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Evening Standard
Evening Standard
World
Elly Blake

Three children die from hepatitis in Indonesia bringing global death toll to four

Health officials are investigating the mystery cause of the global hepatitis outbreak in children

(Picture: PA Wire)

Three children in Indonesia are thought to have died from a mysterious global outbreak of hepatitis.

If confirmed, this would bring the global death toll of the liver inflammation disease to four.

The country’s health ministry announced the children died of “suspected acute hepatitis” last month, all of whom were in Jakarta.

Their symptoms included nausea, vomiting, diarrhoea, fever, jaundice, seizures and loss of consciousness.

Indonesian officials have issued advise to parents warning them what to look out for.

The ages of the children have not been revealed, and it is not known if they had underlying health conditions.

More than 200 cases of hepatitis of “unknown origin” have been confirmed worldwide since the outbreak started.

However, experts say this is just the “tip of the iceberg”.

Most have been detected in the UK and US, but countries including Israel, Ireland Japan and Canada have all reported cases.

The World Health Organisation (WHO) has previously confirmed one death, although it did not reveal the location.

Meanwhile, at least 18 children have required liver transplants.

In what is a mystery for scientists, none of the cases showed signs of having the normal hepatitis-causing viruses, leaving experts stumped over the origins of the disease.

Last week, during a technical briefing, WHO expert Professor Philippa Easterbrook, said: “The causes of the cases remains under active investigation, looking at a rane of possible underlying factors.”

The cases do not feature the viruses typically responsible for acute liver inflammation - hepatitis A, B, C, D and E, she added.

Profesor Easterbrook said there was a possible link to adenovirus, a common infection found in children.

She continued: “It is unusual for an adnovirus to cause this type of severe symptoms and so this is what is being actively investigated at the moment.”

Scientists are urgently looking into what is causing the global outbreak, with public health officials in the UK saying lockdown could be a factor.

The number of investigated cases of “acute hepatitis of unknown origin” in children under the age of 10 has risen to around 145 cases, according to the UK Health Security Agency (UKHSA).

Public health officials said a lack of exposure to common infections during children’s “formative” years, due to social distancing and lockdown restrictions, may explain the global outbreak in cases of the disease that has killed one child worldwide.

Dr Meera Chand - who is leading the UKHSA’s investigation into the rise in cases - told a briefing that children were not being exposed to the virus in their early years due to lockdown restrictions.

A lack of social mixing could be a factor in why it was hitting their age-group the hardest.

The outbreak has seen as many cases detected in the past three months as we would normally expect to see in a year.

Cases are mainly in children under five who have displayed initial symptoms of diarrhoea and nausea, followed by jaundice - a condition in which the skin and eyes yellow, tell-tale signs the liver is struggling.

Dr Easterbrook however played down any causal link between lockdown and the global hepatitis outbreak in children.

She told reporters: “I think this is very much a hypothesis and I think we need to systematically work through this with planned investigations and a number of countries looking at this in much more detail.

“So I think it is an interesting assessment of the data but it really needs to be followed up with more investigations.”

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