PARENTS have been urged to look out for symptoms in their children amid a mysterious hepatitis outbreak.
And some of the first signs may affect the tummy first, causing vomiting or diarrhoea.
Hepatitis is the medical term for liver inflammation, and it’s usually caused by hepatitis A, B, C, D, E.
But health experts say there is no evidence the children are infected with either of these viruses, and they are looking at other causes.
There is increasing evidence the hepatitis cases – of which there are 108 in the UK – are linked with adenovirus infection.
Adenoviruses infect the tissue linings of the respiratory tract, eyes, intestines, urinary tract and nervous system.
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Adenoviruses can cause a whole host of symptoms depending on the area that’s infected.
The European Centre for Disease Prevention and Control said some of the cases in the UK “reported gastrointestinal symptoms, including abdominal pain, diarrhoea and vomiting” in the weeks prior to having hepatitis.
"Most cases did not have a fever", the agency said.
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Similar signs have come from the US, where a spate of cases have occurred in Alabama.
Nine children who had hepatitis between October and February were investigated and all tested positive for adenovirus type 41.
This virus typically causes inflammation of the stomach or intestines, known as acute gastroenteritis, in children, according to the CDC.
Prof Simon Taylor-Robinson, Hepatologist, Imperial College London, said: “Adenoviruses are viruses that can normally cause the common cold in adults, but also diarrhoea, abdominal pain and vomiting in children.
“Sometimes symptoms can be more severe and can rarely cause liver inflammation.
“And there are other viruses around too – Covid-19 has been associated with inflammation of many other body organs.
“At the moment we don’t know for certain what the cause is but the authorities are investigating intensively.
“If parents are worried about symptoms in their children they should contact their doctor.”
Dr Zania Stamataki, Associate Professor in Viral Immunology, Centre for Liver and Gastrointestinal Research, University of Birmingham, said there could be a new form of adenovirus causing hepatitis.
She said: “If an adenovirus is to blame, this could be a new variant of adenovirus that may cause liver injury in children with naïve/immature immune systems."
The most effective way to stem transmission of adenovirus, which spreads all year round, is good hand and respiratory hygiene.
The CDC said it was working with other experts in Europe and the UK to understand the underlying causes of the rare hepatitis clusters.
Other infectious causes still being explored include increased severity of disease following infection with Omicron.
It’s not impossible the cases are due to a new, undiscovered Covid variant, a team led by Public Health Scotland wrote in the journal Eurosurveillance.
Additional cases have also been reported in Denmark, Spain, Ireland and the Netherlands.
In total eight children in the UK have needed a liver transplant after severe illness, and two in the US.
The UK Health and Security Agency (UKHSA) has warned parents of young children to watch out for signs of hepatitis, as well as prevent spread of common viruses.
These include jaundice, which causes yellowing of the skin and eyes.
Dark urine, grey-coloured poo and itchy skin are also key signs.
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The 10 main hepatitis symptoms are:
- Dark urine
- Pale, grey-coloured poo
- Itchy skin
- Yellowing of the eyes and skin (jaundice)
- Muscle and joint pain
- A high temperature
- Feeling and being sick
- Feeling unusually tired all the time
- Loss of appetite
- Tummy pain
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