THE mysterious hepatitis outbreak in children has now spread to 20 counties, according to the World Health Organization (WHO).
The illness has so far been identified in nearly 230 children, including 145 in the UK.
British health officials said the odds of a child developing hepatitis remains “extremely low”, but parents should know the symptoms.
According to the WHO, the majority of the cases have appeared in Europe.
It noted an "unexpected significant increase" in cases among young, previously healthy children in the UK.
The US has the second highest infections (27), followed by Spain (13) and Israel (12).
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WHO spokesman Tarik Jasarevic told reporters in Geneva today: “As of May 1, at least 228 probable cases were reported to WHO from 20 countries, with over 50 additional cases under investigation.”
The update suggests eight countries have detected cases in the last week since the WHO’s previous update.
The WHO has confirmed that one child, from an undisclosed location, has died of the inflammatory liver disease.
A further four deaths – three in Indonesia and one in the US – have been reported by health ministries, but not officially confirmed as related.
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Unusually, some 18 children have needed a liver transplant, including 10 in the UK.
The emergence of the illness in kids, most under the age of 10, has sent ripples of concern through the world.
The source of the ailment is puzzling doctors globally, with hepatitis types A-E ruled out.
It is thought to be related to adenovirus infection.
Adenoviruses are commonly spread by close personal contact, respiratory droplets and surfaces.
There are more than 50 types of adenoviruses, which most commonly cause the common cold.
But early evidence suggests children with hepatitis had been infected with adenovirus type 41 that causes symptoms of tummy pains, vomiting, nausea and diarrhoea.
This comes before signs of liver inflammation, which may include jaundice – yellowing of the skin and eyes.
Indonesia's Health Ministry said that three children had died in hospitals in the capital Jakarta last month.
The children, aged two, eight, and 11, had first shown signs such as tummy pain and vomiting.
They later developed fever, jaundice, convulsions and loss of consciousness, the ministry's spokesperson Siti Nadia Tarmizi said.
US health chiefs published a study on a cluster in Alabama, where nine children had also tested positive for adenovirus 41.
But "it is not usually known as a cause of hepatitis in otherwise healthy children", the agency had said.
Dr Meera Chand, Director of Clinical and Emerging Infections at the UK Health and Security Agency (UKHSA) said it was a concerning time for parents.
She surged them to be alert to warning signs in their children, “particularly jaundice, which is easiest to spot as a yellow tinge in the whites of the eyes”, Dr Chand said.
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She added: “Contact your doctor if you are concerned.
“As always, children experiencing symptoms such as vomiting and diarrhoea should stay at home and not return to school or nursery until 48 hours after the symptoms have stopped.”
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