The Center for Disease Control and Prevention (CDC) is investigating an additional 71 cases of hepatitis without a known cause in children, bringing the total to 180, it reported Wednesday.
Many of the 71 cases are newly reported but occurred months ago. The CDC is looking into cases dating back to October 2021. Those under investigation come from 36 states and territories.
About 9% have required liver transplants, down from 15% as reported earlier this month. At least five children have died, but no deaths have been reported since February.
In April, the CDC issued a health advisory regarding nine pediatric hepatitis cases of unknown etiology in Alabama from October 2021 through February 2022. None had documentation of a previous COVID-19 infection or COVID-19 vaccine. All were positive for adenovirus.
Among the 180 cases nationwide now under investigation, nearly half have had an adenovirus infection, and the CDC said it “continues to be a strong lead.” It also is looking at other possible pathogens including SARS-CoV-2.
The CDC recommends clinicians follow standard practice for evaluating and managing patients with hepatitis and consider adenovirus testing if the cause is unknown. They should report cases to their state public health authorities and to the CDC and submit blood, respiratory and stool/rectal specimens and liver tissue (if biopsy was clinically indicated) for adenovirus testing. More details on specimen collection and testing are available via the CDC website.
The CDC will hold a webinar at 2 p.m. Eastern on May 19 to discuss adenovirus testing in children with hepatitis and answer clinical questions.
Parents and caregivers should watch their children for symptoms of hepatitis, including vomiting, dark urine, light-colored stool and yellowing of the skin, and contact their health care provider with concerns. Families can help protect children from infections by staying up to date on vaccines, washing their hands, avoiding people who are sick and covering coughs and sneezes.
Resources
- CDC guidance for testing children with acute hepatitis of unknown etiology
- Information from Red Book Online about hepatitis cases that may be linked to adenoviral infection
- Information for parents from HealthyChildren.org on adenovirus infections
