An outbreak of hepatitis has been reported in children in multiple countries. According to the World Health Organization, as of 21 April 2022, at least 169 cases of acute hepatitis of unknown origin have been reported from 11 countries in the WHO European Region and one country in the WHO Region of the Americas. The majority of cases have been reported in the UK with 114 identified thus far, Spain (13), Israel (12), the United States of America (9), Denmark (6), Ireland (<5), The Netherlands (4), Italy (4), Norway (2), France (2), Romania (1), and Belgium (1).

Affected children range in age from one month to sixteen years with one death reported and seventeen (17) children requiring liver transplantation.

In these cases, acute hepatitis, which results in liver inflammation, has been reported with symptoms such as abdominal pain, diarrhea and vomiting preceding presentation with severe acute hepatitis, and increased levels of liver enzymes and jaundice (yellowing of skin). Most cases did not have a fever and were not associated with the viruses usually responsible for hepatitis.

Investigations into this outbreak are ongoing to identify the causes of this outbreak. Adenoviruses have been identified in some cases. Adenoviruses are common viruses that cause a range of illness. They can cause cold-like symptoms, fever, sore throat, bronchitis, pneumonia, diarrhea, and pink eye (conjunctivitis). Adenoviruses usually cause mild illness with reports of hepatitis being rare.

On Thursday, the US Centers for Disease Control and Prevention (CDC) issued a health advisory which alerted health care providers and public health authorities of an investigation into acute cases of hepatitis with unknown causes.

Parents are reminded to ensure that their children practice the usual hygiene measures such as thorough handwashing and good respiratory hygiene which help to reduce the spread of many common infections, including adenovirus.

The Ministry of Health will continue to monitor this situation.