By Brenda Goodman, CNN
The US Centers for Disease Control and Prevention said Friday that it’s investigating 109 cases of severe and unexplained hepatitis in children in 25 states and territories that may be linked to a worldwide outbreak.
Among them, 14% needed transplants, and five children have died. Nearly all the children — more than 90% — needed to be hospitalized. Dr. Jay Butler, the CDC’s deputy director of infectious diseases, stressed that the investigation — a partnership between the CDC and state health departments — is an evolving situation.
It’s not clear what’s driving these cases in young children. Butler said some of the common causes of viral hepatitis have been considered but were not found in any of the cases.
Adenovirus has been detected in more than 50% of cases, although its role isn’t clear.
Unusually severe liver inflammation
Pediatric gastroenterologist Dr. Heli Bhatt of M Health Fairview Masonic Children’s Center in Minneapolis has treated two children who are part of the CDC’s investigation. One, a 2-year-old from South Dakota, had a liver transplant this week. Bhatt says liver failure in kids is “super rare.” And even before scientists started tracking this outbreak, half of cases were never explained.
“Even during the first case, I thought it was weird,” says Dr. Markus Buchfellner, a pediatric infectious disease specialist at the University of Alabama at Birmingham, where staffers started seeing cases in October. And then when the second one came in, that’s when I said, ‘OK, we need to talk to someone about this.’ ” He reached out to senior physicians in his department, who contacted the state health department and the CDC.
Buchfellner says the cases stood out because the liver inflammation was so severe.
Sometimes, common viruses like Epstein-Barr or even SARS-CoV-2 will raise a child’s liver enzymes a little, indicating what Buchfellner calls “small bits of hepatitis,” but the kids typically recover as their bodies fight off the infection.
“But it’s very odd to see a child who’s healthy come in with the amount of liver injury that these kids had,” he said.
Initially, UAB saw nine kids with unexplained hepatitis, and all nine tested positive for adenovirus in their blood. None of them tested positive for Covid-19 during their hospitalization or had a documented history of Covid-19, Butler said at the news briefing…