A mystery liver disease of unknown origin, which is leaving children in hospital, has spread from the UK to the US and four countries in Europe.
Cases of the serious disease were confirmed in Denmark, Ireland, the Netherlands, Spain and the US, the European Centre for Disease Prevention and Control said.
“Mild hepatitis is very common in children following a range of viral infections but what is being seen at the moment is quite different,” said Graham Cooke, a professor of infectious diseases at Imperial College London.
US officials have detected nine cases of the acute hepatitis in the southern state of Alabama in children aged 1 to 6. The ECDC did not say how many cases have been identified in Europe.
Last week, British health officials reported 74 cases of hepatitis, or liver inflammation, found in children since January.
The usual viruses that cause infectious hepatitis were not found in any of the cases and scientists and doctors are considering alternative sources, including Covid-19, other viruses and environmental factors.
But Prof Cooke does not believe Covid-19 was responsible.
“If the hepatitis was a result of Covid, it would be surprising not to see it more widely distributed across the country given the high prevalence of [Covid] at the moment,” he said.
British scientists previously said a possible cause was an adenovirus, a common micro-organism usually responsible for conditions such as pink eye, a sore throat or diarrhoea.
US authorities said all nine sufferers in Alabama had tested positive for adenovirus.
Some doctors have noted that adenoviruses are so common in children that merely finding them in those with hepatitis does not necessarily mean the viruses are responsible for the liver disease.
British public health officials ruled out any links to Covid-19 vaccines, as none of the affected children had been vaccinated.
The World Health Organisation said that although there has been an increase in adenovirus in Britain, which is spreading at the same time as Covid-19, the potential role of those viruses in triggering the hepatitis remains unclear.
Some of the children have tested positive for coronavirus, but the WHO said genetic analysis of the virus was needed to determine if there were any connections between the cases.
It said no other links had been found between the children in the UK and none had travelled overseas recently. Lab tests are also under way to determine if a chemical or toxin might be the cause.
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