Since 31 March 2022, there has been an increase in cases of children presenting with severe liver disease of unknown cause (termed ‘acute severe hepatitis of unknown etiology’ (ASHep-UE)) across multiple countries including the UK. Most of these have been children aged 1–6 years, leading to hospital admissions requiring intensive care, and in some cases needing emergency liver transplantation.
Most of the children affected were previously healthy, and all have tested negative for the conventional viruses that cause hepatitis (viral hepatitis A–E). They are distributed across geographical settings, with minimal evidence of links between cases. One current focus based on initial test results is on the possibility of Adenovirus infection. However, these viruses usually cause mild disease and have not previously been associated with severe liver inflammation.
We are setting out to use data collected by IORD to investigate whether we can identify any changes in the frequency of adults or children presenting with abnormal liver function tests and whether there have been changes in Adenovirus, or in other circulating viral infections, in the catchment population for Oxford University Hospitals. This will contribute to national and international efforts to determine the cause of this outbreak and therefore to plan a public health response.