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There has been an outbreak of hepatitis among 109 children, including 5 deaths sparking an investigation by the CDC.

The CDC is investigating 109 cases of severe hepatitis in children, including five deaths, Jay Butler, the CDC’s deputy director of the public health agency announced in April. Out of those 109 children, 90% were hospitalized while 14% of them required a liver transplant.

More than half of the children affected were confirmed to have an adenovirus infection. CDC officials said they don’t know yet if adenovirus is the actual cause though.

“We also don’t know yet what role other factors may play, such as environmental exposures, medications, or other infections that the children might have,” Dr. Jay Butler, deputy director for infectious diseases at the CDC, told reporters.

Jay Butler, the CDC’s deputy director for infectious diseases, said the cases date back to October and were found in 24 states and one territory.


Medical specialists have stated that the more common causes of viral hepatitis have not been found. Officials do not yet know what role other factors, such as environmental exposure, medications or other infections might play in the illnesses.

“This is a very rare presentation of a common scenario,” said Helena Gutierrez, a pediatric gastroenterologist at Children’s of Alabama.

Nine children were diagnosed at the hospital between October and February, all of whom were previously healthy and had the adenovirus in their blood, officials said. Some of them had adenovirus 41, which typically causes stomach illness and can cause hepatitis in immunocompromised children — though none of the children in Alabama were immunocompromised, officials said.

“Kids get sick, they get viruses,” she said.

Gutierrez, who was involved in treating all nine cases, said there have been no cases since February at Children’s. Although two of the nine children needed liver transplants, all have recovered or are recovering.

CDC officials announced that the children who developed the virus in Alabama had a median age of 2. None of them were infected with covid-19 or had a history of having had covid-19. None of the children in Alabama had received a coronavirus vaccine due to their age.

“Covid-19 vaccination is not the cause of these illnesses,” Butler said. “We hope that this information helps clarify some of the speculation circulating online.”

The symptoms of hepatitis include vomiting, dark urine, light-colored stool, and yellowing of the skin. Parents should contact their health provider with any concerns.

He said the cases have been found in the following states and territories: Alabama, Arizona, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Michigan, Minnesota, Missouri, North Carolina, North Dakota, Nebraska, New York, Ohio, Pennsylvania, Puerto Rico, Tennessee, Texas, Washington, and Wisconsin.

As of May 1, the World Health Organization has recorded more than 220 cases in 20 countries in children ages 1 month to 16 years. An additional 50 cases are under investigation, according to a WHO media briefing.

Officials urged clinicians to be alert for cases.

“Typically we don’t report cases of acute liver failure to any kind of public agency,” Gutierrez said. “Because it is under investigation, cases are going to come to the surface; people are going to be testing for adenovirus.”

“It could be that we miss many cases of adenovirus-associated hepatitis in otherwise healthy kids because we don’t check for it and the children recover uneventfully,” Ryan Fisher, a pediatric gastroenterologist and transplant hepatologist at Children’s Mercy in Kansas City said.

Doctors may now go back to earlier cases that were resolved and check samples to see whether there is evidence of the virus.

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