The CDC issued an alert on April 21 so doctors would be on the lookout for hepatitis in children. Physicians at the University of Alabama at Birmingham said in a press briefing on April 25 that they had not identified any more cases since they issued a statewide alert in February. They added that parents do not need to panic, as these cases are very rare, but people should seek medical attention if a child shows signs of liver disease, such as the yellowing of the skin or eyes, along with the more common symptoms such as diarrhea, vomiting, fever, or coughing and sneezing.
A CDC spokesperson told us that the agency has received additional reports from providers as a result of the nationwide health advisory and was working to determine if any met the current case definition.
Other states, meanwhile, have reported their own potential cases, including Wisconsin, Illinois and North Carolina.
Worldwide, the largest outbreak has been in the U.K., which identified 145 cases this year, through April 29, “predominantly” in children under the age of 5. As in the U.S., children in the U.K. aren’t eligible for COVID-19 vaccination until they turn 5.
The U.K. Health Security Agency wrote in an April 25 update, “There is no link to the coronavirus (COVID-19) vaccine. None of the currently confirmed cases in under 10 year olds in the UK is known to have been vaccinated.”
As of April 21, the WHO reported at least 169 hepatitis cases in children 16 years of age and younger in 11 European countries and the U.S. Adenovirus was detected in “at least 74 cases,” the WHO report said, and “of the number of cases with information on molecular testing, 18 have been identified as F type 41.” In those that were tested, 20 children were positive for SARS-CoV-2 and 19 children were coinfected with SARS-CoV-2 and adenovirus.
The WHO has said there is no evidence that COVID-19 vaccination is related in any way to the hepatitis. “Hypotheses related to side effects from the COVID-19 vaccines are currently not supported as the vast majority of affected children did not receive COVID-19 vaccination,” the agency said in its April 23 disease outbreak report.
In an April 28 live Q&A, WHO officials repeated that there is nothing to support a link to the COVID-19 vaccines, as most of the children with hepatitis haven’t been vaccinated, nor are they eligible to be vaccinated yet, because of their age.
Since so many of the children have tested positive for an adenovirus, many investigators consider the virus a top contender to explain the hepatitis. But even if that’s the case, it’s likely there are other factors involved. Experts remain open to other possibilities as well, as the cause is still very much an open question.
“The leading hypothesis at present is that the hepatitis is linked to adenovirus,” a U.K. technical report from April 25 reads. “There may be a cofactor causing a normal adenovirus to produce a more severe clinical presentation in young children, such as increased susceptibility due to reduced exposure during the pandemic, prior SARS-CoV-2 or other infection, or a yet undiscovered coinfection or toxin. Alternatively, there may have been emergence of a novel adenovirus strain with altered characteristics.”
Similarly, the European CDC wrote in an April 28 risk assessment that “the current leading hypothesis is that a cofactor affecting young children having an adenovirus infection, which would be mild in normal circumstances, triggers a more severe infection or immune-mediated liver damage. Other aetiologies (e.g. other infectious or toxic agents) are still under investigation and have not been excluded but are considered less plausible.”
The WHO outbreak alert noted that adenovirus infection “does not fully explain the severity of the clinical picture,” since infection with adenovirus type 41, “the implicated adenovirus type, has not previously been linked to such a clinical presentation.” Adenoviruses, WHO explains, are quite common, but typically are self-limiting and cause respiratory or gastrointestinal symptoms, or sometimes conjunctivitis, or pink eye.
One possible reason for why children could be more susceptible to adenoviruses now could be because they were exposed to them less over the past several years as people spent more time apart during the pandemic. As a result, kids would have less immunity to adenoviruses.
“Factors such as increased susceptibility amongst young children following a lower level of circulation of adenovirus during the COVID-19 pandemic, the potential emergence of a novel adenovirus, as well as SARS-CoV-2 co-infection, need to be further investigated,” the report said, adding that both the U.K. and the Netherlands have reported increases in community adenovirus infections “following low levels of circulation earlier in the COVID-19 pandemic.”
Regardless of the cause, physicians encourage parents and children to wash their hands and practice good hygiene, which can help avoid the spread of adenoviruses as well as other infectious agents.
Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.
Sources
“Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology” (CDCHAN-00462). CDC Health Alert Network. 21 Apr 2022.
“Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland.” World Health Organization. Disease Outbreak News. 15 Apr 2022.
“Multi-Country – Acute, severe hepatitis of unknown origin in children.” World Health Organization. Disease Outbreak News. 23 Apr 2022.
“Hepatitis.” MedlinePlus. National Library of Medicine. Accessed 2 May 2022.
“Hepatitis.” WHO Q&A. 1 Sep 2019.
“Adenovirus Infections.” Children’s Hospital of Philadelphia. Accessed 2 May 2022.
“Adenovirus.” Nemours KidsHealth. Accessed 2 May 2022.
“Adenoviruses.” National Center for Immunization and Respiratory Diseases, Division of Viral Diseases. CDC. Accessed 2 May 2022.
“Understanding Viral Vector COVID-19 Vaccines.” CDC. Updated 14 Mar 2022. Accessed 2 May 2022.
“Is it true? Does the Vaxzevria (AstraZeneca) vaccine contain animal DNA?” Department of Health, Commonwealth of Australia. Updated 4 Sep 2021.
Robertson, Lori. “A Guide to Johnson & Johnson’s COVID-19 Vaccine.” FactCheck.org. Updated 15 Apr 2022.
Corum, Jonathan and Carl Zimmer. “How the Johnson & Johnson Vaccine Works.” New York Times. Updated 7 May 2021.
“COVID-19 Vaccine Recommendations for Children and Teens.” CDC. Updated 6 Apr 2022.
“Viral Vector Vaccines.” COVID-19 Real-Time Learning Network, Updated 22 Feb 2022. Infectious Diseases Society of America.
“Information for UK recipients on COVID-19 Vaccine AstraZeneca (Regulation 174).” Updated 26 Jan 2022. Medicines & Healthcare Products Regulatory Agency. GOV.UK.
Baker, Julia M. et al. “Acute Hepatitis and Adenovirus Infection Among Children — Alabama, October 2021–February 2022.” MMWR. 29 Apr 2022.
“CDC Alerts Providers to Hepatitis Cases of Unknown Origin.” Press Release. CDC. 21 Apr 2022.
Grusich, Katherina. CDC public affairs officer. Email to FactCheck.org. 29 Apr 2022.
Buckley, Katie. Spokesperson for Johnson & Johnson. Email to FactCheck.org. 28 Apr 2022.
CDC Media Statement. “Proactive Statement: MMWR on children with acute hepatitis and adenovirus infection in Alabama.” Email to FactCheck.org. 29 Apr 2022.
Echols, Hannah. “New adenovirus strain potentially linked to pediatric hepatitis outbreak in Alabama.” University of Alabama News. 25 Apr 2022.
“Wisconsin DHS Health Alert #42: Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology.” Wisconsin Department of Health Services. 27 Apr 2022.
“Increase in hepatitis (liver inflammation) cases in children under investigation.” UK Health Security Agency. Updated 29 Apr 2022.
“IDPH Issues Warning About Three Potential Cases of Severe Hepatitis in Children in Illinois.” Press Release. Illinois Department of Public Health. 25 Apr 2022.
Branswell, Helen. “N.C. becomes second U.S. state to report unusual cases of hepatitis in kids.” STAT. 21 Apr 2022.
“LIVE Q&A on acute, severe hepatitis of unknown origin in children.” Live stream from WHO. Available on YouTube. 28 Apr 2022.
“Investigation into acute hepatitis of unknown aetiology in children in England.” Technical briefing. UK Health Security Agency. 25 Apr 2022.
“Increase in severe acute hepatitis cases of unknown aetiology in children.” Risk assessment. European Centre for Disease Prevention and Control. 28 Apr 2022.
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