UNITED KINGDOM –The World Health Organization (WHO) has reported ten cases of severe acute hepatitis of unknown etiology in children under the age of ten in central Scotland.

Etiology is a medical term that refers to the cause or origin of a disease.

WHO said in a statement that 74 cases had been identified in the UK as of April 8. After laboratory testing, hepatitis viruses (A, B, C, E, and D, as applicable) were ruled out, and further investigations are underway to determine the cause of these cases.

More cases are likely to be reported in the coming days, according to the report, given the increase in reported cases over the last month and enhanced case-search activities.

Following the UK notification, WHO reported that less than five cases (confirmed or possible) had been reported in Ireland, with further investigations underway.

It also stated that three confirmed cases of acute hepatitis of unknown etiology had been reported in children ranging in age from 22 months to 13 years old in Spain.

According to the WHO report, children present to healthcare providers with markedly elevated liver enzymes, often with jaundice, and they sometimes have gastrointestinal symptoms, including vomiting.

At least 6 of the 74 UK patients required liver transplants.  So far, no deaths have been reported.

In the UK, clinicians are encouraged to report cases of acute hepatitis in children up to the age of 16 years with a serum transaminase >500 IU/L, in which hepatitis A to E has been excluded, to National Public Health Institutes.

In England, there are approximately 60 cases under investigation, with most cases in children between 2 and 5 years old.

Some cases progressed to acute liver failure and have required transfer to specialist children’s liver units. A small number of children have undergone liver transplantation.

According to the report, the national authorities are currently investigating these cases. WHO stated that more work is needed to identify cases both within the UK and globally.

The UK Health Security Agency has published a guidance for clinicians including advice on how children should be investigated.

The priority, according to the report, is to determine the etiology of these cases in order to guide future clinical and public health actions.

Any epidemiological links between or among the cases could provide clues to the source of the illness.

It stated that the cases’ temporal and geographical information, as well as their contacts, should be reviewed for potential risk factors.

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