Most children with case of severe hepatitis were previously healthy – HSE

Most of the children struck by a severe form of hepatitis – which has led to one death in Ireland and another child needing a liver transplant – were previously healthy, it emerged yesterday.

reland’s disease watchdog said almost all the cases have been in children under 10 years of age. The oldest here was aged 12.

None of the children here caught it from another infected patient.

It follows confirmation that six cases of the very rare but severe hepatitis – a form of liver inflammation – have been diagnosed here, with more victims reported across Europe and other countries.

The HSE said the cause is still being investigated, with a suggestion that it could be linked to the common adenovirus.

Although the condition is very rare, parents are being urged to be alert for symptoms such as pale, grey-coloured stools, dark urine, and yellowing of the eyes and skin .

GP Dr Denis McCauley said yesterday “it is very rare but it is still a worry”.

Children can get a runny nose, diarrhoea and vomiting. “Don’t panic – but look out if your child is not getting better. Look out if they are getting sicker and dehydrated.”

If a child continues to feel unwell, “parents should make contact with their doctor anyway”, he added.

“It is very rare but it could become obvious something is wrong – a bug that is not getting better. Use your own instinct.”

Professor Kingston Mills, an immunology expert in Trinity College, said the cause of these rare hepatitis cases is still under investigation and it is too early to draw conclusions.

He said the theory that lockdown affected children’s immune systems and could be contributing to the cases was questionable.

Dr Suzanne Cotter of the Health Protection Surveillance Centre said serious investigations were ongoing into the possible cause of the cases. 

A fatality linked to the condition is very rare, she added.

The HSE said the number of cases of child hepatitis is higher than normal, although experts point out that simply raising an alert in itself can artificially inflate numbers and include infections that would have happened in normal times.

Dr Cotter said there is some suggestion it could be linked to a common adenovirus, but it might be “ just coincidental”.

“We are looking at everything to see if previous infection may be a co-factor,” she added.

Dr Ciara Martin, the HSE’s lead on children, said the cases are more severe than doctors would normally see.

“Generally, hepatitis can be caused by different things – toxin, bacteria and, more commonly, a virus,” Dr Martin said.

She said the common viruses had not been found in the cases in Ireland.

“Hepatitis does not tend to come on fast. It can take a little time for it to show,” she said.

If a child has hepatitis they would feel tired, lethargic, have a temperature, feel nauseous, and they may not want to eat.

However, she said parents in particular should see if their child’s skin is turning yellow or the whites of their eyes are yellow. Skin can be itchy and urine dark.

“If you see any of these, talk to your doctor,” she said.

She said there is no apparent link to the Covid vaccine, although it will take time to see if it is playing any role.

Adenovirus usually causes mild respiratory symptoms or diarrhoea, and hepatitis risk is very low.

The most effective way to reduce the spread is good hand and respiratory hygiene.

Parents should supervise their children when washing their hands.

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