CDC. 109 cases of hepatitis in children were investigated, 5 cases died

The U.S. Centers for Disease Control and Prevention is investigating the deaths of five children and potentially more than 100 unusual cases of hepatitis in young children, the agency said Friday.

The CDC said it was investigating cases involving 109 children in 25 states and territories who had or suffered from what the agency called “unexplained hepatitis.”

Most of the children have fully recovered, said Dr. Jay Butler, deputy director of infectious diseases at the CDC. But he said more than 90 percent were hospitalized, 14 percent received liver transplants, and more than half had adenovirus infections.

The CDC and overseas experts are investigating whether an adenovirus, a common virus that causes intestinal symptoms such as vomiting and diarrhea, might play a role in these cases. But the agency has yet to determine the cause of the cases or a common link between all cases, and has warned against drawing any conclusions.

Dr Butler called it an “evolving situation” at a news conference on Friday. He later added: “It is important to remember that severe hepatitis in children is rare, although we may be reporting an increase in cases today.”

Hepatitis and liver failure are uncommon in young children, especially among otherwise healthy children, and to date the actual number of hepatitis cases in the United States is not higher than normally observed.

The agency did not release details about the children who died or where they died.

A much larger number – more than 160 cases – of young children who have been reported to have or have recently had hepatitis are being investigated in the UK.

Hepatitis is a liver infection that usually occurs in adults and can be caused by a virus — a virus that responds to medication — or alcoholism, certain medications, or an autoimmune disease. Symptoms include yellowing of the skin and eyes, nausea and abdominal pain.

Dr. Butler also said that so far, there is no evidence that Covid-19 infection or a Covid vaccine has been linked to U.S. cases. The World Health Organization also said this week that the “vast majority” of children were not vaccinated in the cases it reviewed.

The alerts began two weeks ago, when the U.S. Centers for Disease Control and Prevention (C.D.C.) issued a warning that nine cases of hepatitis were starting this fall among young children in Alabama. All had evidence of adenovirus infection. Bit age is 2 years old.

CDC question. Is it to determine whether adenovirus was a cause or an innocent bystander, Dr. Butler. Doctors don’t usually test children for adenovirus infection — which is not a reportable disease in the United States — so it can be difficult to figure out cause and effect. He urged doctors to consider testing for adenovirus when children develop certain symptoms.

It was unclear how likely the nine randomly tested children were to have the adenovirus. The virus is also seasonal, with fall and winter being adenovirus season when Alabama kids get sick.

To make matters worse, the amount of virus, if any, was very small when the kids were checked.

“We are trying to determine the cause,” said Dr. Butler. Since childhood hepatitis is still a “rare event”, searching is difficult.

Other possibilities include environmental exposure, including animal exposure, or an immune response, with responses to adenovirus “high on the list,” Dr. Butler.
“We’re casting a big net,” he said.

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