Adenovirus structure, computer illustration showing the surface structure of the virus’ outer protein coat (capsid).
Katerina Kon | Scientific Photo Library | Scientific Photo Library | fake images
Nine children in Alabama with severe acute hepatitis, three of whom developed liver failure, all tested positive for adenovirus, and none had a history. COVID-19 infection, according to the Centers for Disease Control and Prevention.
The CDC released its most detailed findings yet on children on Friday, after issuing a nationwide health alert last week. He said adenovirus infection may be an underrecognized contributor to liver injury in otherwise healthy children, but more research is needed.
While hepatitis is not uncommon in children, the cluster of cases in Alabama surprised doctors because previously healthy children had severe symptoms and did not test positive for the hepatitis virus.
Public health authorities in the US and Europe are closely monitoring cases of severe hepatitis in children after the UK alerted the World Health Organization earlier this month about a cluster of cases there. The WHO has identified 169 cases worldwide so far, with the vast majority of them in the UK.
The nine children in the US were patients at the Children’s of Alabama hospital, ranging in age from 2 to 6 years old, according to the CDC. Three of the patients suffered liver failure and two required liver transplants. All of them have recovered or are recovering.
The children’s symptoms before hospital admission included vomiting, diarrhea, and upper respiratory symptoms. Eight of the patients had scleral jaundice, a yellowing of the whites of the eye. Seven had enlarged livers, six had jaundice and one had encephalopathy, a broad term for brain disease.
All of the children tested positive for adenovirus, a common infection that can cause respiratory illness, upset stomach, conjunctivitis, and bladder inflammation or neurological disease in rarer cases. Adenovirus is a known cause of hepatitis in children with weakened immune systems, but all of the Alabama patients had normal immune systems and no significant health problems, according to the CDC.
Although six of the children also tested positive for the Epstein-Barr virus, the CDC does not believe these were acute infections because they tested negative for antibodies. All of the children tested negative for hepatitis A, B and C viruses, according to the CDC. None of them had a history of Covid-19 infection.
Doctors in Alabama identified the first five cases last fall. The CDC and the Alabama Department of Public Health launched an investigation in November. They identified four more cases in Alabama as of February of this year. No additional cases have been identified in Alabama since February.
The CDC said they are monitoring the situation closely to better understand the cause of severe hepatitis in children and find ways to prevent the disease. The public health agency told doctors to note that tests of whole blood, rather than plasma, might be better at detecting the presence of adenoviruses.