Several severe hepatitis cases in children reported in the US have drawn great concern from health officials and parents, and the country's Centers for Disease Control and Prevention (CDC) has ruled out Covid-19 as a factor in the those cases. Nine severe hepatitis cases in children were reported in Alabama during October 2021 to February 2022, seven girls and two boys ranging in age from 1 month to 6 years old, Xinhua news agency reported. Those cases were the first that drew attention to the liver illnesses in children in the US. All of the nine children's whole blood specimens tested positive for adenovirus. None of them had a history of Covid-19 infection, nor had received a Covid-19 vaccine, according to a latest report of the CDC. Before admission, some kids reported vomiting, diarrhea, and upper respiratory symptoms. Upon admission, some had scleral icterus, hepatomegaly, jaundice, and encephalopathy, according to the CDC.
Three of the kids suffered liver failure and two needed liver transplants. They have either recovered or are recovering. All patients received negative test results for hepatitis viruses A, B, and C. Several other causes of pediatric hepatitis and infections were also ruled out including autoimmune hepatitis, Wilson disease, bacteremia, and urinary tract infections, according to the CDC. The CDC said adenovirus may be the cause of these reported cases, but other potential environmental and situational factors are still being investigated. Roughly a dozen other cases are now being investigated in eight other states: one in Delaware, another in Louisiana, three in Illinois, two in North Carolina and four in Wisconsin, according to NBC News report. The Tennessee Department of Health said that it has six cases. State health departments in Georgia and New York also said they are investigating "a handful" of potential cases.
The cluster of cases, along with recently identified possible cases in Europe, suggests that the adenovirus should be considered in the differential diagnosis of acute hepatitis of unknown etiology among children, according to the CDC. Adenovirus type 41 is primarily spread via the fecal-oral route and predominantly affects the gut. It is a common cause of pediatric acute gastroenteritis typically with diarrhea, vomiting and fever, often accompanied by respiratory symptoms, said the CDC. Adenovirus is recognized as a cause of hepatitis among immunocompromised children, and might be an "underrecognised" contributor to liver injury among healthy children, said the CDC. The agency is monitoring the situation closely to understand the possible cause of illness and identify potential efforts to prevent or mitigate illness. The World Health Organization has alerted physicians worldwide to be on the lookout for such unusual cases of hepatitis.