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May 27, 2022

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What the CDC Alert on Hepatitis in Children Means

The US Centers for Disease Control and Prevention is looking into 109 reports of hepatitis from an unknown cause, Dr. Jay Butler, CDC deputy director for Infectious Diseases, said at a media briefing last week. Five children have died. On April 25, the agency issued an alert for doctors and health care providers to be aware of a possible link between hepatitis in children and an adenovirus. 

Although it’s rare, children can develop hepatitis with an unknown cause, Butler said, adding that it’s important to put the (overall rare) cases into perspective. He noted that a preliminary analysis didn’t find a significant increase in pediatric hepatitis cases or liver transplants. 

But the number of hepatitis cases in otherwise healthy children is what prompted the CDC to start investigating and pinpoint a link. 

“It’s important to note that this is an evolving situation,” Butler said. “We’re casting a wide net to help broaden our understanding.” The CDC is conducting a review of these reports, which date back to 2021, he said. 

Adenoviruses are common viruses that can cause coldlike symptoms, bronchitis, diarrhea, pinkeye and more. Hepatitis is an inflammation of the liver that can lead to liver failure in some cases. The liver’s role is to filter blood, help fight infections and other important functions.  

Because adenoviruses aren’t known to cause hepatitis in otherwise healthy children who aren’t immunocompromised, the CDC is asking public health authorities to report all hepatitis cases with unknown causes to their local and state health departments. 

What does the CDC know? Is there a hepatitis outbreak? 

No, the CDC didn’t declare an outbreak or public health emergency. The case reports are still rare occurrences, but health officials are investigating the cases because it’s unusual for otherwise healthy children to develop severe hepatitis. 

There are 109 US reports of children who had hepatitis across 25 states and territories over the past several months, including five deaths. Over 90% of children were hospitalized, and some needed liver transplants, Butler said at the media briefing. The United Kingdom is investigating similar cases in children.

The original CDC alert was based on a report of nine children ranging ages 1 to 6 years old who were treated at a hospital in Alabama for hepatitis. Some tested positive for adenovirus type 41. Adenovirus 41 is more typical in immunocompromised patients, and isn’t known to cause hepatitis in otherwise healthy children, Butler said. He added that the nine initial cases haven’t been linked to COVID-19 infection, and none of the sick children had been vaccinated. Most weren’t even eligible for a COVID-19 vaccine, which is only available to kids age 5 and up.

“At this time, we believe adenovirus may be the cause for these reported cases, but investigators are still learning more — including ruling out other possible causes and identifying other possible contributing factors,” the CDC said in April. While there’s no clear link, adenovirus has been detected in more than half of the 109 cases being investigated, Butler said.

What are the symptoms of hepatitis? Are there vaccines?

Hepatitis can have different causes, including drug use, alcohol use and even certain medical conditions. It can also be caused by a virus; the most common types of viral hepatitis in the US are hepatitis A, B and C. The CDC has ruled out all three of these types of hepatitis in the pediatric cases it announced. 

Some cases of hepatitis are acute (they don’t last more than six months) while others are chronic (lasting more than six months). Hepatitis C, which is spread through blood contact, causes chronic liver infection in 75% to 85% of patients, according to the Cleveland Clinic. There are vaccines for hepatitis A and hepatitis B.

The CDC said it’s asking parents and caregivers to be aware of the symptoms of hepatitis and contact their health care provider with any concerns. 

Some symptoms of hepatitis include: 

  • Fatigue
  • Fever 
  • Loss of appetite, nausea or vomiting 
  • Abdominal pain 
  • Dark urine or light-colored stool
  • Joint pain 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.