MILWAUKEE – At least four children in Wisconsin, including one who died and one who required a liver transplant, have come down with mysterious hepatitis cases that appear to be part of a worldwide outbreak linked to an adenovirus.
So far close to 200 cases – 114 of them in the United Kingdom – have been reported. Other countries with possible cases include the U.S. (19), Spain (13), Israel (12), Denmark (6), Ireland (5), The Netherlands (4), Italy (4), Norway (2), France (2), Romania (1) and Belgium (1), according to the World Health Organization and the U.S. Centers for Disease Control and Prevention.
The cases have not been linked to Hepatitis Viruses A, B, C, D or E but may be related to an adenovirus, a family of more than 50 viruses, which spread from person to person through droplets. Adenoviruses are one cause of the common cold.
Health officials investigating the hepatitis outbreak have been zeroing in on one particular suspect, Adenovirus type 41, which causes symptoms of diarrhea, vomiting and fever and can be accompanied by breathing problems.
CDC alert:Health officials warn of unusual hepatitis cases in young children
The Wisconsin Department of Health Services released no information on the ages, counties or genders of the children whose illnesses are under investigation.
“I think this is something that’s interesting and gets my attention, but I don’t have a lot of fear and I don’t think parents should be anxious,” said Dr. Gregory DeMuri, a pediatric infectious disease doctor at UW Health. “I don’t have a sense at the moment that this is going to result in a serious threat to public health.”
DeMuri recommended that parents make decisions about whether to have their children wear masks based on COVID-19 numbers in their community and not on the small number of hepatitis cases linked to Adenovirus 41.
Hepatitis symptoms to watch for
The symptoms to watch out for in severe hepatitis cases include nausea, vomiting, diarrhea, pain in the upper abdomen and yellowness of the skin or eyes, DeMuri said. In particular, yellowing of the eyes and skin, also known as jaundice, indicates sickness in the liver.
DeMuri urged parents to make sure their children are vaccinated against Hepatitis A and Hepatitis B.
Although the WHO and CDC issued reports on the outbreak this week, a large children’s hospital in Alabama identified nine children, all under the age of 10, who suffered severe liver injuries between October 2021 and February.
A CDC report Friday on the Alabama cases said none had compromised immune systems or tested positive for Hepatitis Viruses A, B or C. The CDC said the children’s medical records did not indicate that any had been infected with the virus that causes COVID-19. While all the children in Alabama survived, three developed acute liver failure and two required liver transplants.
So far, the World Health Organization report only confirms one other death in addition to that of the Wisconsin child.
More:Child dies as mystery liver disease outbreak spreads across US and Europe
A report by the UK Health Security Agency on Monday listed several working theories that might explain the outbreak. These include, from most likely to least:
- Another factor affecting some children that is rendering normal adenovirus infections more severe, or causing them to trigger an inappropriate immune response. Such a factor could be a prior infection with the virus that causes COVID-19, an effect that’s restricted to infection from the omicron variant, or co-infection involving SARS-CoV-2 and another infection.
- A novel variant of the adenovirus.
- A drug, toxin or environmental exposure.
- A new pathogen either acting alone or in combination with another infection.
- A new variant of SARS-CoV-2.