4 Cases Of Unusual Hepatitis In Children Found In Wisconsin

WISCONSIN — Wisconsin health officials are investigating the cause of significant liver damage in four children, one of whom died, the state Department of Health Services announced Wednesday.

In the other three cases of liver inflammation, or hepatitis, two of the children had severe outcomes, and one required a liver transplant. Wisconsin is the fourth state investigating cases involving hepatitis in children that do not seem to have been caused by common hepatitis viruses: hepatitis A, B, C, D or E.

Alabama reported nine similar cases between November and February, including two that required liver transplants. Earlier this week, Illinois reported three cases and North Carolina reported two.

The cases are part of a growing trend in other countries involving acute hepatitis of unknown origin. The World Health Organization announced that as of April 21, there were 169 such cases in 11 countries, mostly in the United Kingdom, which had reported 114 cases. Other countries reporting cases include Spain, Israel, the U.S., Denmark, Ireland, The Netherlands, Italy, Norway, France, Romania and Belgium. Of those, 17 needed liver transplants, and one died.

Adenovirus, which was confirmed in 74 of those cases, is a possible link, but officials are still investigating the causative agent. Adenovirus type 41, the implicated adenovirus type, has not previously been linked to hepatitis in otherwise healthy children, according to WHO.

The Wisconsin Department of Health Services issued a health advisory urging state doctors to report additional cases of hepatitis of unknown cause in children under 16 and to encourage adenovirus testing in those cases.

In Alabama, five of the nine specimens that were sequenced positively identified for adenovirus type 41 infection.

In the United Kingdom, adenovirus was found 40 of the 53 specimens tested compared with just 10 in 60 for coronavirus, which is consistent with community transmission of COVID-19 in the country, according to a report from the UK Health Security Agency. The cases are primarily in children under 5 years old.

Adenoviruses spread from person to person and commonly cause respiratory illness but can also cause other illnesses such as gastroenteritis, pink eye and bladder infection. It is unclear how adenoviruses might cause hepatitis, and it could be one factor alongside others that lead to the acute liver problems, according to WHO.