So far, at least 18 cases have been reported in at least four states – and dozens of cases in Europe.
The latest clinical details shared by the CDC on Friday came from Alabama, where the first cases were found. Clinical records of nine patients admitted to a children’s hospital after October 1, 2021 were analyzed.
The patients were from different parts of the state with no epidemiological links. All were considered to be in generally good health, with no significant comorbidities and no impairment of the immune system. The average age was about three years, ranging from the youngest of two years to the largest of five years.
Vomiting and diarrhea were the most common symptoms among patients prior to admission, and some also had upper respiratory symptoms. On admission, most had an enlarged liver, along with jaundice and yellowing of the eyes.
All patients received negative test results for hepatitis A, B and C viruses, and many other causes of pediatric hepatitis and infections were excluded. But adenovirus was detected in all patients.
Of the nine patients in Alabama, six received positive results for the Epstein-Barr virus identified as having previous infections. Other detected viruses included enterovirus/rhinovirus, pneumonitis virus, respiratory syncytial virus, and human coronavirus OC43.
No patient had a documented history of previous Covid-19 infection.
Three patients developed acute liver failure, two of whom underwent a liver transplant. The CDC reports that all patients recover or recover, including transplant recipients.
Hepatitis is inflammation of the liver, which is a vital organ that processes nutrients, purifies the blood, and helps fight infections. When the liver is inflamed or damaged, its function can be affected.
Most often, hepatitis is caused by a virus, and adenovirus is a common type of virus that spreads from person to person and can cause a range of mild to severe illnesses. But these viruses are rarely reported as a cause of acute hepatitis in otherwise healthy people.
Adenovirus is known to be a cause of hepatitis among immunocompromised children, but it may be an “unrecognized contributor to liver injury among healthy children,” according to the CDC. The disease spreads primarily from feces to the mouth.
There is no vaccine for adenovirus in children. Adenoviruses tend to linger on surfaces, and alcohol-based hand sanitizers don’t work well against them, according to Dr. Ashlisha Kaushik, a spokesperson for the American Academy of Pediatrics.
“Washing hands thoroughly with soap and water is the best thing,” Kaushik said. “Keep away from anyone who is sick with coughing and sneezing, and teach your children to cough or sneeze into their sleeve.”
Jacqueline Howard, Brenda Goodman, Michael Needleman, Jon Bonnefield, and Jane Christensen of CNN contributed to this report.