Trends in Acute Hepatitis of Unspecified Etiology and Adenovirus Stool Testing Results in Children — United States, 2017–2022

Abstract

https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_462.pdf † Since April 2022, providers have been encouraged to report to public health authorities persons under investigation for acute hepatitis meeting the following definition: children aged <10 years with elevated aspartate aminotransferase or alanine aminotransferase levels (>500 U/L) with an unknown etiology for their hepatitis since October 1, 2021.

Severe Acute Hepatitis in Children of Unknown Etiology

“…3 Recent data from the US has not found an increase in hepatitis-associated emergency department visits, hospitalizations or liver transplants compared to pre-COVID-19 pandemic baseline levels. 5 That said, within the reported number of cases, it is possible that some new etiologies could exist.…”

“…4 Notably, recent data from the US did not find an increase in hepatitis-associated emergency department visits, hospitalizations or liver transplants compared to pre-COVID-19 pandemic baseline levels. 5 In addition, the incidence of pediatric acute liver failure (PALF; also referred to as fulminant liver failure or fulminant hepatitis), the most severe phenotype of severe acute hepatitis in children, remains uncertain, despite the availability of a clear definition. 6 INR values, the key indicator of liver synthetic function used to assess for PALF, were not provided in either of the 2 initial reports, 1,2 although data are emerging in more recent reports from transplant centers.…”

Interim Analysis of Acute Hepatitis of Unknown Etiology in Children Aged <10 Years — United States, October 2021–June 2022

“…Current U.S. data do not suggest an increase in pediatric hepatitis of unknown etiology or percent positivity for adenovirus types 40/41 over baseline levels (8). Additional hypotheses are under investigation, including the potential role of previous SARS-CoV-2 infection and adeno-associated virus-2, a nonpathogenic parvovirus that has been detected in a high proportion of cases in the United Kingdom (9).…”

Severe acute hepatitis of unknown cause in children

“…In the United States, hepatitis-associated emergency department visits, hospital admissions and transplantations have not increased compared with pre-COVID-19 pandemic levels. 6 However, at least 46 children have required transplantation and 22 have died since Oct. 1, 2021. 1…”

“…In the United States, hepatitis-associated emergency department visits, hospital admissions and transplantations have not increased compared with pre-COVID-19 pandemic levels. 6…”