Data shows no increase in pediatric hepatitis, adenovirus 40/41 compared to pre-pandemic levels

Recently, Morbidity and Mortality Weekly Report announced data that it could not demonstrate an increase in pediatric hepatitis or adenovirus types 40/41 above pre-COVID-19 pandemic baseline levels.

This report comes after the Centers for Disease Control and Prevention (CDC) issued a request in April 2022 for health care providers to report cases of pediatric hepatitis of unknown etiology.

Anita K. Kambhampati, MPH, division of viral disease at the CDC National Center for Immunization and Respiratory Diseases, and colleagues evaluated trends in pediatric hepatitis-associated emergency room visits and hospitalizations, liver transplants, and stool testing for adenovirus type 40/41. To do this, they used data from the National Syndromic Surveillance Program (NSSP), the Premier Healthcare Database Special Release (PHD-SR), the Organ Procurement and Transplant Network (OPTN), and Labcorp.

Electronic health data from emergency departments (ED) across all 50 states and the District of Columbia, supplied by NSSP, linked visits to hepatitis of unspecified etiology among children aged 0 to 4 and 5 to 11 from January 2018 to March 2022. These cases were identified by the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-100CM) discharge diagnosis codes.

Additionally, data from OPTN on pediatric liver transplants in those 18 and younger in the US from January 2017 to March 2022 with acute hepatic necrosis of unknown etiology was collected. Labcorp also accessed data on all stool specimens tested for adenovirus 40/41 on June 6, 2022.

Kambhampati et al reported that from October 2021 to March 2022 there was no increase in weekly ED visits with hepatitis-associated discharge codes compared with pre-COVID-19 pandemic baseline levels. There were no significant changes in hepatitis-associated hospitalizations in the same time period compared to the months before the pandemic in children 0 to 4 (22 and 19.5, respectively) or 5 to 11 years (12 and 10.5, respectively), according to the CDC.

Data from October to March 2017 to 2018, 2018 to 2019, and 2019 to 2020, showed that the percentage of stool specimens positive for adenovirus types 40/41 ranged from 5% to 19% in those 0 to 4 years and 3% to 14% in children 5 to 9 years old. From October 2021 to March 2022, the percentage of specimens positive for adenovirus types 40/41 returned but did not exceed pre-pandemic levels for both groups. This is after a drop in testing volume and percentage of positive specimens from April 2020 to September 2021.

Reference:

Trends in acute hepatitis of unspecified etiology and adenovirus stool testing results in children. Centers for Disease Control and Prevention. Published June 17, 2022. Accessed June 21, 2022. https://www.cdc.gov/mmwr/volumes/71/wr/mm7124e1.htm