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CDC says adenovirus may have caused outbreak of severe hepatitis in children in Alabama

Structure of the Adenovirus, computer illustration showing the surface structure of the virus’ outer protein coat (capsid).

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US health officials say the adenovirus may have caused a severe hepatitis outbreak that broke out in nine children in Alabama in February.

All 9 children had severe acute hepatitis, 3 had liver failure, tested positive for adenovirus and none had a history of Covid-19 infection, according to the Centers for Disease Control and Prevention.

“At this point, we believe that adenovirus maybe The cause of these reported cases is the cause, but other potential environmental and situational factors are still being investigated, the CDC said in a statement. Common links or contacts between these children were found. “

The CDC on Friday released its most detailed findings to date on children, after issuing a nationwide health alert last week. It said adenoviral infection could be a contributing cause of unrecognized liver damage in otherwise healthy children but needed further investigation.

Although hepatitis is not uncommon in children, a case series in Alabama surprised doctors because previously healthy children had severe symptoms and did not test positive for the hepatitis virus. liver.

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 of a spate of cases. there. To date, WHO has identified 169 cases worldwide, with the majority of them in the UK

All nine children in the US are patients at Alabama Children’s Hospital, ranging in age from about 2 to 6 years old, according to the CDC. Three of the patients had liver failure and two needed a liver transplant. All of them have recovered or are recovering.

The child’s symptoms prior to admission included vomiting, diarrhea, and upper respiratory tract symptoms. In eight of the patients with enterocolitis, the whites of the eyes turned yellow. Seven had liver enlargement, 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 problems, colic, pink eye and bladder or neurological disease in some cases. rarer case. Adenovirus is known to cause hepatitis in children with weakened immune systems, but the patients in Alabama have normal immune systems and do not have significant health conditions, according to the CDC.

Although six of the children also tested positive for Epstein-Barr virus, the CDC did not believe these were acute infections because they tested negative for antibodies. According to the CDC, the children all tested negative for hepatitis A, B and C viruses. None of them had a history of Covid-19.

Doctors in Alabama identified the first five cases last fall. The CDC and the Alabama Department of Public Health began an investigation in November. They have identified four more cases in Alabama through February of this year. No additional cases have been identified in Alabama since February.

The CDC said it is monitoring the situation closely to better understand what causes severe hepatitis in children and find ways to prevent the disease. The public health agency asked doctors to note that testing whole blood, rather than plasma, may be better at detecting the presence of adenovirus.

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