The US Centers for Disease Control and Prevention (CDC) said Friday it is investigating more than 100 cases of severe hepatitis in children, including five deaths, that have occurred in 25 states and territories across the country over the past seven months.
More than 90% of the children were hospitalized and 14% required liver transplants, he said. More than half of the children had confirmed adenovirus infection. The latter has not been confirmed as the actual cause, according to the CDC.
It is not yet clear what explains these cases in young children. Jay Butler, deputy director of infectious diseases at the CDC, told the press that some of the common causes of viral hepatitis have been considered, but none have been found.
The first cases of severe hepatitis were identified from October 2021 to February 2022 in nine children aged one month to 6 years in Alabama (south). On April 21, the CDC issued a nationwide alert to notify clinicians and public health authorities of a cluster of children identified as having hepatitis and adenovirus infection.
According to the CDC, adenovirus may be behind the reported cases, but other potential environmental and situational factors are still being investigated. These cases, along with recently identified possible cases in Europe, suggest that adenovirus should be considered in the differential diagnosis of acute hepatitis of unknown etiology in children, he said.
Adenovirus type 41 spreads mainly by the fecal-oral route and mainly affects the intestine. It is a common cause of acute gastroenteritis in children, which is characterized by diarrhea, vomiting and fever, often accompanied by respiratory symptoms, according to the CDC.
He indicated that this virus is recognized as a cause of hepatitis in immunocompromised children and might be an “unrecognized” factor in liver damage in healthy children.
On May 1, the World Health Organization (WHO) reported at least 228 probable cases of hepatitis of unknown origin in children in 20 countries, and dozens more are under investigation.
