On 5 April, the WHO was informed of 10 cases of severe acute hepatitis (inflammation of the liver) in children under 10 in Scotland. Three days later, he received reports of 74 cases across the UK. Usually in Scotland, there are about 7-8 cases a year in patients without underlying diseases. Similar cases have been reported in Alabama, with a few reported in Ireland and Spain. “Mild hepatitis is very common in children after a series of viral infections, but what is happening right now is very different,” Professor Graham Cooke, professor of infectious disease at NIHR Imperial College London, said in a statement. they present with more severe inflammation, which in a few cases leads to liver failure and requires transplantation “. In a case report based on patients first seen in Scotland, doctors note that the severity of the disease seen in children was “unfortunately remarkable”. They report that the children did not have a significant medical history before being admitted to the hospital, where they all remained for at least six days, with three children in need of liver transplants. The symptoms in the cases were similar. “For two children, close contact was reported in one household or other setting with two other cases. Symptoms reported included jaundice (eight out of nine cases), abdominal pain (seven out of nine cases) and nausea and malaise (six out of nine cases). “Almost all reported gastrointestinal symptoms, such as diarrhea or vomiting and lethargy, but not fever, in the weeks before admission,” the report, published in Eurosurveillance. The cause of the increase in cases is not yet known. Hepatitis A, B, C, E, and D viruses have been ruled out by laboratory tests, while SARS-CoV-2 (the virus that causes COVID-19) and / or adenoviruses have been detected in several cases, with the WHO noting that there has been an increase in adenovirus activity in the UK. Experts are divided on the cause of the disease, without enough evidence to go on yet, although a virus of some description seems possible. “When there is a group of cases like this, I think it is possible that there is a viral cause,” said Professor Simon Taylor-Robinson, a hepatologist at Imperial College London, who did not take part in the study. “A number of viruses can cause hepatitis – hepatitis A to E is well known and Epstein Barr virus (which causes glandular fever) can be another cause.” Complicating matters, several viruses – including adenoviruses, which in rare cases can cause inflammation of the liver – are currently circulating. “It is not uncommon to have adenoviruses in the spring. And there are other viruses around – COVID-19 has been linked to inflammation of many other organs in the body,” Taylor-Robinson said. “At the moment we do not know what the cause is or if any of these viruses are involved. It is also difficult to determine the cause and effect because the viruses may be common anyway, so the cause may be present but not necessarily. “ Although worrying, experts point out that the liver is very good at regenerating itself over time. Parents and carers should contact a healthcare provider if they notice symptoms of hepatitis in their children. In the meantime, the health authorities and the WHO will continue to investigate. “Hepatitis is uncommon in children. “In relation to viral hepatitis, childhood infection causes a very rare clinical illness (this is true of most viral infections – the disease is often much worse if contracted as an adult),” said Will Irving, a professor of virology at the University. of Nottingham. Scientific Media Center. “The current harvest of hepatitis cases in children under the age of 10 is therefore very unusual. No specific cause has been identified so far, but investigations are ongoing to determine the cause. “These include looking for toxins in samples from patients (toxicology) and also trying to identify any virus that may be responsible.”