Parents are being told to adopt good hand hygiene and be alert to the signs of hepatitis in their children as an unexplained outbreak, first detected in the UK, appears to be spreading with cases now in Europe and the US.

More than 70 instances have so far been identified in England and Scotland, which has lead to a small number of youngsters reportedly requiring liver transplants but cases - says the European Centre for Disease Prevention and Control - are now being picked up in countries including Spain, Denmark, Ireland and the Netherlands alongside a further cluster in the American state of Alabama.

Parents are being warned to look out for the signs and symptoms of the inflammatory liver condition and practice good hand and respiratory hygiene because of the so-far unexplained spike in the number of youngsters falling ill.

Itchy skin, muscle and joint pain and a lack of appetite are among the signs and symptoms associated with the condition but so far none of the common viruses known to lead to hepatitis have been detected in the young patients.
Scientists and medics say the increase in infection is not related to the Covid vaccine as none of the UK's young patients had yet been given a jab but officials have not yet ruled out coronavirus infection as a possible cause.

One of the other potential causes under investigation is that a group of viruses called adenoviruses may be leading to the illness.

Adenoviruses are a family of common viruses that usually cause a range of mild illnesses including sickness, diarrhoea and colds and while most people recover without complications and they don’t typically cause hepatitis, it is a known rare complication.

Families are being urged to remain vigilant to signs of illness in their children while adopting good hygiene and hand washing - all of which can help prevent the spread of adenoviruses - while scientists rush to identify the root cause.

Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said: "We are working swiftly with the NHS and public health colleagues in Scotland, Wales and Northern Ireland to investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.

"One of the possible causes that we are investigating is that this is linked to adenovirus infection. However, we are thoroughly investigating other potential causes. Normal hygiene measures such as good handwashing – including supervising children – and respiratory hygiene, help to reduce the spread of many of the infections that we are investigating.

"We are also calling on parents and guardians, to be alert to the signs of hepatitis – including jaundice – and to contact a healthcare professional if they are concerned.

The signs and symptoms of hepatitis in children can include:

* dark urine

* pale, grey-coloured poo

* itchy skin

* yellowing of the eyes and skin (jaundice)

* muscle and joint pain

* a high temperature

* feeling and being sick

* feeling unusually tired all the time

* loss of appetite

* tummy pain

Parents with concerns about their children's health should contact a health professional, say those investigating.

Dr Chand added: "We are also reminding parents to be aware of the symptoms of jaundice – including skin with a yellow tinge which is most easily seen in the whites of the eyes – and to contact a healthcare professional if they have concerns."