Investigation of an outbreak of viral hepatitis in children in the United Kingdom

The Scottish Public Health Service is investigating an outbreak of hepatitis cases in young children admitted to at least four hospitals. These are 11 children between the ages of one and five who were treated in hospitals in Lanarkshire, Glasgow, Tayside and Fife, with a rare type of hepatitis other than A or E.

Dr. Meera Chand, director of clinical and emerging infections at the UK Health Security Agency (UKHSA), said that “research is being conducted to find possible causes of contagion, including possible links to infectious diseases.”

In addition, another 60 cases of viral hepatitis in children under 10 years of age are being investigated in England, according to the British newspaper Daily Mail.

Both coronavirus and a 'range of other infections' are being considered as the cause, health authorities said. But there is “no evidence” that the coronavirus vaccine is linked to any of the cases and most affected children are too young to be eligible for the injection.

“We are working to raise awareness among health professionals, so that any other children who may be affected by these cases can be identified early and appropriate tests carried out. We also remind parents to be aware of the symptoms of jaundice, including skin with a yellow tint that is most easily seen in the whites of their eyes, and to contact a healthcare professional if they have any concerns,” said Chand.

Hepatitis often has no noticeable symptoms, but may include dark urine, pale gray stools, itchy skin, and yellowing of the eyes and skin. Infected people may also suffer from muscle and joint pain, high fever, nausea, and be unusually tired all the time.

When hepatitis is transmitted by a virus, it is usually caused by the consumption of food and drink contaminated with the feces of an infected person or by blood-to-blood or sexual contact. In Scotland, health chiefs said that the number of cases in such a short period of time, combined with the geographical spread and severity of the disease, was “unusual”. There are usually about seven or eight children per year in Scotland that do not have an underlying diagnosis.

There are currently no clear causes for cases that have been detected in Lanarkshire, Tayside, Greater Glasgow and Clyde and Fife. And Public Health Scotland said no clear connection has been identified between the cases.

Dr. Nicholas Phin, the organization's director of public health, said his research was in its early stages. “If you have a child who 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 family doctor or other health professional. We continue to investigate these cases and will provide further updates when they become available,” said the doctor.

A contagious disease

Viral hepatitis is an infection that causes inflammation and damage to the liver. This inflammation is usually a “swelling” that occurs when tissues in the body are injured or infected. Early diagnosis can prevent health problems resulting from infection, as well as transmission of the virus, so they recommend testing for viral hepatitis at least once in your life.

They represent a high burden of disease and mortality worldwide. It is estimated that 57% of cases of liver cirrhosis and 78% of cases of primary liver cancer are due to hepatitis B or C virus infections. According to estimated data from the World Health Organization (WHO), 325 million people in the have chronic hepatitis B or C in the world.

Hepatitis C is a liver disease caused by the HCV virus, which causes acute and chronic infections. New infections are usually asymptomatic. Some people have acute hepatitis, which does not cause a life-threatening disease. “Approximately 30% of infected people eliminate the virus spontaneously within six months, without the need for treatment. In the remaining 70%, chronic HCV infection will occur, and in these cases the risk is to suffer from cirrhosis and liver cancer,” says doctor Verónica Bermejo (M.N. 116,561), an infectiologist at Helios Salud.

According to WHO estimates, 71 million people worldwide are chronically infected with the hepatitis C virus. It is transmitted mainly by blood, in small quantities, by sharp injuries. Through the sexual route it is unlikely.

“Hepatitis C is a disease that has gained relevance in recent times as it went from being an agent of chronic infection and arduous to eradicate, to being a curable infection in more than 95% of cases. The WHO wonders whether the HCV vaccine is still necessary, since today we have curative treatments with high efficacy and excellent tolerance. Treatment for HCV has a dual objective: individual cure and preventing transmission, that is, preventive treatment,” says Bermejo.

At present, HCV treatment consists of direct-acting antiviral drugs. Its duration ranges from 8 to 24 weeks, with cure rates greater than 95%.

“Hepatitis B and A can be prevented with safe and effective vaccines currently available. There is also a combined vaccine that provides protection against these two diseases,” he clarifies. However, he adds that there is still no effective vaccine against hepatitis C. Prevention depends on reducing the risk of exposure to the virus: safe handling and disposal of sharps and waste, appropriate and safe use of injections, testing donated blood, condom use, among others.

“Vaccines play a key role in the prevention of hepatitis A and B because when other prevention measures may fail, being vaccinated is the best shield. People born before the years of the start of universal vaccination in Argentina, should consult for vaccination,” Bermejo concluded.

KEEP READING: