July 2, 2022

CDC Issues Alert For Adenovirus Testing in Children With Acute Hepatitis

The CDC has issued a Health Alert Network (HAN) Alert for conducting adenovirus testing in children with acute Hepatitis. This comes after reports from Alabama of nine children under the age of 10 presenting with symptoms of severe hepatitis. Three of those children were in acute liver failure; those patients tested positive for adenovirus. Officials think these illnesses may be related to adenovirus 41.

CDC Issues Alert For Adenovirus Testing in Children With Acute Hepatitis

None of the children had COVID-19 and none had any previous health conditions. Two of the patients required liver transplants.

Hepatitis A, B, C, D, and E are viruses, but hepatitis just means inflammation of the liver, and can be caused by chemicals, toxins, medications, alcohol use, and other viruses. Patients with liver inflammation can get very sick and suffer liver failure; some may require transplants.

All five Alabama patients who had their blood sequenced had adenovirus type 41. In two patients, plasma samples were negative for adenovirus by quantitative polymerase chain reaction, but both patients were positive when retested using whole blood.

Cases of pediatric hepatitis in children who tested negative for the hepatitis viruses A, B, C, D, and E were reported in the United Kingdom earlier this month. Some of those patients had adenovirus infections.

Adenoviruses are double-stranded DNA viruses that are spread through person-to-person contact, respiratory droplets, and contact with surfaces. Depending on the type, these viruses can cause respiratory illnesses, conjunctivitis, cystitis, and neurological disease.

Adenovirus type 41 usually causes pediatric acute gastroenteritis, with symptoms of diarrhea, vomiting, and fever. This virus is not known to be a cause of hepatitis in otherwise health children even though there are reports of hepatitis in immunocompromised children infected with this virus.

The CDC is asking that clinicians and state public health authorities tell them about children under the age of 10 with elevated (AST) or alanine aminotransferase (ALT) or alanine aminotransferase who have an unknown etiology for their hepatitis since October 1, 2021. Whole blood testing may be more sensitive than testing plasma by PCR.

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