In a follow-up on the higher than usual rates of liver inflammation (hepatitis) in children in the United Kingdom from the beginning of the month, the European Centre for Disease Prevention and Control (ECDC) reports today additional cases in children have been reported in Denmark, Ireland, the Netherlands, and Spain.
Investigations are ongoing in all countries reporting cases. At present, the exact cause of hepatitis in these children remains unknown. The incident team in the United Kingdom, where most of the cases have occurred to date, consider that an infective cause is most likely based on the clinical and epidemiological features of the cases under investigation.
In addition, nine cases of acute hepatitis among children between 1 and 6 years old in the state of Alabama in the United States who also tested positive for adenovirus have been reported.
So far in the UK, of the confirmed cases, 49 are in England, 13 are in Scotland and the remainder are in Wales and Northern Ireland.
The cases in the United Kingdom presented clinically with severe acute hepatitis, with increased levels of liver enzymes (aspartate transaminase (AST) or Alanine aminotransaminase (ALT) greater than 500 IU/L) and many cases were jaundiced. Some of the cases reported gastrointestinal symptoms, including abdominal pain, diarrhea and vomiting in the preceding weeks.
Laboratory investigations of the cases excluded viral hepatitis types A, B, C, D and E in all cases. Of the 13 cases reported by Scotland for which detailed information is available regarding testing, three tested positive for SARS-CoV-2 infection, five tested negative and two were documented to have had an infection in the three months before presentation. Eleven of these 13 cases had results for adenovirus testing and five tested positive.
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