To assist reply these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency doctor and professor of well being coverage and administration on the George Washington College Milken Institute College of Public Well being. She can also be writer of “Lifelines: A Physician’s Journey within the Combat for Public Well being” and the mom of two younger youngsters.

Dr. Leana Wen: Hepatitis is an irritation of the liver tissue. There are a variety of causes. Individuals might need heard of hepatitis A, B and C, that are liver infections attributable to the contagious hepatitis viruses. Heavy alcohol use, sure medicines and particular toxins may also result in hepatitis, as can some medical situations. There’s additionally one thing known as autoimmune hepatitis, which is the place the physique’s personal immune system assaults the liver.

Hepatitis is not widespread in youngsters, particularly hepatitis that’s not linked to one of many hepatitis viruses. That is the explanation why the instances of unexplained hepatitis have been flagged to date. There aren’t many instances, however they’re important sufficient to warrant nearer investigation.

CNN: What number of youngsters have been affected by the unexplained hepatitis to date, and what can we learn about them?

9 youngsters have been recognized who haven’t any clear causes of hepatitis. They arrive from completely different places within the state with no recognized hyperlink to 1 one other. All are typically wholesome, no underlying medical situations. The reported median age is about 3 years, with the vary from 1 to six years outdated.

Three of the 9 youngsters within the Alabama cohort ended up with acute liver failure, a life-threatening situation. Two have obtained liver transplants. In response to the CDC, all 9 of the youngsters are presently recovering, together with these with the liver transplants.

CNN: How come there are such a lot of instances from one state?

Wen: We do not know. My guess is that there is not essentially one thing particular to Alabama, however presumably there are instances that aren’t being reported in different states. That is why the CDC issued its well being advisory, in order that clinicians might be conscious and flag these instances in the event that they see them.

CNN: What can we learn about what causes these hepatitis instances?

Wen: When sufferers current with indicators of hepatitis, they’d usually get a diagnostic workup that appears at whether or not they have hepatitis A, B or C; whether or not they have been uncovered to toxins and medicines; whether or not they have sure autoimmune markers; and so forth. All of those are adverse within the youngsters to date.

One commonality among the many preliminary 9 instances in Alabama within the CDC report is that every one have bloodwork displaying adenovirus an infection. (Two extra youngsters have been recognized since these 9 instances have been first reported.)

CNN: Might these instances be associated to Covid-19?

Wen: It appears unlikely. Not one of the youngsters within the Alabama case collection are within the hospital due to a Covid-19 an infection. There’s additionally no hyperlink with having obtained the Covid-19 vaccine. The UK Well being Safety Company beforehand reported that none of its over 100 instances to this point had been vaccinated.

CNN: How nervous ought to dad and mom be, and what are signs they need to be looking out for?

Wen: These instances of unexplained hepatitis in youngsters stay very uncommon. Nonetheless, some have been extraordinarily critical. Mother and father shouldn’t be overly involved however ought to know that that is one thing underneath investigation after which ought to contact their physician if they’re involved.

Preliminary signs of hepatitis are nonspecific, that means that lots of people get these signs on account of different causes. They embrace nausea, vomiting, stomach ache, fever, fatigue, lack of urge for food and joint ache. Later indicators embrace darkish urine and light-colored stools as (effectively as) jaundice — the pores and skin turning yellow and yellow being seen within the whites of the eyes and eyelids.

A number of youngsters have viral sicknesses that may trigger gastrointestinal upset, fever and fatigue. In case your baby is unable to maintain fluids down, that is an indication that it’s best to contact your physician. Additionally, if the signs are persistent and never getting higher, or in case your baby begins getting torpid, contact your physician.

Probably the most regarding indicators are in the event you begin seeing darkish urine, light-colored stools and yellowing of the pores and skin or yellowing within the whites of the eyes. You must search instant medical consideration in case your baby begins common viral signs after which proceeds to having these indicators.

CNN: Is there something that may be executed to stop these hepatitis instances?

Wen: Because the trigger stays unknown, we will not say what measures will assist forestall them. If, certainly, there’s a hyperlink to adenovirus, then the identical methods we have now been utilizing all through the coronavirus pandemic could be useful, resembling thorough handwashing with cleaning soap and water and urging folks to remain house when sick.