109 hepatitis cases in kids, 5 deaths, prompt investigation
The deaths of five children and what may be an unusual group of more than 100 hepatitis cases in young children in the United States are under investigation by the Centers for Disease Control and Prevention, the agency said Friday.
The CDC said it was examining cases involving 109 children in 25 states and territories who had or have what the agency is calling “hepatitis of unknown cause.”
Dr. Jay Butler, deputy director for infectious diseases at the CDC, said most of the children had fully recovered. But more than 90% were hospitalized, 14% received liver transplants and more than half had adenovirus infections, he said.
The CDC and experts overseas are exploring whether a type of adenovirus, a common virus that causes intestinal symptoms like vomiting and diarrhea, may be a factor in these cases. But the agency has not determined a cause for the cases or a common link among all of them, and it cautioned against drawing conclusions.
Butler called it “an evolving situation” in a news briefing Friday. Later, he added, “It’s important to remember that severe hepatitis in children is rare even with the potential increase in cases that we’re reporting today.”
The agency did not provide details about the children who died or where those deaths occurred.
The United Kingdom is investigating a far greater number — more than 160 cases — of young children reported to have or have had hepatitis recently.
Hepatitis, a liver infection, typically occurs in adults and can be caused by viruses — which respond to treatment with drugs — or from alcoholism, from some medications, or from autoimmune conditions. Symptoms include yellowing skin and eyes, nausea, and abdominal pain.
Butler also said there was no evidence so far that either a Covid-19 infection or the Covid vaccine was linked to the U.S. cases. The World Health Organization also said this past week that the “vast majority” of children had not been vaccinated in the cases it had reviewed.
The alarm began two
weeks ago when the CDC issued an alert, citing nine hepatitis cases among young children in Alabama that began last fall into this year. All had evidence of an adenovirus infection. Their median age was 2.
The problem for the CDC is to determine if the adenovirus is a cause or an innocent bystander, Butler said. Doctors do not normally test children for adenovirus infections — it is not a reportable disease in the United States — and that makes it difficult to untangle causes and effects. He urged doctors to consider testing for adenovirus if children were ill with certain symptoms.
It is not known how likely it would be for nine children tested at random to have had adenovirus infections. The virus also is seasonal, and the fall and winter, when the Alabama children were ill, is adenovirus season.
Complicating the situation further is that by the time the children were evaluated, the amount of virus, if it was found at all, was very low.
The CDC and experts overseas are exploring whether a type of adenovirus may be a factor in these cases.