The UK Health Security Agency (UKHSA) has recently detected higher than usual rates of liver inflammation (hepatitis) in children. Similar cases are being assessed in Scotland.
Public health doctors and scientists at the UK’s public health agencies are continuing to investigate 74 cases of hepatitis (liver inflammation) in children since January 2022, where the usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.
Of the confirmed cases, 49 are in England, 13 are in Scotland and the remainder are in Wales and Northern Ireland.
One of a number of potential causes under investigation is that a group of viruses called adenoviruses may be causing the illnesses. However, other possible causes are also being actively investigated, including coronavirus (COVID-19), other infections or environmental causes.
There is no link to the COVID-19 vaccine. None of the currently confirmed cases in the UK has been vaccinated.
Adenoviruses are a family of common viruses that usually cause a range of mild illnesses and most people recover without complications. They can cause a range of symptoms, including colds, vomiting and diarrhoea. While they don’t typically cause hepatitis, it is a known rare complication of the virus.
Adenoviruses are commonly passed from person to person and by touching contaminated surfaces, as well as through the respiratory route.
The most effective way to minimise the spread of adenoviruses is to practice good hand and respiratory hygiene and supervise thorough handwashing in younger children.
Dr Meera Chand, Director of Clinical and Emerging Infections at UKHSA, said: “We are working swiftly with the NHS and public health colleagues in Scotland, Wales and Northern Ireland to investigate a wide range of possible factors which may be causing children to be admitted to hospital with liver inflammation known as hepatitis.
“One of the possible causes that we are investigating is that this is linked to adenovirus infection. However, we are thoroughly investigating other potential causes.
“Normal hygiene measures such as good handwashing – including supervising children – and respiratory hygiene, help to reduce the spread of many of the infections that we are investigating.
“We are also calling on parents and guardians, to be alert to the signs of hepatitis – including jaundice – and to contact a healthcare professional if they are concerned.”
UKHSA, working with partners, will continue to make the public aware of findings throughout the course of the investigation.
Boosters continue to provide high levels of protection against severe disease from Omicron in older adults
Latest data from UKHSA shows booster doses are continuing to provide high levels of protection against severe disease from the Omicron variant among older adults.
Figures show that around 3 months after they received the third jab, protection against hospitalisation among those aged 65 and over remains at about 90%.
With just 2 vaccine doses, protection against severe disease drops to around 70% after 3 months and to 50% after 6 months.
The Joint Committee on Vaccination and Immunisation (JCVI) has taken this latest evidence into account in their ongoing review of the booster programme.
The Committee advises that at this present time:
there is no immediate need to introduce a second booster dose, or fourth jab, to the most vulnerable (care home residents and those aged over 80) – the timing and need for further booster doses will continue to be reviewed as the data evolves
priority should continue to be given to rolling out first booster doses to all age groups
unvaccinated individuals should come forward for their first 2 doses as soon as possible
Professor Wei Shen Lim, the JCVI’s chair of COVID-19 immunisation, said: “The current data shows the booster dose is continuing to provide high levels of protection against severe disease, even for the most vulnerable older age groups.
“For this reason, the committee has concluded there is no immediate need to introduce a second booster dose, though this will continue to be reviewed.
“The data is highly encouraging and emphasises the value of a booster jab. With Omicron continuing to spread widely, I encourage everyone to come forward for their booster dose, or if unvaccinated, for their first 2 doses, to increase their protection against serious illness.”
The latest study looked at booster doses in those aged over 65, who were among the first to be eligible when the booster rollout began in mid-September.
Whilst with a booster dose, the duration of protection against severe disease remains high, protection against mild symptomatic infection is more short-lived and drops to around 30% by about 3 months.
Following advice from the UK Health Security Agency and in the light of the rapid increase in Omicron cases, the UK Chief Medical Officers and NHS England National Medical Director have recommended to ministers that the UK COVID-19 alert level should increase from Level 3 to Level 4.
Transmission of COVID-19 is already high in the community, mainly still driven by Delta, but the emergence of Omicron adds additional and rapidly increasing risk to the public and healthcare services.
Early evidence shows that Omicron is spreading much faster than Delta and that vaccine protection against symptomatic disease from Omicron is reduced. Data on severity will become clearer over the coming weeks but hospitalisations from Omicron are already occurring and these are likely to increase rapidly.
When vaccine protection is reduced in the way that is happening with Omicron it is essential to top up that protection with a booster. Both booster vaccines (Pfizer and Moderna) increase the immune response substantially and show good effectiveness although with some reduction compared to Delta.
The NHS is currently under pressure mainly driven by non-COVID-19 pressures. With a variant spreading with increased transmissibility and reduced vaccine effectiveness, we are likely to see this pressure rise soon.
It is extremely important that if you are eligible, you get your COVID-19 vaccination now – whether this be your first, second or booster dose.
People should continue take sensible precautions including ventilating rooms, using face coverings, testing regularly and isolating when symptomatic.
Chief Medical Officer for England, Professor Chris Whitty
Chief Medical Officer for Northern Ireland, Professor Sir Michael McBride
Chief Medical Officer for Scotland, Professor Gregor Smith
Chief Medical Officer for Wales, Dr Frank Atherton
NHS England National Medical Director, Professor Stephen Powis
The UK Health Security Agency (UKHSA) is urging all those eligible to take up their flu vaccine by 10 December to ensure protection in time for Christmas.
The vaccine takes 14 days before it provides maximum protection, so people should get it before 10 December to help keep themselves and vulnerable relatives safe throughout the festive season.
Flu is a highly infectious disease and can lead to serious complications for those living with a long-term health condition, including respiratory and heart conditions, diabetes, kidney disease, liver disease or a chronic neurological disease like multiple sclerosis or cerebral palsy. People with underlying health conditions overall are 11 times more likely to die if they catch flu compared to healthy adults.
Pregnant women are also at increased risk of serious complications and should have the flu vaccine to help protect themselves and their babies.
While many people aged 65 and over have already come forward for their flu vaccination, exceeding the WHO target of 75%, less than half of those with underlying health conditions have taken up the offer. Uptake in pregnant women also lags behind other groups, with just 34.4% vaccinated so far this season.
While levels of flu infection are still low, typically levels ramp up over December, with a peak in January. We are calling on people to take up the flu vaccine, along with practicing good hygiene, ventilating rooms, and staying at home if unwell.
Health and Social Care Secretary, Sajid Javid said: “Getting your winter vaccines – whether that is your flu jab if eligible or your booster jab – is one of the most important things people can do for yourself an your family this winter.
“Record numbers of people took up the offer of a free flu vaccine last year and the programme is expanding even further this year, with a record 35 million people in England eligible.
“Don’t delay – book your flu vaccine as soon as possible.”
Dr Conall Watson, Consultant Epidemiologist at UKHSA, said: “The threat of flu has not gone away – it can cause serious illness and be fatal.
“Flu vaccination saves lives. If you are eligible, you don’t have to wait to be called up – book your flu vaccine as soon as possible to help protect yourself and family this Christmas.”
Almost 20 million COVID-19 booster vaccines and third doses have been administered in the UK.
The Delta variant sub-lineage known as Delta AY.4.2 was designated a Variant Under Investigation (VUI) by the UK Health Security Agency (UKHSA) on 20 October 2021 and has been given the official name VUI-21OCT-01.
The designation was made on the basis that this sub-lineage has become increasingly common in the UK in recent months, and there is some early evidence that it may have an increased growth rate in the UK compared to Delta. More evidence is needed to know whether this is due to changes in the virus’ behaviour or to epidemiological conditions.
The genome of VUI-21OCT-01 does not have many mutations compared to Delta. However, a small change may be enough to cause a difference in the virus properties in some circumstances. UKHSA is monitoring this closely.
The original Delta variant remains overwhelmingly dominant in the UK, making up approximately 99.8% of all cases. As of 20 October, there were 15,120 cases of VUI-21OCT-01 confirmed by whole genome sequences in England since it was first detected in July.
In the last week, VUI-21OCT-01 accounted for approximately 6% of all Delta cases. Cases have been confirmed through whole genome sequencing in all 9 regions of England.
While evidence is still emerging, so far it does not appear this variant causes more severe disease or renders the vaccines currently deployed any less effective. As is routine for any new variants under investigation, UKHSA is carrying out laboratory and epidemiological investigations to better understand the properties of this variant.
Dr Jenny Harries, Chief Executive of the UK Health Security Agency, said: “Viruses mutate often and at random, and it is not unexpected that new variants will continue to arise as the pandemic goes on, particularly while the case rate remains high.
“It is testament to the diligence and scientific expertise of my colleagues at UKHSA, and the genomic sequencing capacity developed through the pandemic, that this new variant has been identified and analysed so quickly. However, it should serve as objective evidence that this pandemic is not over.
“The public health advice is the same for all current variants. Get vaccinated and, for those eligible, come forward for your third or booster dose as appropriate as soon as you are called. Continue to exercise caution. Wear a mask in crowded spaces and, when meeting people indoors, open windows and doors to ventilate the room.
“If you have symptoms take a PCR test and isolate at home until you receive a negative result.”
UKHSA continues to examine all available data relating to SARS-CoV-2 variants in the UK and abroad. We constantly assess the genetic diversity within the known Variants of Concern (VOCs) to inform our ongoing public health response to the pandemic. New sub-lineages within Delta continue to be identified. This is to be expected and UKHSA is monitoring the situation closely.
Home antibody tests available for up to 8,000 people a day
UK Health Security Agency to launch UK-wide antibody surveillance programme for the general public for the first time
Home antibody tests available for up to 8,000 people a day across the UK who opt in to the service through NHS Test and Trace
Data will improve understanding of the protection provided by antibodies generated following COVID-19 infection and vaccination
Thousands of adults a day will be given free access to antibody tests through a new national surveillance programme launched by the UK Health Security Agency this week, to help improve our understanding of immunity against COVID-19 from vaccination and infection.
For the first time, the programme will offer antibody testing to adults in the UK who test positive. From Tuesday, anyone aged over 18 will be able to opt in to take part when booking a PCR test through NHS Test and Trace. Up to 8,000 people who opt in and then receive a positive PCR result will be sent two finger prick antibody tests to complete at home and send back to a lab for analysis.
The UK Health Security Agency will work alongside NHS Test and Trace testing services in England, Scotland, Wales and Northern Ireland to monitor levels of antibodies in positive cases across the UK.
The data collected will help estimate the proportion of those who got COVID-19 despite developing antibodies as a result of having a vaccine or previously catching coronavirus.
The initiative could also provide insight into any groups of people who do not develop an immune response. The UK Health Security Agency will use the data to inform our ongoing approach to COVID-19 and provide further insight into the effectiveness of the vaccines against different variants.
Secretary of State for Health and Social Care Sajid Javid said: ”Our new national antibody testing will be quick and easy to take part in, and by doing so you’ll be helping strengthen our understanding of COVID-19 as we cautiously return to a more normal life.
“I’m proud to see all parts of the UK uniting around this new initiative and working together to arm ourselves with even more valuable insights into how COVID-19 vaccines are protecting people up and down the UK.
“Our phenomenal vaccination programme continues to build a massive wall of defence across the country – already preventing around 24 million infections and more than 100,000 deaths in England alone. I urge everyone across the UK to get both vaccinations as soon as possible.”
All adults interested in the study are encouraged to opt in. Anyone taking part must take their first antibody test as soon as possible after receiving a positive PCR result, before the body has had time to generate a detectable antibody response to the current infection. The first test will determine the level of antibodies a person had before their current infection.
The second test should be taken 28 days after testing positive for COVID-19 and will measure antibodies generated in response to the infection. By comparing the two antibody test results, the UK Health Security Agency will be able to see how well vaccinated individuals boost their immunity when they are infected and how this might vary with different variants.
Testing positive for antibodies does not mean someone is immune from COVID-19 and people must continue to follow the rules, get tested if they have symptoms and self-isolate if positive or are a contact of a positive case and have not received both vaccine doses, to prevent the virus from spreading.
Chief Executive of the UK National Health Security Agency Dr Jenny Harries said: “We are rolling out antibody testing across the UK to gain vital data into the impact of our vaccination programme and on immune responses to different variants of COVID-19.
“This innovative programme is only possible thanks to the thousands of people who continue to help with studies on vaccine and treatment effectiveness each week.
“The best way to protect yourself and those around you is by getting vaccinated. I encourage anyone who has not yet come forward to book their first and second jabs.”
Dr Susan Hopkins, Public Health England’s COVID-19 Strategic Response Director said: “Our testing armoury is stronger than ever now we are rolling out antibody testing to thousands of people in England, Scotland, Wales and Northern Ireland alongside the vast testing capacity we have built including our NHS Test and Trace system.
“Antibody testing surveillance shows how health teams across the UK are dedicated to working together to find innovative ways to understand the effectiveness of COVID-19 vaccines and target future treatments for COVID-19.”
The NHS has guidance on what you can do to look after yourself and treat any symptoms you may have following a positive PCR result. It remains vital people continue to get a PCR swab test if they have symptoms and self-isolate when asked by NHS Test and Trace. Individuals should not change their behaviour based on an antibody result.
Antibodies are part of the body’s immune response to help fight off infection and are generated either after being infected or following vaccination. Antibody testing looks for evidence of this immune response, whereas PCR and antigen testing tells someone if they have the virus at the time of test.
Antibody testing will contribute to our understanding of the protection provided by vaccines. 87% of people aged 16 and over have now received their first COVID-19 vaccine dose and 76% have had their second dose.
The government is working closely with the NHS to make it as easy as possible to get a vaccine, including through ‘grab a jab’ pop-up vaccine sites across the country, such as London-based nightclub Heaven, as well as football stadiums and festivals up and down the country.
Advice and information on the benefits of vaccination have been shared at every opportunity, including through a range of partnerships with industries catering for predominantly younger audiences.
This work has included partnerships with high-profile entertainment and sports personalities on short films encouraging people to get the jab, such as film stars Jim Broadbent and Thandiwe Newton, and football figures Harry Redknapp and Chris Kamara.
The UK Government has also partnered with dating apps, social media platforms and large companies, such as Uber and Deliveroo, on adverts and incentives to get the vaccine.
UK Government Minister for Scotland Iain Stewart said: “I’d urge everyone in Scotland to opt in for this new antibody test when booking a PCR test through Test and Protect. It’s a quick and easy process and you’ll be making a massive contribution to our understanding of COVID-19.
“Ensuring as many people as possible are tested and vaccinated is our biggest line of defence as we continue our journey out of this pandemic.”
3,190 new cases of COVID-19 were reported in Scotland yesterday. The pandemic is far from over.
