Acute severe hepatitis in children
In April 2022, the United Kingdom reported an increase in cases of acute severe hepatitis not caused by some known hepatitis viruses, such as hepatitis A, B, C and E. The World Health Organization encouraged countries to identify, investigate and report potential cases. Between April and September 2022, the Public Health Agency of Canada (PHAC) collaborated with provincial and territorial health partners to investigate 28 cases in Canada.
As of September 23, 2022, the national investigation was closed. Although the Canadian investigation is now closed, some countries continue to investigate their cases, and PHAC will monitor the outcomes of these investigations as they are reported.
Cases of acute severe hepatitis in children occur each year in Canada. One of the goals of this investigation was to determine how many cases of severe acute hepatitis are typically reported each year. Canadian hospitalization data was analyzed to determine the baseline number of cases that occurred annually in the past 10 years. It was determined that the number of acute severe hepatitis cases reported during this investigation was not above baseline.
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What is acute severe hepatitis
Hepatitis is an inflammation of the liver. Depending on the cause, the disease can be very sudden and progress to liver failure over a few days to weeks (acute). Some types of hepatitis can be treated and most cases recover. Acute severe hepatitis in children is a rare condition in Canada, and in many cases, an underlying or contributing cause is not known. Most children recover with supportive medical care.
Investigation findings in Canada
Between April and September 2022, PHAC investigated 28 cases of acute severe hepatitis in children in Canada that met the national case definition.
Cases were identified in the following provinces:
- Alberta (5)
- British Columbia (1)
- Manitoba (3)
- Ontario (14)
- Quebec (4)
- Saskatchewan (1)
The children, who were between <1 and 13 years old, became sick between November 3, 2021 and August 11, 2022. All children were hospitalized. Four children required a liver transplant. No deaths were reported. Some children may have lived in one jurisdiction and received treatment in another jurisdiction. These children were counted in the province where they live.
It is important to note that the definition used to include cases in the national investigation was very broad. Some of the children may have had a diagnosis for their liver condition (for example, autoimmune hepatitis or a viral infection) but they were included to explore possible factors that may have triggered the condition. Available case information was shared with the World Health Organization to support the international investigation into possible causes.
What parents can do
As a parent or caregiver, you should be aware of the symptoms of hepatitis and contact your healthcare provider with any concerns. Symptoms of severe acute hepatitis in children may include:
- jaundice (yellowing of the skin or eyes)
- abdominal pain
- nausea
- vomiting
- dark urine
- light-coloured stools
- loss of appetite
- fever
- fatigue
Other things you can do:
- Encourage your child to:
- wash hands often
- avoid people who are sick
- cover coughs and sneezes
- avoid touching the eyes, nose, or mouth
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