Nebraska DHHS and Local Health Departments Investigating Pediatric Hepatitis Cases of Unknown Origin

Lincoln, Neb. – On April 21, 2022, the CDC released a Health Alert Network (HAN) Advisory (https://emergency.cdc.gov/han/2022/han00462.asp) describing a cluster of cases of hepatitis (liver inflammation) in children, potentially associated with an adenovirus infection. The Nebraska Department of Health and Human Services (DHHS) and local health departments (LHDs) are investigating nine similar cases of pediatric hepatitis of unknown origin, which were reported by community members and Children’s Hospital.

Among these nine, hepatitis was identified between November 5, 2021, and March 6, 2022. The median age of the patients is two (range = 1 – 9). Three of the nine tested positive for adenovirus. There have been no identified transplants and no identified deaths. Investigations are ongoing.

• Two cases reported in Douglas County
• Two cases reported in Sarpy/Cass jurisdiction
• Two cases reported in East Central jurisdiction
• One case reported in Public Health Solutions jurisdiction
• One case reported in Two Rivers jurisdiction
• One case reported in Southwest jurisdiction

Dr. Matthew Donahue, Nebraska State Epidemiologist said, “Adenoviruses spread through respiratory droplets and through contact with contaminated surfaces. They traditionally cause common colds, diarrhea, and pink eye. It’s not yet clear if these cases of hepatitis are a result of adenovirus infection, a combination of infections, or a factor not yet identified. The unknowns surrounding these cases underscore the role of public health investigations. Clinicians should notify their local public health department if they’re treating a patient less than 10 years of age with hepatitis of unknown origin (AST or ALT >500U/L).”

For more information about symptoms of hepatitis and more information about adenovirus, see CDC’s HAN Advisory: https://emergency.cdc.gov/han/2022/han00462.asp. For a map of Nebraska LHDs, click here.