CDC issues health advisory about acute hepatitis in children, two needed liver transplants

The U.S. Centers for Disease Control and Prevention have issued a health advisory to health care providers and public health officials recommending they test for adenovirus in children who have hepatitis and the cause is not know.

The CDC said that in November it was notified of five pediatric patients in Alabama “with significant liver injury, including three with acute liver failure, who also tested positive for adenovirus. All children were previously healthy. None had COVID-19.”

Another four patients were later identified “for a total of nine patients admitted from October 2021 through February 2022.” The patients tested positive for adenovirus type 41 infection.

Two of the children needed liver transplants. None of the patients died.

“A possible association between pediatric hepatitis and adenovirus infection is currently under investigation,” the CDC said.

In addition to testing for adenovirus, health officials are asked to report cases to state public health officials and the CDC.

CNN reported, “Last week, public health officials in the United States and the United Kingdom announced that they had launched an investigation into cases of severe acute hepatitis in children. At the time, the World Health Organization had identified 74 cases among children across the UK, and Alabama health officials identified nine cases of hepatitis in children, ages 1 to 6, who also had tested positive for adenovirus since October. None of the children had Covid-19.”

According to the CDC, “Hepatitis is inflammation of the liver that can be caused by viral infections, alcohol use, toxins, medications, and certain other medical conditions. In the United States, the most common causes of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C viruses.

Signs and symptoms of hepatitis include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.”

Adenoviruses are viruses that spread by close personal contact, respiratory droplets, and fomites. “There are more than 50 types of immunologically distinct adenoviruses that can cause infections in humans.

Adenoviruses most commonly cause respiratory illness but depending on the adenovirus type they can cause other illnesses such as gastroenteritis, conjunctivitis, cystitis, and, less commonly, neurological disease. There is no specific treatment for adenovirus infections.”

Adenovirus type 41 commonly causes pediatric acute gastroenteritis, which typically presents as diarrhea, vomiting, and fever; it can often be accompanied by respiratory symptoms.

While there have been case reports of hepatitis in immunocompromised children with adenovirus type 41 infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children.”

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