51 Hepatitis outbreak in children 3 Location Elevated AST Total AST Elevated ALT Total ALT Banbury, UK 0 0 0 0 Edinburgh, UK 86 349 900 19,255 Glasgow, UK 829 27,337 640 28,293 Highlands, UK 2 20 20 1,778 Oxford, UK 6 15 39 2,230 ABU, UK* 14 113 61 4,333 CVU, UK* 31 272 224 8,594 CTM, UK* 8 94 35 4,411 SBU, UK* 9 74 45 4,138 Amersfoort, NL 13 364 10 412 Amsterdam (1), NL 193 2,827 196 3,734 Amsterdam (2), NL 90 2,911 82 3,489 Groningen, NL 378 3,020 233 3,020 Den Bosch, NL 4 266 11 304 The Hague, NL 23 649 21 736 Leiden, NL 150 2,942 73 3,063 Nijmegen, NL 3 386 3 537 Utrecht, NL 604 19,711 621 21,606 Dublin, Ireland 0 0 0 1 Willemstad, CuraƧao 9 217 5 216 Table 1: Counts of elevated (>200 U/L) AST and ALT tested and total number of tests for the 3-week to 5-year-olds. Some hospitals did not admit any children in the 3-week to 5-year-olds. *Pooled data from health boards. UK: United Kingdom, NL: the Netherlands, ABU: Aneurin Bevan University Health Board, CVU: Cardiff and Vale University Health Board, CTM: Cwm Taf Morgannwg University Health Board, SBU: Swansea Bay University Health Board ALT First, we examined rates for elevated ALT values for 3-week to 5-year-olds by location (Figure 1). There is a possible trend towards an increase in rate for elevated ALT in our period of interest in the Netherlands, at the end of 2021/ start of 2022 (Figure 1b), but this is not seen in the UK ( Figure 1a). For the UK, the rate increases at the start of 2018 (Figure 1a). In the Netherlands, a similar increase takes place at the start of 2016 (Figure 1b). When pooling all available data, the increased rate is seen from 2018 onwards (Figure 1c). Results for all age groups can be found in Supplementary Figure 3.
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