The Wisconsin Department of Health Services (DHS) has issued an advisory through its Health Alert Network notifying clinicians and public health authorities of a recent increase in cases of acute hepatitis and adenovirus in children.
The bulletin was issued Wednesday, April 27.
According to the bulletin: “From November 2021 to February 2022, clinicians at a large children’s hospital in Alabama identified nine pediatric patients with significant liver injury, including three with acute liver failure, who also tested positive for adenovirus. All children were previously healthy. All five of the nine specimens that were sequenced had adenovirus type 41 infection identified. Two patients required liver transplant; no patients died.
“Since being notified of this adenovirus-associated hepatitis cluster, DHS is now investigating at least four similar cases among children in Wisconsin. This includes two children who had severe outcomes, one liver transplant, and one fatality.”
The full text of the alert is here: https://content.govdelivery.com/accounts/WIDHS/bulletins/3154f31.
Additionally, earlier information provided on the Center for Disease Control and Prevention (CDC) and DHS websites describes a nationwide outbreak of hepatitis A.
According to information found on the CDC’s website, outbreaks of the disease were first identified in 2016. Since then, as of April 29, 2022, 44,217 cases have been reported nationwide, with 27,022 or 61% of those cases requiring hospitalization. There have been 420 deaths.
Information supplied by the CDC further notes that since March of 2017, the center’s Division of Viral Hepatitis (DVH) has been assisting multiple state and local health departments with hepatitis A outbreaks, which, the center notes, is spread through person-to-person contact.
A map on the CDCs website shows the number of cases within each state that have been determined to be associated with the nationwide outbreak. Data is current as of April 29. According to the map, there have been no publicly reported cases in Wisconsin of hepatitis A that are associated with the outbreak.
According to the update: “‘Outbreak-associated’ status is currently determined at the state level in accordance with each state’s respective outbreak case definition.”
A link to the CDC update, titled: “Widespread person-to-person outbreaks of hepatitis A across the United States” is here: https://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm.
According to information found on the Wisconsin DHS website, the state is not having an outbreak, but the information notes: “we are monitoring for cases throughout the state.”
Information on the DHS website notes the following as people who are at a “higher risk” for hepatitis A:
• People who use drugs (injection or non-injection)
• People experiencing unstable housing or homelessness
- Men who have sex with men
- People who are currently or were recently in jail or prison
- People with chronic liver disease, including cirrhosis, hepatitis B or Hepatitis C
According to the website, “The single best way to prevent a hepatitis A infection is by getting vaccinated against the virus. The vaccine is recommended for all children one year of age or older and other groups of people who are at high risk for getting hepatitis A. Also, it is always important to wash your hands properly after using the toilet, changing diapers, and before touching any food.”
The website also states: “Hepatitis A is a liver infection that is caused by the hepatitis A virus. Anyone can get hepatitis A, but children and people who live in, or travel to, countries where hepatitis A is common are more likely to get it. Once you have had hepatitis A, you cannot get sick from it again.
“There are approximately 10–30 cases of hepatitis A reported in Wisconsin each year. Hepatitis A rates in the U.S. have declined by more than 95% since the hepatitis A vaccine first became available in 1995. There have been multi-state outbreaks in recent years.”
Information about hepatitis A as cited on the DHS website, is here: https://www.dhs.wisconsin.gov/viral-hepatitis/hav.htm.
The above graphic, found on the CDCs website, shows the number of hepatitis A cases associated with a nationwide outbreak. The data is current as of April 29. According to the update: “‘Outbreak-associated’ status is currently determined at the state level in accordance with each state’s respective outbreak case definition.” A link to the CDC update, titled: “Widespread person-to-person outbreaks of hepatitis A across the United States” is here: https://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm.
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