Dr. Colm Henry:

Of course it is a cause for concern when something new comes along that has not been identified previously and does not correspond to existing known hepatitis cases. We have had a small number of cases in this country. I believe we have had six cases and another seven cases are under investigation. Fortunately we have very good public health epidemiological links with other countries and we are getting daily reports from the Health Protection Surveillance Centre on the patterns seen in the UK. Thankfully it is rare. Some of the children get very ill, including a relatively high proportion progressing to needing liver transplants. Tragically, some children do not survive. It is a very rare condition but nevertheless a new condition.

In the best tradition of epidemiology we are looking at all the cases for common experiences and exposures and anything that suggests a common trait between them. There is some suggestion, particularly from the UK where there have been many more cases, that it may be associated with adenovirus. It may be a reaction to the adenovirus. This is not yet a definitive position internationally. Information is being pooled all of the time. Our public health people are linking with their colleagues in Europe all of the time to pool information on the profile of patients getting the illness here, their experience and how the illness progresses. It is of concern. Perhaps by the time we speak again we will have more information because we will have more numbers and, perhaps, more outcomes from the pooled experiences of Irish, British and other cases.