Parents in the UK are being warned to check their children for signs of hepatitis after more than 220 children have now been identified with sudden onset hepatitis in the UK bringing the total to 222.
Of them, at least 11 have needed a liver transplant.
An update from the UK Health Security Agency (UKHSA) confirmed a further 20 cases recorded as of May 25.
There are now 168 cases of the liver inflammation disease under investigation in England, with 17 in Wales, 31 in Scotland and 16 cases being examined in Northern Ireland.
Public Health Scotland (PHS) has said the number of cases in such a short period of time, combined with the geographical spread and severity of illness, is “unusual” and requires further investigation.
Director of Clinical and Emerging Infections at the UK Health Security Agency (UKHSA), Dr Meera Chand, said: “It’s important that parents know the likelihood of their child developing hepatitis is extremely low.
“However, we continue to remind everyone to be alert to the signs of hepatitis – particularly jaundice, look for a yellow tinge in the whites of the eyes – and contact your doctor if you are concerned.
“Our investigations continue to suggest that there is an association with adenovirus and our studies are now testing this association rigorously.”
For some people, hepatitis is a short-term illness.