☷Proactive Statement MMWR on children with acute hepatitis and adenovirus infection in Alabama
Centers for Disease Control and Prevention ( By Press Release office)
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Media StatementFor Immediate Release: Friday , April 29 , 2022Contact: Media Relations ( 404 ) 639 - 3286A new study published by the Centers for Disease Control and Prevention ( CDC ) today , “Acute Hepatitis and Adenovirus Infection Among Children — Alabama , October 2021–February 2022” provides additional clinical and epidemiologic information from an ongoing investigation involving children in Alabama with hepatitis ( inflammation of the liver ) of unknown cause . These findings build on previous information shared about the cluster of nine cases currently under investigation by CDC and the Alabama Department of Public Healthexternal icon . In the fall of 2021 , clinicians at a children’s hospital in Alabama identified five patients with severe hepatitis and adenovirus infection , including some with acute liver failure . A review of hospital clinical records identified four additional cases , all of whom had liver injury and adenovirus infection . All were previously healthy , ranged in age from about 1 to 6 - years - old , and had no significant underlying conditions . Among the findings in the MMWR: two of the pediatric patients in Alabama required liver transplants , and three developed liver failure , but all have since recovered or are recovering . Prior to hospitalization , most of the children experienced vomiting and diarrhea , while some experienced upper respiratory symptoms . During hospitalization , most had yellowing eyes , yellowing skin ( or jaundice ) , and an enlarged liver . All nine patients tested positive for adenovirus , and six tested positive for Epstein - Barr Virus but did not have antibodies , which implies an earlier , not active infection . Laboratory tests identified that some of these children had adenovirus type 41 , which more commonly causes pediatric acute gastroenteritis . Additionally , some showed a history of other viruses including enterovirus/rhinovirus , metapneumovirus , respiratory syntactical virus , and human coronavirus OC43 . At this time , we believe adenovirus may be the cause for these reported cases , but other potential environmental and situational factors are still being investigated . Adenovirus type 41 is not usually known as a cause of hepatitis in otherwise healthy children , and no known epidemiological link or common exposures among these children has been found . Some causes have already been ruled out , including:hepatitis viruses A , B , and CSARS - CoV - 2 infectionautoimmune hepatitisWilson diseaseIt’s important to note that this report is specific to the Alabama investigation , and CDC does not have an update at this time on any other suspected cases in the U . S . CDC is taking every potential reported case seriously and working vigilantly with state and local public health officials and clinicians to identify and investigate other potential cases . On April 21 , CDC issued a nationwide Health Alert Network ( HAN ) Advisory asking all physicians to be on the lookout for symptoms and to report any suspected cases of hepatitis of unknown origin to their local and state health departments . CDC is working with commercial and state public health laboratories to provide guidance on how to submit testing . CDC is also aware of an increase in cases of pediatric hepatitis without a known cause recently reported in Europeexternal icon , and has been in contact with our European counterparts to understand what they are learning . Adenovirus has been confirmed in several of the European cases , but not all . Investigators are ruling out other possible causes and identifying other possible contributing factors . As we learn more , we will share additional information and updates .
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