Bulgaria’s Health Ministry issues advice to GPs following reports of mysterious hepatitis in children in other countries

Bulgaria’s Ministry of Health has distributed information to all general practitioners in the country about the emergence of a previously unknown type of hepatitis in children in a number of countries.

The Ministry has published recommendations for doctors to be on the lookout for symptoms in their pediatric patients and asked GPs to send samples from all suspected cases to the National Centre for Infectious and Parasitic Diseases for testing.

"In the case of a possible or confirmed case of acute hepatitis of unknown origin in a child, the doctor/medical facility should send the relevant clinical sample to the National Reference Laboratory "Hepatitis Viruses", Department of Virology of the National Centre for Infectious Diseases and Parasitology, NCIPD, Blvd. "Gen. Stoletov 44A, Sofia, for further laboratory tests and molecular biological studies for pathogens", the Ministry of Health specified.

On 5 April this year, the UK health authorities reported to the World Health Organization (WHO) an increase in the number of cases of acute hepatitis of unknown aetiology in children under the age of 10 years, across central Scotland.

By 20 April, 111 cases had been identified in the UK.

These are cases of previously healthy children, aged 2 to 5 years, who have been hospitalised due to having symptoms of acute hepatitis - jaundice, vomiting, diarrhoea, nausea etc. A total of 8 of all reported cases developed complications requiring liver transplantation. In all other cases the infection ended with a favourable outcome.

So far, 12 EU countries have reported sporadic cases - Austria (2), Belgium (2), Denmark (6), France (2), Germany (1), Ireland (5), Italy (17), the Netherlands (4), Norway (2), Poland (1), Romania (1) and Spain (12), with a total of 5 children requiring liver transplantation.