Is there an increase in pediatric hepatitis of unknown cause in the US?

In early 2022, global health agencies reported clusters of severe acute hepatitis in children that tested negative for common hepatitis viruses A-E. This raised concern about a possible outbreak in the US. However, official US surveillance data through May 2022 found no increase in pediatric hepatitis of unknown cause or adenovirus-related hepatitis compared to pre-COVID-19 pandemic levels ². While individual cases have been reported, the overall rate has not risen above baseline.

What the research says

A US Centers for Disease Control and Prevention (CDC) analysis of national surveillance data from October 2021 to June 2022 found no increase in pediatric hepatitis of unknown cause or adenovirus trends compared with pre-pandemic levels ². Preliminary investigations into US cases during this period did not identify common exposures among affected children ³. A case series from Alabama described children with severe hepatitis and adenovirus infection, but this does not indicate a nationwide increase ¹. Globally, over 1,200 cases were reported across 37 countries by July 2022, with severe outcomes including liver transplants and deaths ⁴. However, most cases occurred in the United Kingdom, not the US ⁵. The cause remains unknown, but hypotheses include a novel adenovirus variant, SARS-CoV-2 coinfection, or autoimmune hepatitis triggered by infection ⁶.

What to ask your doctor

• What signs of hepatitis should I watch for in my child, such as jaundice, dark urine, or abdominal pain?
• Are there any specific tests you recommend if my child develops symptoms of hepatitis?
• Should I be concerned about adenovirus or other viral infections causing liver inflammation?
• How does the current rate of pediatric hepatitis compare to previous years in our area?
• Is there any follow-up needed for children who have had COVID-19 or adenovirus infection?