Childhood hepatitis: How to spot the severe illness and why it’s on the rise

Dr Muiris Houston: None of the usual viruses has been identified as a cause

I thought childhood jaundice was a relatively common condition. Why are doctors and scientists concerned about recent cases of hepatitis in children?
There has been a sharp and unusual increase in severe acute hepatitis cases among children under ten in the UK, the US, Spain and Ireland in recent months. Severe hepatitis in children is rare. And none of the usual viruses that cause hepatitis has been identified as a cause.

Is hepatitis always caused by infection?
No. Hepatitis is the medical term for inflammation of the liver. The five hepatitis viruses (A to E) are a common cause of the condition. But it can also be due to injury, drugs, and autoimmune disease – where the body's immune system turns on itself.

Could Covid-19 be the cause?
It is possible but unlikely. Sars-CoV-2 has been detected in some of the children and isolated cases of hepatitis have been reported in some adults with severe Covid-19. None of the children diagnosed with hepatitis in the UK have received a Covid-19 vaccine, so there's no reason to believe vaccines are linked to this sudden rise in cases of hepatitis.

So what could be causing this spike in childhood illness?
Adenovirus is a possible trigger that is currently in the sights of investigating scientists. It is a common childhood infection, although rarely known to cause hepatitis. But the UK has seen a recent rise in adenovirus cases so it is possible a hitherto unknown strain of the virus is to blame. Experts have also speculated that due to restricted social mixing during the Covid pandemic, a routinely circulating adenovirus could be severely impacting younger children whose immune systems have not been challenged in the usual way.


How might I know if my child had hepatitis?
Symptoms in children usually include some of the following: yellowing of the skin and eyes, a high temperature, vomiting, dark urine and grey-coloured faeces.

What treatment is available for hepatitis?
Antiviral drugs if a virus is the cause. Otherwise supportive care in hospital, with liver transplant necessary in severe cases should liver failure occur. According to the World Health Organisation, six of the 74 children affected in the UK have undergone a transplant so far.