Update on hepatitis in young children in Scotland

Public Health Scotland (PHS) is asking parents and care-givers to continue to be vigilant about hand and respiratory hygiene, particularly the supervision of hand-washing as investigations into a rise in cases of sudden onset hepatitis (liver inflammation) in children aged 10 and under continue. If a child shows signs of jaundice, where the skin has a yellow tinge and is most easily seen in the whites of the eyes, then parents should contact their GP or other Health Care professional. 

A total of 14 cases have been identified in Scotland since January 2022, where the usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected. The total number of cases identified in the UK is now 108. All the children affected presented to health services between January 2022 and 12 April 2022.

There is no link to the COVID-19 vaccine. None of the currently confirmed cases in the UK are known to have been vaccinated. 

All potential causes are being explored, but infection is considered to be more plausible based on available evidence.

Some of the children have tested positive for adenoviruses, and therefore this is being considered. 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. While they don’t 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.

Although adenovirus infection has been detected in 77% of the UK’s cases that have been tested, the pattern of disease is unusual. PHS is investigating other possible contributing factors including another possible infection or an environmental cause.

We are also working jointly with clinical and scientific colleagues across the UK to investigate whether there has been a change in the genome of the adenovirus.

Dr Jim McMenamin, Head of Health Protection (Infection Services) at PHS, said:

“I strongly encourage parents and others taking care of young children to be vigilant about hand and respiratory hygiene. Where possible make sure that young children wash their hands frequently.

“Parents should contact their GP or other healthcare professional if they notice signs of jaundice in their child. The symptoms to look out for are a yellow tinge in the whites of their eyes or on their skin. Other symptoms can include dark urine, pale grey coloured poo, itchy skin, muscle and joint pains, tiredness, feeling sick, a high temperature, loss of appetite and stomach pain.

“We are working with NHS and public health colleagues across the UK to thoroughly investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.

“Although our investigations increasingly suggest that there is a link to adenovirus infection, we are continuing to look into other potential causes and will issue further updates as the situation develops and we have more information”.