Ten children in the UK have required liver transplants following a surge in severe hepatitis cases among young children, with 114 cases now confirmed across all four nations. The rise is most likely due to reduced exposure to adenoviruses during Covid restrictions, experts say.
Dr Meera Chand, incident director for the UK Health Security Agency (UKHSA) investigation, told an emergency session at the European Congress of Clinical Microbiology and Infectious Diseases that of 81 cases in England, 43 children have fully recovered, while 38 remain in hospital. Seven of the transplants occurred in England. No deaths have been reported.
The leading hypothesis is that lockdowns and social distancing limited children's exposure to common viruses, leading to an inadequate immune response when encountering adenoviruses as society reopens. Adenoviruses typically cause cold-like symptoms but can rarely trigger hepatitis.
Of 53 English hepatitis cases tested for adenovirus, 75% were positive. Adenovirus infections in one- to four-year-olds are at their highest in five years. Prof Deirdre Kelly, a paediatric hepatologist, noted that Birmingham Children's Hospital saw 40 unexplained hepatitis cases this year compared to six in the same period in 2018.
Other possibilities include recent Covid infection suppressing immunity or a new adenovirus strain, though genotyping shows no evidence of this. Most cases involve adenovirus 41F, which usually causes gastrointestinal symptoms. Similar outbreaks have been reported in 12 other countries, with at least 169 cases globally.
