Mysterious illness is causing liver damage in children, CDC says. What we know

A mysterious cluster of children with infection-induced liver damage within the U.S. has prompted a public health advisory from the Centers for Disease Control and Prevention.

The notice mirrors a similar update from the European Centre for Disease Prevention and Control after several kids in Europe have also suffered acute hepatitis and adenovirus.

Experts from both agencies say they are unsure what is causing the illness in children.

The CDC says it became aware of the infections in November 2021 after a large Alabama children’s hospital reported “five pediatric patients with significant liver injury, including three with acute liver failure, who also tested positive for adenovirus.”

None of the five children had COVID-19, officials say, and were all “previously healthy.”

Since then, the Alabama hospital identified four other pediatric patients from October 2021 through February 2022 who had hepatitis and adenovirus infection, officials say. In the five cases sequenced, they all were found to have adenovirus type 41 infections.

No deaths were reported, the CDC says, but two of the patients required liver transplants.

Two more cases have also been reported in North Carolina, according to NBC.

“A possible association between pediatric hepatitis and adenovirus infection is currently under investigation,” the CDC says in the notice to public health professionals on April 21. “Cases of pediatric hepatitis in children who tested negative for hepatitis viruses A, B, C, D, and E were reported earlier this month in the United Kingdom, including some with adenovirus infection.”

In the European department’s April 19 update, officials reported dozens of cases of acute hepatitis with unknown origins in children. Cases have been reported in countries including Denmark, Ireland, the Netherlands and Spain.

What is hepatitis?

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

The liver inflammation caused by hepatitis can lead to many symptoms, including “fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice,” officials say.

While there are different strains of hepatitis, common ways some can be spread are through fecal matter, blood and other body fluids.

Illnesses can last for months, and treatment varies.

What are adenoviruses?

“Adenoviruses are common viruses that cause a range of illness,” the CDC says. “They can cause cold-like symptoms, fever, sore throat, bronchitis, pneumonia, diarrhea, and pink eye (conjunctivitis).”

Adenoviruses are spread through close contact, officials say, and while they mostly cause respiratory illnesses, they may also lead to gastroenteritis, neurological disease and other infections.

The adenovirus type 41 infection found in the pediatric cases “commonly causes pediatric acute gastroenteritis, which typically presents as diarrhea, vomiting, and fever,” according to the CDC. “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.”

What is the CDC doing about the infections?

In its April 21 Health Alert Network Health Advisory, the CDC recommended that clinicians consider adenovirus testing in children with hepatitis of unknown origin.

The department also requested that medical personnel and state public health staff notify the CDC of similar cases in children under 10 meeting a certain criteria since Oct. 1, 2021.

The CDC says it is investigating a potential link between adenovirus infections and pediatric hepatitis.

This story was originally published April 21, 2022 at 12:25 PM with the headline "Mysterious illness is causing liver damage in children, CDC says. What we know."