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SINGAPORE: A 10-month-old boy in Singapore was found to have acute hepatitis with unknown cause, said the Ministry of Health (MOH) in a statement on Saturday (Apr 30). 

It added that investigations are ongoing to determine if the case is similar to those in the recent global outbreak.

MOH said that it had been notified on Friday of a case of acute hepatitis, or liver inflammation, in the infant. 

The case had presented at KK Women’s and Children’s Hospital Emergency Department on Monday, and he was admitted for further investigations.

The case and his household contacts are currently well, said MOH. 

“Investigations are ongoing to determine if the case has a similar presentation to the cases of acute hepatitis of unknown cause reported internationally and by the World Health Organization,” it added. 

“Laboratory testing has determined the case to be negative for the common viruses that cause hepatitis (hepatitis type A, B, C and E viruses). The case has a previous history of COVID-19 infection in December 2021, although there is no evidence at this time that the acute hepatitis is related to COVID-19.”

More than 200 suspected and probable cases of acute hepatitis of unknown cause have been reported in children across 17 countries, said the ministry.

MOH added that it is monitoring the situation closely, and has informed all medical practitioners to be vigilant to young children presenting with signs and symptoms of hepatitis for which a cause cannot be identified. 

 

Hepatitis can be caused by viral infections, alcohol use, toxins, medications, and certain medical conditions. The exact cause of acute hepatitis in these cases worldwide is currently unknown, although initial investigations suggest that the cases may be linked to adenovirus infection, said MOH.

Adenovirus is a common virus that typically causes respiratory or gastrointestinal illness, and is not typically known to cause hepatitis in healthy children. 

Normal hygiene measures such as handwashing and good respiratory hygiene help to reduce spread of many common infections, including adenovirus infection. Children who are unwell are advised to stay home from school until symptoms have stopped or assessed to be fit to return to school.

 

Parents and guardians should be alert to the signs of hepatitis and seek early medical attention if concerned. The symptoms of hepatitis include:

  • dark urine 
  • pale, grey coloured faeces
  • yellowing of the white part of the eyes or skin (jaundice)
  • itchy skin
  • muscle or joint pain
  • fever 
  • nausea, vomiting or abdominal pain
  • lethargy or loss of appetite

WHO said last Saturday that at least one child death had been reported following an increase of acute hepatitis of unknown origin in children, and that at least 169 cases had been reported in children in 12 countries.

The figures come as health authorities around the world investigate a mysterious increase in severe cases of hepatitis in young children.

As of Apr 21, acute cases of hepatitis of unknown origin had been reported in the United Kingdom, the United States, Spain, Israel, Denmark, Ireland, the Netherlands, Italy, Norway, France, Romania and Belgium.