Child hepatitis outbreak: CDC investigating 100+ cases in 24 states including Washington

Health experts are puzzled over an outbreak of unexplained cases of hepatitis in children that has impacted kids around the world, including here in the U.S. and Washington state.

The Centers for Disease Control and Prevention (CDC) recently sent out a health alert to state health officials about the ongoing investigation into those cases.

"Fifteen days ago, the CDC issued a nationwide health alert to notify clinicians and public health authorities about an investigation involving 9 children in Alabama, identified between October of 2021 and February of 2022, with hepatitis, or inflammation of the liver and Adenovirus infection," said Jay Butler, M.D., Deputy Director for Infectious Diseases, CDC. "All nine ultimately tested positive for Adenovirus, which is a common virus which typically causes mile cold or flu-like symptoms or stomach and intestinal problems," said Butler.

"The symptoms of a significant infection with hepatitis usually have to do with the belly," said Frank Bell, Pediatric Infectious Disease Physician, Swedish. "Belly pains, sometimes fever, often diarrhea and vomiting."

Bell says it's understandable that parents would be concerned about the CDC's investigation of the 109 hepatitis cases of unknown origin in children across the country. More than 90% of the children needed to be hospitalized. Officials said 14% of the children needed transplants and five of them died.

The CDC wouldn't say how many cases were under investigation in Washington state.

Washington State Department of Health's spokesperson, Teresa McCallion told FOX 13 Friday, "We are aware of the situation and are actively investigating." 

"We see a lot of hepatitis, most of it is pretty mild.  What we have been alerted to in the last couple of weeks, but going on for a few months now, is a more serious or more intense inflammation of the liver which seems to be affecting younger children," he said.

"We are doing more testing," Bell said.

Local doctors say they are now on the lookout for Adenovirus, which the CDC said was present in the cases in Alabama and some of the other hepatitis cases under investigation. 

"This is early stage in all these investigations, especially the more recent ones.  We don't know of all those children who have come to our attention, with signs or symptoms that might be consistent with hepatitis, said Bell.  "We don't know which of those might be related to this particular outbreak and which are part of just the regular infections that go on in preschool-aged children all the time."      

"With Adenovirus infections, these children seem to be developing vomiting and diarrhea," said Dr. Pamela Valentino, Medical Director of Hepatology and Liver Transplantation at Seattle Children’s Hospital.

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Valentino says the Adenovirus is very common, but the CDC is investigating whether something has changed.

"It just seems like an exaggerated response that's going on," said Valentino.

"We received a number of reports of similar illnesses from health care providers and state health departments across the country and we have been working diligently to evaluate these reports," said Butler.

"When someone develops liver disease that's causing failure we get more worried in those instances when children develop yellow eyes, that's the best place to look," said Valentino.

Valentino says if a child isn't feeling well, or is getting dehydrated, it may be a good idea to go to an urgent care setting if you can't access a pediatrician.  She did have some reassuring words for parents and caregivers.

"When new illnesses arise that have a lot of uncertainty, we all get a little worried. In general, this is a small number of patients," said Valentino.

"This is still an extremely rare phenomenon," said Bell.

The Washington State Department of Health (DOH) sent out a statement Friday afternoon, saying it is, "Working with the Centers for Disease Control and Prevention (CDC) to identify children with hepatitis of an unknown cause."

The statement went on to say, "Investigators are examining a possible relationship to adenovirus type 41 infection.  DOH is in the process of conducting a retrospective analysis of pediatric cases involving hepatitis or adenovirus infections. This is an evolving situation, and we will provide additional details as they become available."

If you have any questions about your child’s health, The DOH recommends that you call your child’s healthcare provider.  The DOH also suggested:

  • Be aware of the symptoms of liver inflammation, which include: fever fatigue loss of appetite nausea vomiting abdominal pain dark urine light-colored stools (poop) joint pain jaundice (yellowing of the skin)
  • fever
  • fatigue
  • loss of appetite
  • nausea
  • vomiting
  • abdominal pain
  • dark urine
  • light-colored stools (poop)
  • joint pain
  • jaundice (yellowing of the skin)
  • Help your child take everyday actions to help prevent disease, like: washing hands often, avoiding people who are sick, covering coughs and sneezes, and teaching them to avoid touching the eyes, nose, or mouth.
  • washing hands often,
  • avoiding people who are sick,
  • covering coughs and sneezes, and
  • teaching them to avoid touching the eyes, nose, or mouth.