They warn of cases of hepatitis in minors in the US 0:35
(CNN) --
The US Centers for Disease Control and Prevention (CDC) is investigating cases of hepatitis of unidentified origin in minors.
Up to 109 cases are being analyzed.
On Friday, the CDC reported that these cases have affected fewer than 25 states and US territories.
Almost all minors have had to be hospitalized;
five have lost their lives, according to the CDC.
The rise in these serious and mysterious cases has prompted the CDC to issue a Physician Health Warning for health care providers to be vigilant and report cases.
What is hepatitis?
Symptoms, treatment and risks
What should parents know about cases of hepatitis in minors?
To what extent should they worry and what are the symptoms they should pay attention to?
Is there a relationship between cases of hepatitis and covid-19?
To help answer these questions, I spoke with Dr. Leana Wen, a CNN medical analyst, emergency room physician, and professor of health policy and management at the George Washington University Milken Institute School of Public Health.
She is also the author of "Lifelines: A Doctor's Journey in the Fight for Public Health" and the mother of two young children.
CNN: Let's start at the beginning. What is hepatitis and how common is it in children?
Dr. Leana Wen:
Hepatitis is an inflammation of the hepatic (liver) tissue.
There are several causes.
People may have heard of hepatitis A, B, and C, which are liver infections caused by the contagious hepatitis viruses.
Excessive alcohol consumption, certain medications, and specific toxins can also cause hepatitis, as can some diseases.
There is also so-called autoimmune hepatitis, in which the body's own immune system attacks the liver.
Hepatitis is not common in children, especially hepatitis that is not related to one of the hepatitis viruses.
That is why these cases have been indicated as of unexplained origin until now.
There are not many cases, but they are significant enough to warrant further investigation.
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CDC Releases Details on Hepatitis Cases of Unknown Cause in Children: Some Have Vomiting, Diarrhea, Respiratory Symptoms and Enlarged Liver
CNN: How many children have been affected by hepatitis of unknown origin so far, and what do we know about them?
Wen:
As of May 1, the World Health Organization (WHO) has reported at least 228 probable cases of childhood hepatitis, with dozens more under investigation.
These cases have been detected in more than 20 countries.
Twenty-five states and US territories have reported cases, with 109 cases under investigation so far, according to the CDC.
A week ago, a CDC report looked at clinical details from one state, Alabama, that has been tracking these childhood hepatitis cases since October.
Nine children with no clear causes of hepatitis were identified.
They come from different parts of the state and no relationship between them has been identified.
All are generally healthy with no underlying medical conditions.
The reported average age is about 3 years, with a range of 1 to 6 years of age.
Three of the nine Alabama children ended up with acute liver failure, a life-threatening condition.
Two have received liver transplants.
According to the CDC, all nine children are currently recovering, including those who received a liver transplant.
CNN: How come there are so many cases in one state?
Wen:
We don't know.
My guess is that there is not necessarily something specific to Alabama, but there are possibly cases that are not being reported in other states.
That is why the CDC issued the health advisory, so that doctors are aware and report these cases if they see them.
The UK was the first to report the cases to the WHO.
They have been actively searching.
Its Health Security Agency has identified at least 163 confirmed cases in England, Scotland, Wales and Northern Ireland.
It's possible that now that US doctors are aware, more cases will be reported here as well.
CNN: What do we know about the causes of these hepatitis cases?
Wen:
When patients show signs of hepatitis, they are usually given a diagnostic test to see if they have hepatitis A, B, or C;
if they have been exposed to toxins and medications;
if they have certain autoimmune markers, etc.
So far, all these tests have been negative in minors.
One of the common threads among the nine initial cases from Alabama that appear in the CDC report is that they all have blood tests that show an adenovirus infection.
(Two more children have been identified since those nine cases were first reported.)
Given the possible relationship, this is why the CDC has issued its specific health alert.
He advises doctors to watch for cases of childhood hepatitis and report them immediately to the CDC and state health authorities.
It also directs health care providers to order specific adenovirus tests in these children.
CDC investigates more than 100 cases of unexplained hepatitis in children, including 5 deaths
CNN: Could these cases be related to covid-19?
Wen:
It seems unlikely.
None of the children in the Alabama case series are in the hospital due to a COVID-19 infection.
There is also no relationship with having received the covid-19 vaccine.
The UK Health Security Agency previously reported that none of its more than 100 cases to date had been vaccinated.
CNN: How concerned should parents be and what symptoms should they watch for?
Wen:
These cases of hepatitis of unknown origin in minors are still very rare.
However, some have been extremely serious.
Parents should not be overly concerned, but they should know that this is something that is being investigated and that they should contact their doctor if they are concerned.
The early symptoms of hepatitis are nonspecific, which means that many people have these symptoms for other reasons.
Some symptoms are: nausea, vomiting, abdominal pain, fever, fatigue, loss of appetite and joint pain.
Later signs include dark urine and light-colored stools, as well as jaundice, when the skin and whites of the eyes turn yellow.
Many children suffer from viral illnesses that can cause gastrointestinal upset, fever, and fatigue.
If your child can't keep fluids down, it's a sign that you should contact your child's doctor.
Also, if symptoms persist and don't improve, or if your child becomes lethargic, contact your doctor.
The most concerning signs are if you start to see dark urine, light-colored stools, and yellowing of the skin or the whites of the eyes.
You should seek immediate medical attention if your child begins with general viral symptoms and then progresses to these signs.
CNN: Can anything be done to prevent these cases of hepatitis?
Wen:
As the cause remains unknown, we cannot say what measures will help prevent them.
If, indeed, there is a link to adenovirus, then the same strategies we have been using throughout the coronavirus pandemic, such as thorough handwashing with soap and water and urging people to stay home when they are sick, would be helpful. ill.
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