Another 25 British children have fallen ill with hepatitis of unknown origin as the mysterious outbreak continues.
Health officials announced the new cases today, bringing the cumulative British total to 222 since the first was spotted in January.
Of the confirmed patients, 158 were in England, 31 in Scotland, 17 in Wales and 16 in Northern Ireland.
They are mainly in children under five – but a small number of children over the age of 10 have also been removed.
Scientists are still confused as to what causes the life-threatening liver disease, with weakened immunity to the cold due to blockage still presumably one of the main culprits.
The complication has been seen in hundreds of children in Europe, the United States, South America, the Middle East and Asia. At least 12 young people died and dozens needed liver transplants. No children died in the UK.
The UK Health Security Agency (UKHSA) said it was still investigating to find out what was behind the mysterious outbreak – with the usual hepatitis A, B, C, D and E viruses excluded from laboratory test results.
Scientists are still confused about the cause of the disease, which has been spotted in the United States, Western Europe and a handful of other countries. Globally, at least 12 young people have died and dozens have needed liver transplants
The main theory is that the set of hepatitis cases is triggered by a group of viruses that usually cause the common cold, known as adenoviruses.
Scientists are investigating whether a mutated strain of adenovirus has evolved to become more severe, or whether a lack of social mixing during the pandemic has weakened children’s immunity.
Nor could they rule out an old Covid infection being involved.
UKHSA officials said there was no evidence linking the blast to the Covid vaccine, as most cases were in children under five who had not been stung.
New cases appear to be slowing down, with the 25 registered in the nine days to May 25 less than 26 percent of the 34 registered in the six days to May 16.
Dr Tassos Grammatikopoulos, a consultant at King’s College Hospital in London who treated some of the sick children last week said Britain “seems to have passed the peak” of the blast.
Dr Renu Bindra, a senior medical advisor at UKHSA, said: “Our research continues to suggest an association with adenovirus, and we are investigating this link, along with other potential contributing factors including previous infections such as Covid.
“We are working with other countries that are also seeing new cases to share information and learn more about these infections.”
She added: “The likelihood of children developing hepatitis remains extremely low.
“Maintaining normal hygiene measures, including ensuring that children regularly wash their hands properly, helps reduce the spread of many common infections, including adenovirus.
“We continue to remind everyone to be on the lookout for signs of hepatitis – especially hepatitis, look for a yellow tint in the whites of the eyes – and contact your doctor if you are concerned.”
Symptoms of the complication usually begin with diarrhea or illness. It can then cause the skin and eyes to turn yellow.
No new deaths or liver transplants have been reported in the last seven days, the Centers for Disease Control and Prevention (Disease Control Center) revealed in their weekly update with the totals remaining at 14 and six respectively.
The agency did not disclose where the deaths occurred due to “confidentiality issues,” but at least one was recorded in Wisconsin health care providers in the state say.
Globally, Britain has now recorded the highest number of deaths and apparent cases from any nation – although this may be due to stronger surveillance than other nations.
Top experts fear that health care providers will not understand what is behind the strange pattern – which has sickened at least 520 children worldwide since March – for months.
While mild liver inflammation is not uncommon in children, severe disease as seen in these cases is.
Dr. Jason Kindrachuk, an assistant professor of medical microbiology and infectious diseases at the University of Manitoba, Canada, said experts are continuing to investigate the outbreak around the world.
He told The Guardian: ‘The playing field changes from hour to hour. Inch after inch, we begin to find out what this problem is.
‘But I don’t think we still have all those pieces of the puzzle to say,’ Well, that’s what we think is happening. ”
The United States and Indonesia both have five deaths in the blast, while Palestine and Israel have recorded one each.
Q&A: What is the mysterious global hepatitis outbreak and what is behind it?
What is hepatitis?
Hepatitis is an inflammation of the liver that is usually caused by a virus infection or liver damage due to drinking alcohol.
Some cases resolve on their own, without ongoing problems, but a fraction can be fatal, forcing patients to need liver transplants to survive.
What are the symptoms?
People who have hepatitis generally have fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, and joint pain.
They may also suffer from hepatitis – when the skin and whites of the eyes turn yellow.
Why do experts care?
Hepatitis is usually rare in children, but experts have already seen more cases in the current outbreak than they would normally expect in a year.
Cases are of “unknown origin” and are also severe, according to the World Health Organization.
What are the main theories?
Experts say the cases may be linked to an adenovirus, often associated with colds, but further research is ongoing.
This, in combination with Covid infections, could cause the sting in cases.
About three-quarters of British cases were positive for the virus.
British experts tasked with investigating the series of diseases believe that the endless cycle of confinement may have played a contributing role.
Restrictions may have weakened children’s immunity due to reduced social mixing, leaving them at increased risk of adenovirus.
This means that even a “normal” adenovirus could cause the severe results because children do not respond to it as they have done in the past.
Other scientists say it may have been the adenovirus that acquired “unusual mutations.”
This would mean that it could be more transferable or better able to circumvent children’s natural immunity.
New Covid variant
UKHSA officials included “a new variant of SARS-CoV-2” in their working hypotheses.
Covid caused liver inflammation in very rare cases during the pandemic, although these were across all ages rather than isolated in children.
The CDC noted that environmental leaks are still being investigated as possible causes of the diseases.
These could include contamination or exposure to particular drugs or toxins.