December 9, 2022

Dogs or paracetamol could be the source of a mysterious outbreak of hepatitis in children, experts warn

Having a pet dog or taking paracetamol could trigger mysterious cases of hepatitis in children, health chiefs have warned.

Official data shows 163 children in the UK have contracted the disease, 11 of whom need liver transplants.


Hepatitis is an inflammation of the liver and is usually caused by the hepatitis A, B, C, D or E virusCredit: Getty

No children have died in the UK from the disease, and there are now believed to be more than 250 cases worldwide.

Doctors have now warned that cases of the disease are more common in households where there are dogs.

In 92 cases across the UK, 64 positives were in children from families with dogs or who had been exposed to dogs, according to data from the UK Health Security Agency (UKHSA).

Doctors are now exploring this link, but point out that it may be due to the high number of dog owners in the UK.

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It was also found that three quarters of the respondents mentioned the use of paracetamol.

Fewer ibuprofen uses were reported and none reported aspirin use.

The prevalence of paracetamol use is considered to be in line with guidelines on the management of acute illness in children, experts said.

Investigations of the condition have included interviews with parents and questionnaires sent to families who have been affected.

Earlier this week, the World Health Organization said there were 230 children across the world with the disease.

Hepatitis is an inflammation of the liver and is usually caused by the hepatitis A, B, C, D or E virus.

None of the children in the UK have tested positive for these strains, and none appear to be immunocompromised.

British health officials have said the chance of a child developing hepatitis remains “extremely low”, but parents should be aware of the symptoms.

The key signs you need to watch out for are:

  • yellowing of the white part of the eyes or skin (jaundice)
  • dark urine
  • pale gray colored faeces (poo)
  • itchy skin
  • muscle and joint pain
  • a high temperature
  • to feel and be sick
  • feeling unusually tired all the time
  • loss of appetite
  • stomach pain

Dr Meera Chand, director of clinical and emerging infections at UKHSA, said parents should always be alert for key signs.

“In particular jaundice, look for a yellow tint in the whites of the eyes – and contact your doctor if you are concerned.

“Our investigations continue to suggest that there is an association with adenovirus and our studies are currently testing this association rigorously.

“We are also investigating other contributors, including the former SARS-COV-2, and working closely with NHS and academic partners to understand the mechanism of liver damage in affected children.”

Doctors said the investigation into the cause was still ongoing and that adenovirus was the most frequently detected virus in the samples tested.

However, they pointed out that it is not common for it to cause hepatitis.

Adenoviruses are typically spread through close personal contact, respiratory droplets, and surfaces.

There are more than 50 types of adenoviruses, which most often cause the common cold.

But early evidence suggests that children with hepatitis have been infected with adenovirus type 41 which causes symptoms of abdominal pain, vomiting, nausea and diarrhoea.

This precedes signs of liver inflammation, which can include jaundice – yellowing of the skin and eyes.

The most common signs of the virus are:

  • common cold and flu symptoms
  • fever
  • sore throat
  • bronchitis
  • pneumonia
  • conjunctivitis
  • gastrointestinal problems such as sickness and diarrhea.

Severe illnesses are less common with viruses, but people with weakened immune systems or who already have respiratory or heart conditions are at higher risk of developing severe symptoms.

Less common signs include inflammation or infection of the bladder and problems that affect the brain or spinal cord.

Hepatitis is a rare side effect.

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Hygiene is important when dealing with adenoviruses as they are spread through close personal contact such as touching.

Just like Covid, they can also be spread through coughing and sneezing and touching surfaces with adenoviruses.

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