CDC investigating 109 cases of hepatitis in children, 5 deaths

The Centers for Disease Control and Prevention is investigating 109 cases of unexplained severe hepatitis in children, officials said Friday. Five children have died.

Jay Butler, Deputy Director of Infectious Diseases at the CDC, said the case dates back to October and was found in 24 states and one region. He said more than 90% of the patients were hospitalized and 14% had a liver transplant. He said the majority had recovered.

Incidents found in at least 20 countries continue to mystery scientists who could not determine the cause. Severe hepatitis in infants is still rare, officials say, urging parents not to panic, but to be aware of unusual signs such as jaundice (jaundice that causes yellowing of the skin and white of the eyes). increase.

“Although rare, children can develop severe hepatitis, and it’s not uncommon for the cause to be unknown,” Butler said. He said there was no “significant increase” in the number of cases of childhood hepatitis or liver transplants, including before the pandemic.

The main suspect is adenovirus. This is a common family of about 50 viruses that cause symptoms ranging from colds and stomach upsets to conjunctivitis and, rarely, symptoms that affect the brain and spinal cord. According to Butler, about half of the children in the United States under investigation for hepatitis cases have confirmed adenovirus infection, but authorities still do not know if it is the cause of the disease.

Authorities said some of the more common causes of viral hepatitis (such as hepatitis A, B, C, D, and E) have not been found. Authorities do not yet know what other factors, such as environmental exposure, dosing, and other infectious diseases, can play a role in the disease.

“This is a very rare presentation of a common scenario,” said Helena Gutierrez, a pediatric gastroenterologist at Children’s of Alabama.

Nine children were diagnosed in the hospital between October and February, all previously healthy and had adenovirus in their blood, officials said. Some of them had adenovirus 41. This usually causes stomach illness and can cause hepatitis in children with weakened immunity, but children in Alabama did not have weakened immunity.

“Children get sick and get infected with the virus,” she said.

Gutierrez, who was involved in all nine treatments, said he had no cases with children since February. Two of the nine children needed a liver transplant, but all have recovered or are recovering.

CDC officials said the median age of children sick in Alabama was two years. Authorities are working through blood tests to determine if some children had previously had an unknown coronavirus infection.

None of the children in Alabama had been vaccinated with the coronavirus vaccine, officials said.

“Covid-19 vaccination is not the cause of these illnesses,” Butler said. “We hope this information will help reveal some of the speculation that is widespread online.”

According to Butler, cases were found in the following states and territories: Alabama, Arizona, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, and Louisiana. , Missouri, Minnesota, Missouri, North Carolina, North Dakota, Nebraska, New York, Ohio, Pennsylvania, Puerto Rico, Tennessee, Texas, Washington, Wisconsin.

As of May 1, the World Health Organization has recorded more than 220 cases in 20 countries for children aged 1 month to 16 years. According to the WHO media briefing on Wednesday, another 50 cases are under investigation.

WHO officials said new case notifications and broader searches will allow more cases to be detected before the cause can be identified. British officials first warned WHO about a case of severe hepatitis in Scotland in early April. The CDC issued a warning on April 21 regarding the US incident.

Authorities urged clinicians to pay attention to the case.

“Usually, we don’t report cases of acute liver failure to any kind of public agency,” Gutierrez said. “Because we are investigating, the incident will surface. People will test adenovirus.”

Under normal circumstances, doctors may miss cases of adenovirus-related hepatitis. In mild cases, we usually do not order viral research other than looking for common hepatitis A, B, or C. The mercy of children in Kansas City.

“Otherwise we may have missed many cases of adenovirus-related hepatitis in healthy children, because we don’t check it and the children recover safely,” Fisher said. Said.

Doctors can go back to the previous case that was resolved and check the sample to see if there is evidence of the virus and increase the number further.

Leina Alrabadi, a pediatric gastroenterologist at Stanford Children’s Health, reported a 4-year-old hepatitis case in March a few weeks after the CDC’s April 21 warning. She did not cause liver failure in that particular case.

“We always had children who went on to transplant for an unknown cause,” Alrabadi said, adding that it was premature to know what was causing the outbreak of severe cases.

Still, WHO scientists said they do not believe that adenovirus alone explains the severity of liver inflammation. Researchers in the United Kingdom and elsewhere are investigating other factors, such as whether infants are more susceptible to adenovirus after less exposure during a pandemic. Whether a new adenovirus may have emerged. According to the WHO, some children test positive for the coronavirus, but the infection rate is only slightly higher than in the general population.

Doctors advised to see a pediatrician if the child had abnormal symptoms, and said the pandemic strengthened the lesson of keeping the child safe from adenovirus and other pathogens.

“Continue to carry out hand hygiene. Before eating, playing in the playground, and touching young siblings who are not in school or day care,” Gutierrez said.