Nine Alabama children have become ill with a seemingly mysterious case of hepatitis and two of the children now need liver transplants, according to the Centers for Disease Control and Prevention.

The CDC announced Friday that it believes it may have uncovered the cause for the cases — adenovirus.

Adenovirus causes a variety of illnesses, including the common cold, bronchitis, pneumonia and conjunctivitis.

The nine children who fell ill with hepatitis, which is an inflammatory condition of the liver, were previously healthy and between the ages of one and six. According to the findings released Friday, the children have either recovered or are on the road to recovery.

The CDC began ruling out possible causes after the first cases started cropping up in the state this last fall. It ruled out hepatitis A, B and C; COVID-19; autoimmune hepatitis and Wilson disease.

All nine children, who were diagnosed with hepatitis since last fall, tested positive for adenovirus while six tested positive for Epstein-Barr virus but did not have antibodies, meaning they had an earlier infection that was not active.

Lab tests showed some of the children had adenovirus type 41, which usually causes acute inflammation of the stomach and small intestine in children.

Some showed a history of other viruses, including enterovirus/rhinovirus, metapneumovirus, respiratory syntactical virus, and human coronavirus OC43.

Two of the children needed liver transplants and three developed liver failure, according to the CDC’s recently released study.
Most of the children experienced vomiting and diarrhea, while some had upper respiratory symptoms before being hospitalized.
Most of the children had yellowing eyes, yellowing skin and an enlarged liver while hospitalized.

The CDC is unclear if the Alabama cases are linked to other childhood hepatitis cases reported in Europe, although it said it is in contact with European health officials “to understand what they are learning.”