Parents warned to be alert to symptoms after child dies from hepatitis

Large increase in hepatitis infections identified across several countries in recent weeks

A senior Health Service Executive official has urged parents to be "alert" following the death of a child in Ireland from hepatitis and an increase in unexplained cases of the condition across several countries in recent weeks.

Six probable cases of children with hepatitis of an unknown cause have been identified in the State over the last 10 weeks. One of the children has died and another required a liver transplant.

A HSE spokeswoman said the six children, aged between one and 12 years, were all hospitalised as a result of the illness

Hepatitis is an inflammation of the liver commonly caused by hepatitis viruses A, B, C and E. However, none of these has been detected in recent cases.

Dr Ciara Martin, HSE national clinical lead for children, called on parents not to panic but said they should remain “alert” to the issue.

“It is a concern but the right people are looking at it,” she told The Irish Times. “Obviously it’s new, it’s something that we would like to know the answer to.”

The spike in unexplained child hepatitis was first identified in Britain and has since seen 450 suspected cases reported worldwide. US and UK health authorities suspect the cases may be linked to some type of adenovirus infection, which commonly causes colds, flu or sore throats in children.

Infections of adenovirus have been found in more than half of children with unexplained hepatitis in Britain, as well as many of the suspected cases under investigation in the US. Other early theories about what might be causing the cases include a possible new variant of adenovirus, a side-effect of Covid-19 infection, a toxin or some other form of environmental exposure.

The HSE spokeswoman said the six suspected hepatitis cases were “more than would usually be expected” over a 10-week period.

“The children affected have no links to the other children involved. To date no single virus has been identified in the cases,” she said. “The Irish cases have no links to the UK cases, and none had a recent travel history to the UK before onset of symptoms.”

More severe

Dr Martin, a consultant in paediatric emergency medicine, said recent cases appeared to be more severe than hepatitis A infections often seen in children.

In any year the health service might see a small number of unexplained hepatitis cases in children, on average one of which might require a liver transplant, she said.

Health officials have set about contact tracing the recent cases to search for any common link between the children, such as a type of food, toy or activity.

“In this case nothing has come up that has connected any of the children in Ireland or elsewhere,” Dr Martin said.

Medics have ruled out any link between the unexplained hepatitis cases in children and the Covid-19 vaccine. In the UK, where officials have a significant amount of early data, the vast majority of children being treated for hepatitis had not even received a Covid-19 vaccine.

Parents have been advised to look out for symptoms of hepatitis in their children, such as jaundice (where the skin or whites of the eyes appear to turn yellow), very dark urine, pale or grey coloured stool, and itchy skin.

Dr Martin reiterated that the number of unexplained hepatitis cases remained “very small”.

“Don’t worry if your child has a childhood illness, it’s probably just a childhood illness,” she said.