CDC issues health advisory on children with hepatitis

The Centers for Disease Control and Prevention (CDC) has issued a health alert regarding a cluster of children in Alabama found to have hepatitis and adenovirus infections, with the cause of their conditions currently unknown.

According to the CDC’s health advisory, all of the children found to have hepatitis were healthy beforehand and none of them had previously had COVID-19.

While no patients have died so far, two have required liver transplants. An investigation into a possible link between hepatitis and adenovirus is underway, as three of the children tested positive for the pathogen.

In total, nine patients were admitted between October and February.

The agency has recommended that providers consider testing for adenovirus in children found to have hepatitis due to unknown origin. It also recommended testing whole blood by PCR instead of testing plasma, as that method may be more sensitive.

The CDC has asked clinicians and state public health officials to notify the agency of children under the age of 10 found to have elevated aspartate aminotransferase or alanine aminotransferase, which could indicate liver damage.

It had previously stated it was investigating the cluster of cases along with Alabama health officials.

“CDC is working with state health departments to see if there are additional U.S. cases, and what may be causing these cases. At this time adenovirus may be the cause for these, but investigators are still learning more — including ruling out the more common causes of hepatitis,” CDC spokesperson Kristen Nordlund said in a statement to Stat last week.

Hepatitis is an inflammation of the liver that can be caused by numerous factors including viral infection, medical conditions, medications, toxins and alcohol. It can also be caused by hepatitis viruses, which are spread through the bodily fluids of infected individuals.

Symptoms of hepatitis include abdominal pain, dark urine, light-colored stools, joint pain and jaundice.

A similar situation has come to light in the U.K., with at least 10 children under the age of 10 being identified as having “severe acute hepatitis” due to an unknown cause.

The World Health Organization (WHO) was notified of these cases earlier this month. Testing in the U.K. has ruled out hepatitis viruses types A, B, C and E, according to the organization.

Like in the U.S., adenovirus may be linked to these cases, as the WHO noted the U.K. has observed a rise in adenovirus activity.