By Clair McFarland, Cowboy State Daily
Although three neighboring states have seen the mysterious hepatitis cases in children now being reported nationally, the phenomenon hasn’t hit Wyoming.
In a May 6 press conference Dr. Jay Butler, deputy director of the Centers for Disease Control and Prevention, listed 25 U.S. states and territories in which acute hepatitis has been diagnosed in children. The cause is not yet known.
Among those states are Wyoming neighbors Idaho, Nebraska, and Colorado. Children in nearby North Dakota have also been diagnosed with the illness.
Of 109 cases currently being investigated by CDC, five children have died of acute hepatitis, but Butler would not say which states the fatalities occurred in because he was concerned about preserving patient privacy with “such a small number” of fatalities.
Of the infected children, 90% have been hospitalized and 14% have received liver transplants. Hepatitis can cause liver failure.
Hepatitis can be caused by known hepatitis viruses such as Hepatitis A, B, C, D, or E, but in these pediatric cases affecting children roughly 2 years of age, the cause is unknown.
Most of the children being investigated also have a particular strain of adenovirus – adenovirus 41 – that usually only causes hepatitis in immunocompromised people.
But Butler said the infected children were healthy before their livers started shutting down.
There has been no sign of the illness in Wyoming, according to the state Department of Health.
“Wyoming has had no reported pediatric cases of the hepatitis of current interest,” Kim Deti, a department spokeswoman, told Cowboy State Daily.
Deti said WDH issued a document to health care providers last month to watch out for hepatitis symptoms and informed the department of “testing recommendations.”
The document urged clinicians watch patients for loss of appetite, fever, fatigue, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain and jaundice, or yellowish coloration. All are hepatitis symptoms.
Adenovirus symptoms also are included in the notice. While many adenoviruses cause respiratory symptoms, the strain identified in the majority of the 109 child hepatitis sufferers cause stomach issues, such as vomiting and diarrhea. It can be accompanied by respiratory symptoms as well.
Wyoming clinicians have been advised to test for adenovirus in children with hepatitis of unknown cause, to inform WDH of any children under 10 with a high enzyme count indicating liver damage and to “save samples” from hepatitis-suffering children under medical care.
Clinicians also were told to report prior cases dating back to October of last year.
Butler told reporters May 6 that the CDC and clinicians are investigating many potential causes of the hepatitis.
He emphasized that the first nine children diagnosed with the illness in the country, in Alabama, were not vaccinated for COVID-19. They also had no known history of COVID-19.
The median age of the 109 infected children is 2, Butler said, so most would not be eligible for the COVID-19 vaccination.
According to news reports, the United Kingdom identified cases of pediatric hepatitis on April 5, about two weeks before the first cases were identified in the United States.
Many of the UK children had access to dogs, but Butler would not attribute the illness to the presence of dogs or any other environmental factor. He added environmental factors are among the many causes being considered.
Butler said the number of acute hepatitis cases in children is not above the baseline, or unusually high compared to years past. But he said officials are taking notice because of the apparent link between hepatitis and adenovirus, which spreads easily.
The WDH said in its notice to Wyoming doctors last moth that adenovirus spreads by close personal contact, respiratory droplets, and “fomites,” or carriers of infection.
“There is no specific treatment for adenovirus infections,” the notice reads.