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CDC investigates 180 pediatric hepatitis cases, including 13 in Colorado

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Posted at 10:07 PM, May 20, 2022
and last updated 2022-05-21 00:07:17-04

COLORADO SPRINGS — More children are getting a deadly and unexplained strain of hepatitis.

On Friday, the Centers for Disease Control and Prevention said they were investigating 180 reported cases of "unusual hepatitis" in children in 36 states and territories from the past seven months. That number is up 71 cases from two weeks ago.

While this may appear to be a large increase in cases, the agency said most of them are “retrospective" since they are looking at patients as far back as October 2021. Not all the cases that have been detected are recent, and some may end up not even being related to the current investigation.

The Colorado Department of Public Health and Environment identified 13 cases of pediatric hepatitis with an unknown origin in the state. All of them meet the broad criteria in CDC’s call for potential cases, which include all children younger than 10 with hepatitis of an unknown cause. 10 were hospitalized, but they are either recovering or improving.

Case numbers are listed below according to the month in which patients first presented with liver disease. Case counts for all time periods may change as CDPHE identifies more patients.

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"At least half of the cases nationwide have tested positive for adenovirus which is an unusual cause of hepatitis in anyone, especially children who aren't typically prone to hepatitis. Usually the adenovirus would cause stomach bug type symptoms, and not hepatitis. Why this particular adenovirus causing hepatitis among younger children, CDC is still working to figure out," said Dr. Becky Blackwell, Chief Medical Officer at Centura St. Anthony Summit Hospital.

The state health department said 2 of the 13 cases tested positive for adenovirus. While some children haven't tested positive, it is suspected to be involved in some capacity.

"Early signs of hepatitis is pretty vague so it can be a little hard to detect. Generally not feeling well, fever, stomach ache, vomiting, and diarrhea. All of those can be early signs of hepatitis. It is very generalized and vague which makes hepatitis hard to identify in the early stages," said Blackwell.

Hepatitis may be rare among children, but Blackwell says parents should be aware of the more severe symptoms like fatigue, loss of appetite, jaundice (yellowing of the skin or eyes), or colorless stool.

"The CDC and health department are both recommending testing for adenovirus for children under ten who present with hepatitis of unknown cause," said Blackwell.

CDC continues to examine possible causes, including testing for and ruling out some of the viruses that commonly cause hepatitis (hepatitis A, B, C, D, and E).

"CDC's investigation is pursing four lines of investigation. First, we are working to better understand if this is a true increase in the number of cases among children or an existing pattern that has been revealed in the improvement of detecting cases. Second, we are collaborating closely with clinicians and public health departments nationwide to identify and investigate potential cases with unknown origin. Third, we are actively investigating to identify potential causes and factors, and rule out others. As we better understand the situation, we'll be able to further refine our guidance and implement potential interventions. Four, we are looking at lab testing to look more closely at the geno and other pathogens," said Jay Butler, M.D., Deputy Director for Infectious Diseases.

"These cases do not constitute an "outbreak" yet, but that clusters of illness, such as the one first reported in Alabama earlier this month, are "unusual," said Dr. Umesh Parashar, M.D., Chief, Viral Gastroenteritis Branch, Division of Viral Diseases.

The state's hepatitis cases will be recorded every Thursdays on the website. [cdphe.colorado.gov] CDC will provide updates on their investigation here.