Twenty-one “probable cases” of children with hepatitis of unknown cause have been identified in Ireland since March and a small number of children are under investigation, the State’s infectious disease watchdog has said.
The Health Protection Surveillance Centre (HPSC) said the number of cases that have come to its attention are “more than would usually be expected over this period of time”.
All probable cases are in children under the age of 12. All but one of the children needed hospital treatment. Two children have received liver transplants and there has been one death associated with the disease.
To date, no single virus has been identified in all cases. Investigations are currently trying to identify the cause of the illnesses. UK health authorities have also reported an increase in hepatitis of unknown cause in children.
“Information gathered thus far from the UK investigations suggest that the recent cases of hepatitis may be linked to adenovirus infection, however this theory is still under investigation,” the HPSC said in a statement. “The Irish cases have no links to the UK cases.”
The common viruses that cause hepatitis (hepatitis viruses A, B, C, and E) have not been detected in any of the cases.
One area being explored is whether the hepatitis cases are linked to an increase in infections caused by adenovirus, a common cause of childhood and adult illnesses such as mild cold or flu-like illnesses or diarrhoea. However, adenovirus infections rarely cause hepatitis. Other possible causes such as another infection, including Covid-19, or something in the environment, are also being investigated.
In Ireland, as in other countries, investigations are under way to determine if current or prior Covid-19 infection may increase the risk of the disease in some children. None of the Irish cases who were tested on admission to hospital had evidence of a Covid-19 infection at that time. The HSPC said the majority of the cases had not received a Covid-19 vaccination.
The watchdog said Ireland is liaising closely with the European Centre for Disease Control, as well as authorities in the UK and the World Health Organisation to identify the cause of this illness.
“GPs and paediatric consultants are aware of the recent increase in cases of hepatitis amongst children and will be alert to identify any further cases that may develop,” it said.
Parents are advised to go to their GP if their child develops symptoms of hepatitis. Symptoms can include pale, grey-coloured stools; dark urine; as well as yellowing of the eyes and skin, or jaundice.
The HSPC said that if a child has any of these three symptoms, parents should contact their GP “without delay”.
Other symptoms include muscle and joint pain; a high temperature; feeling and being sick; feeling unusually tired all the time; a general sense of feeling unwell; loss of appetite; tummy pain; and itchy skin.
If a child is unwell with respiratory or diarrheal or hepatitis symptoms, parents are advised to keep them at home and not to send them to crèche, preschool, or school until they have recovered.