Expert Interview

Everything To Know About The Unexplained Rise In Pediatric Hepatitis Cases

We asked renowned pediatricians to unpack this worrisome outbreak, from symptoms to the likelihood your child could catch the mysterious infection.

A rise in unexplained pediatric hepatitis cases has led to an uptick in child hospitalizations.
aquaArts studio/E+/Getty Images

By now, you've likely heard about the unexplained rise in pediatric hepatitis cases impacting children between the ages of one and six — not just in the U.S. but in other countries such as Spain, Denmark, the Netherlands, and the U.K. On May 6, the Centers for Disease Control and Prevention (CDC) announced that it's currently investigating more than 100 cases in kids across multiple states. Of the roughly 109 reported cases, CNBC reports that the agency noted more than 90 percent required hospitalization. Five children have died as a result of complications from the virus.

Naturally, health officials, doctors, and parents alike are on high alert, particularly given that these cases have seemingly come out of nowhere and are causing severe illness in otherwise healthy children. Before you panic, it's worth noting that even amid the current outbreak, pediatricians say it's still "very rare" that your little one will develop severe symptoms — despite an onslaught of worrying headlines and social media posts. Experts say most afflicted children should recover fully.

But what should parents know about this unexplained spike in pediatric hepatitis? What are the symptoms? Could it be transmitted by the family pet (another recent headline)? To help shine a light on the subject, Scary Mommy spoke with Rebekah Diamond, M.D., an assistant professor of pediatrics at Columbia University and author of the forthcoming book Parent Like a Pediatrician, and Mona Amin, M.D., a board-certified general pediatrician and founder of PedsDocTalk.

What is hepatitis?

First, a brief explainer on what hepatitis actually is and why there might be a current outbreak. "The word 'hepatitis' just means inflammation of the liver," explains Diamond. "There are specific viruses that are famous for causing liver inflammation, and these are commonly referred to as 'hepatitis,' so it's confusing! If you hear about Hepatitis A, B, C, D, or E, this is what that's referring to."

"In children, it's typically caused by viral infections, toxins, medications, or certain medical conditions," adds Amin. "As a parent, you've likely heard of Hepatitis A and B — we have vaccines for those, so hepatitis is not common in children these days, which is the reason for the current media attention."

Has there been any clear pattern in reported cases?

In early April, health care officials in Britain flagged the first cluster of these mystery hepatitis cases. In ruling out typical hepatitis viruses, doctors didn’t find any commonalities in diet, travel, exposure, or underlying risk factors that might explain the outbreak.

At a World Health Organization (WHO) telebriefing on May 10, officials said the number of probable cases of this acute hepatitis in kids has reached 348, reported from 20 countries across the globe. And 70 more cases are currently pending confirmation.

In the U.S., a rash of cases in Alabama between October and February — nine total, with two children ultimately requiring liver transplants — prompted the CDC to issue a nationwide alert about symptoms to watch for in kids.

Yet, no pattern or single cause that would link the cases has been identified. “These are children who have previously been fit and well,” explained Richard Pebody, head of the WHO/Europe High-Threat Pathogens team, during an online question-and-answer session in late April. “This is an unusual phenomenon that we’re seeing, and that’s why we’re alerting parents and public health authorities.”

What could be causing this outbreak?

Much of the current outbreak is still under review by local and national health officials, but Diamond notes, "Hepatitis in children existed long before this current outbreak. It's most commonly due to an unknown reason or a virus — like cytomegalovirus (aka CMV, the group of viruses that cause chickenpox, herpes simplex, and mononucleosis), Epstein-Barr virus (EBV), adenovirus, or many others — that causes liver inflammation. Having one of these common viruses (which usually cause cold or stomach bug symptoms) doesn't mean a kid will have hepatitis; it's a very rare complication. It's not completely clear what is causing the current outbreak, but all signs point to a virus, likely an adenovirus."

"As of now, adenovirus 41 is the suspected strain, though we can't say this for 100 percent certainty, as not all cases of hepatitis have had a positive adenovirus test," adds Amin. "Hepatitis A and B have been ruled out."

What symptoms should parents watch for in their kids?

If your kiddo comes down with something, here's what you should look out for:

  • Yellowing skin and eyes (jaundice)
  • Nausea
  • Diarrhea
  • Vomiting
  • Severe abdominal pain
  • Fever
  • Fatigue
  • Loss of appetite
  • Dark-colored urine
  • Light-colored stools
  • Joint pain
  • Respiratory symptoms like a runny nose, cough, and even pink eye

"Since these symptoms can look like many other illnesses, the top symptoms to look for that would be concerning are signs of jaundice and light-colored stools — those symptoms require immediate medical attention," notes Amin.

While Amin underscores that overall "we still need more information" about this particular outbreak, both docs note that there is no clear link between COVID-19 or the vaccine, as it's believed none of the cases were vaccinated or had COVID at the time of illness.

Amid news reports that the outbreak might be linked to household pet dogs, Diamond says, "It's important to do a thorough investigation and see if any links can be made, but this is very unconvincing as a potential cause," with Amin agreeing that more information is needed.

What should you do if you suspect your child has hepatitis?

If you are concerned at all, Diamond recommends checking in with your pediatrician or family doctor. "Outbreaks of serious and rare viruses are something that simply happen. It's fantastic when this is something we have a vaccine for, like measles, chicken pox, COVID, and flu. But often, these are viruses that we don't have vaccines for, so it's important to prioritize hand washing and staying in touch with your pediatrician if you have any concerns. It's important to remember that this is serious but very rare." She emphasizes that "the best way to prevent unnecessary childhood sickness and/or death and suffering is to stay up to date on all vaccines, including influenza and COVID."

Amin agrees, adding, "I don't want parents to panic as it's still relatively rare, but I do think they should be aware of signs and symptoms. As of now, I don't see a reason to worry ... Good hygiene is always your best bet — hand washing, covering your mouth and nose when you sneeze or cough, leaving your shoes outside, assessing risk vs. benefit at large gatherings, etc. It's not a bad thing if you're extra precautious given we're still in a pandemic, but I am not changing any plans at this point."

Expert Sources:

Rebekah Diamond, M.D., an assistant professor of pediatrics at Columbia University and author of the forthcoming book Parent Like a Pediatrician

Mona Amin, M.D., a board-certified general pediatrician and founder of PedsDocTalk