Joint ECDC-WHO/Europe surveillance bulletin: Hepatitis of unknown origin in children

Surveillance summary

This report provides an overview of the cases of hepatitis of unknown origin in children aged 16 years and below reported to European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe through The European Surveillance System (TESSy) hosted at ECDC.

As of 20 May 2022, 276 cases of acute hepatitis of unknown aetiology in children aged 16 years and below have been reported from the European region, of which 276 were classified as probable and none as epidemiologically linked, by 16 countries (Austria (two), Belgium (14), Cyprus (two), Denmark (seven), Greece (three), Ireland (six), Italy (27), the Netherlands (14), Norway (five), Poland (one), Portugal (11), Republic of Moldova (one), Serbia (one), Spain (29), Sweden (nine), and the United Kingdom (144)).

Of the 276 probable cases, 162 had reported information on outcome. Of these, 138 have recovered, while 23 remain under medical care.

The epicurve shows cases by the date of onset of first symptoms of disease when available, and the date of hospitalisation or date used for statistics when the former are not available. A sustained increase in the number of reported cases has occurred from week 51 2021, followed by a sharp rise corresponding with an observed maximum on weeks 12 and 13 2022. As severe hepatitis can take some time to develop after the onset of the first symptoms and as investigations take time, there may be a delay in the reporting of cases. The recent decrease in cases is therefore challenging to interpret.

The majority (75.4%) of cases are <5 years of age.

Of 156 cases with information, 22 (14.1%) were admitted to an intensive care unit. Of the 117 cases for which this information was available, 14 (12%) have received a liver transplant. There has been one death associated with this disease.

Overall, 181 cases were tested for adenovirus by any specimen type, of which 110 (60.8%) tested positive. The positivity rate was the highest in whole blood specimens (69.5%). Typing data were only available for four cases: type 40 (n = 1), type 41 (n = 2), and type other (n = 1).

Of the 188 cases PCR tested for SARS-CoV-2, 23 (12.2%) tested positive. Serology results for SARS-CoV-2 were only available for 26 cases, of which 19 (73.1%) had a positive finding. Of the 63 cases with data on COVID-19 vaccination, 53 (84.1%) were unvaccinated.

Read the full report here.

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