Acute hepatitis of unknown origin in childrenBMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1197 (Published 17 May 2022) Cite this as: BMJ 2022;377:o1197
- Muge Cevik, clinical lecturer1,
- Angela L Rasmussen, professor2,
- Isaac I Bogoch, associate professor diseases3,
- Jason Kindrachuk, Canada research chair4
- 1Division of Infection and Global Health Research, School of Medicine, University of St Andrews, St Andrews, UK
- 2Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- 3Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
- 4Laboratory of Emerging and Re-emerging Viruses, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Correspondence to: J Kindrachuk
Recent reports of severe acute hepatitis of unknown aetiology in previously healthy children across multiple countries have resulted in health alerts and a race to identify the underlying cause.
By 11 May, around 450 probable cases of acute hepatitis of unknown cause had been reported worldwide,1 with 163 in the UK by 3 May.2 Affected children were aged between 1 month and 16 years, although more than three quarters of those in the UK were under 5 years and those in the US had a median age of 2 years.2 Eleven children have died so far, and 31 have been reported to require liver transplants (11 in the UK, 5 in Europe, and 15 in the US).34 Gastrointestinal symptoms are common,245 including jaundice (71%), vomiting (63%), pale stools (50%), and diarrhoea (45%). Fever (31%) and respiratory symptoms (19%) are reported less often.6 Most affected children have not received a covid-19 vaccine.
Tests for hepatitis viruses A–E have been universally negative. Detailed laboratory investigation by the UK Health Security Agency …