Prompted by a cluster of hepatitis cases of unknown origin among children in multiple states and countries, state health officials are asking parents to watch for signs of liver inflammation in their children — especially after bouts with either upper respiratory or stomach-intestinal illnesses.
Signs of liver inflammation can include yellowing of the eyes or skin, sometimes known as jaundice. While the cases are rare among children, in about 10% of those affected the liver inflammation has led to liver failure and the need for transplant.
Epidemiologists with the Minnesota Department of Health (MDH) are investigating three Minnesota children under age three who had liver inflammation and may be part of a national cluster of hepatitis in children. While the cause remains under investigation, the hepatitis may be associated with infection with a type of virus known as adenovirus type 41. Some reported illnesses in the United States date back to fall 2021; the illnesses have occurred in children younger than 10 years old.
“If your child recently had vomiting and diarrhea or symptoms of a common cold and then develops yellowing of the eyes and skin, it is important to have your child evaluated by a health care provider right away,” said Minnesota State Epidemiologist Dr. Ruth Lynfield. “Other symptoms can include abdominal pain, fatigue, dark urine and clay-colored stools. Getting medical care quickly can help diagnose and treat the condition as needed.”
Among the Minnesota cases, one child required a liver transplant and has recovered while the other two recovered without the need for a transplant. Dr. Lynfield said MDH epidemiologists are aware of at least two others with possible cases at Minnesota hospitals who are not Minnesota residents; those have been referred to their respective state health departments.
MDH epidemiologists began looking into possible cases in the state in late April after learning of cases in Europe and in other areas of the United States. They alerted health care providers at the time, asking them to report any recent instances of hepatitis of unknown cause in children.
“We’re grateful for the reports we’ve received from clinicians so far and look forward to continuing to work with them in this investigation,” Dr. Lynfield said. “The more information we can gather, the faster we can help determine how best to protect other children.”
According to a CDC announcement today, at least 109 children in 25 states have been identified in the Unites States as part of the cluster of cases. At least 228 probable cases in 20 countries have been identified, according to the World Health Organization. Among the national cases, prior to hospitalization, most of the children experienced vomiting and diarrhea, while some experienced upper respiratory symptoms. During hospitalization, most had yellowing eyes and skin, and an enlarged liver.
While health officials identified adenovirus in many of the affected children, other potential factors are being investigated. Adenovirus 41 often causes vomiting and diarrhea in children, but it is not typical for the virus to cause hepatitis in otherwise healthy children, and to date disease investigators have found no common epidemiological link or exposures among the children.
Until more information is available, the best advice for people seeking to protect themselves and their children is to use the general disease prevention measures, such as frequent and thorough hand washing; avoiding touching eyes, nose or mouth with unwashed hands; covering coughs and sneezes; and avoiding close contact with people who are sick.
More information about the ongoing national investigation can be found on the CDC website at CDC Alerts Providers to Hepatitis Cases of Unknown Origin. General information about hepatitis in Minnesota can be found on the MDH hepatitis home page.