US warns doctors to look for hepatitis in children as probe widens

US health officials have sent out a nationwide alert warning doctors to be on the lookout for symptoms of pediatric hepatitis, possibly linked with a cold virus, as part of a wider probe into unexplained cases of severe liver inflammation in young children.

The warning follows investigations in the US and Europe of clusters of hepatitis in young children.

The US Centers for Disease Control and Prevention (CDC) said it is working with counterparts in Europe to understand the cause of the infections. A common cold virus known as an adenovirus has been confirmed in several of the European cases, but not all.

UK health authorities on Thursday said they have identified a total of 108 cases of pediatric hepatitis. In some instances, cases were so severe that children required liver transplants.

The US alert directs doctors to report any suspected cases of the disease that occur with unknown origin to their state and local health departments.

It also suggests doctors conduct adenovirus testing in young patients with symptoms of the disease, which include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.

The warning followed a CDC investigation with the Alabama Department of Public Health into a cluster of nine cases of hepatitis of unknown origin in previously healthy children ranging in age from 1 to 6-years old.

The first such US cases were identified in October 2021 at a children’s hospital in Alabama that admitted five young patients with significant liver injury – including some with acute liver failure – of unknown cause. In those cases, the children tested positive for adenovirus.

The more common forms of the liver disease – hepatitis A, hepatitis B, and hepatitis C – were ruled out.

A review of hospital records identified four additional cases, all of whom had liver injury and adenovirus infection.

The CDC is working with state health departments to identify US cases. While the leading theory is that the cases are caused by a specific type of adenovirus, health officials are considering other possible contributing factors as well.