Twelve children have died from the mystery hepatitis being detected in an increasing number of countries.
An update by EU health chiefs on Wednesday said there had been 11 casualties worldwide but a 12th suspected death was announced in Ireland on Thursday.
The European Centre for Disease Prevention and Control (ECDC) said there had also been 450 cases of the deadly liver disease globally.
That number is bound to be higher because the UK announced 13 more cases on Thursday and experts believe the recent spate is just the tip of the iceberg.
Five deaths have been confirmed in Indonesia and five have been recorded in the US, with one in Palestine.
Twenty-one countries have now detected ‘severe hepatitis of unknown origin’ among children mostly under the age of 10 since early April. At least 26 youngsters have required liver transplants.
Scientists are puzzled as to what is causing the unusual illness, but the main theory is that it is triggered by a group of viruses that normally cause the common cold.
There have been around 350 cases of ‘severe hepatitis of unknown origin’ in children recorded in 21 countries since April
Most of the worldwide cases have been picked up in the UK (176) and the US (110) so far but a lack of surveillance in some countries could be masking the true scale of the outbreak.
The common viruses that cause hepatitis: hepatitis viruses A, B, C, and E; have not been detected in any of the cases reported worldwide.
Three quarters of the UK’s cases have tested positive for adenoviruses, which has made the virus the chief culprit.
Scientists are probing whether a mutated strain of adenovirus has evolved to become more severe, or if a lack of social mixing during the pandemic weakened children’s immunity.
They also have not been able to rule out an old Covid infection being involved.
In a bizarre twist last week, health chiefs in the UK are also investigating whether ‘dog exposures’ are to blame.
The UKHSA said last week that a ‘high’ number of the British children with hepatitis were from families which own dogs.
Officials did not explain how dogs could potentially be to blame, but they are known carriers of adenovirus strains.
However, Covid vaccines have been ruled out as a possible cause because the majority of the ill British children haven’t been vaccinated due to their young age.
The UKHSA said the majority but not all child cases tested positive for adenovirus, but it admits this could be due to the way testing is done.
Some of the negative cases had only looked for adenovirus in respiratory and faecal samples, even though it is mainly detected in the blood.
In new guidance this week, the Centers for Disease Control and Prevention (CDC) in the US has told doctors treating children with hepatitis to take liver samples for analysis.
Parents are advised to go to their GP if their child develops symptoms of hepatitis, which include pale, grey-coloured stools, very dark urine, or a yellowing of the eyes and skin.
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