Three children in Indonesia have died from a mysterious liver disease, the country’s health ministry has said, raising the global death toll to at least four. A severe type of acute hepatitis has been identified in almost 170 children across 11 countries in recent weeks, raising concerns from the World Health Organization (WHO) of the disease’s “unknown origin”. The symptoms afflicting the children before signs of liver inflammation have included nausea, vomiting, diarrhoea and abdominal pain. At least one death was previously reported. Indonesia’s health ministry said three children had died in hospitals last month in the capital, Jakarta, after displaying some of the symptoms. The children, aged two, eight and 11, also had fever, jaundice, convulsions and loss of consciousness, said the ministry’s spokesperson Siti Nadia Tarmizi. “At the moment, we suspect the cases as acute hepatitis, but we need to confirm that they are not due to known hepatitis viruses A, B, C, D, and Rb,” Tarmizi said. She added that the health ministry was currently investigating the cause of the disease by running a full panel of virus tests. The ministry also called on parents to immediately take their children to hospital if they showed any sign of the symptoms. The emergence of a possible new disease afflicting only young children – most are under 10 years old with no underlying conditions – has caused concern in a global health community already grappling with Covid-19. The WHO said that there was an “unexpected significant increase” in cases in the UK among young, previously healthy children, as well as in Ireland and the Netherlands. In the United States, the Centers for Disease Control and Prevention published a study on Friday on a cluster in Alabama, where nine children also tested positive for a common pathogen called adenovirus 41. The pathogen is known to cause gastroenteritis in children, but “it is not usually known as a cause of hepatitis in otherwise healthy children”, the agency said. Adenoviruses are commonly spread by close personal contact, respiratory droplets and contact with contaminated surfaces. There are more than 50 types of adenoviruses, which most commonly cause colds but also many other diseases.