cases was “less than five” which is more than would usually be expected over a six week period.

The cases are not linked, it said.

“Investigations are currently ongoing to identify the cause of these illnesses,” it added.

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In the UK health authorities have also reported an increase in hepatitis of unknown cause in children. Investigations are underway in the UK to determine the cause of the illness. The Irish cases have no links to the UK cases, and none had a recent travel history to the UK before onset of symptoms.

The common viruses that cause hepatitis (hepatitis viruses A, B, C, and E) have not been detected in any of the cases. Other possible causes of the hepatitis are under investigation.

The HSE said it and the Department of Health continue to keep the cases under review and issued precautionary information to GPs and paediatric consultants in this specialty.

Parents are advised to be aware of symptoms of hepatitis and to go to their GP if their child develops jaundice (discolouration of the white of the eye, dark urine and/or pale stools). The GP will assess the child and refer on for further assessment as indicated.

“If your child is unwell with respiratory or diarrhoeal or hepatitis symptoms keep your child at home and do not send to crèche/preschool/school until they are better,” the HSE advised.

The European Centre for Disease Prevention and Control (ECDC) said earlier this week it had been informed of an increase in acute hepatitis cases among children in the UK.

The children, all under 16 years old, presented with markedly elevated transaminases, which is a type of enzyme.

Another common symptom was jaundice. In some of these cases, children initially had gastrointestinal symptoms, including vomiting.

In England, there are approximately 60 cases under investigation, with most occurring in children between two and five years old.

Some cases progressed to acute liver failure and have required transfer to specialist children’s liver units. A small number of children have undergone liver transplantation.

In Scotland, ten cases that required hospital admission were in children aged between one and five. Most of the cases in Scotland presented from March 2022 onwards.

In Wales, there are currently no known cases under investigation, but a very small number of cases from early 2022 had similar clinical presentations.

In Northern Ireland, there are currently no confirmed cases reported, according to the ECDC.

Some of the children hospitalised in England did test positive for Covid-19 and others had adenovirus.

The ECDC said medical staff should report similar cases to their national public health institutes if the child has a serum transaminase of >500 IU/L and hepatitis A to E has been excluded.