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Explainer: A child in Tarrant County contracted ‘pediatric hepatitis of unknown origin.’ What is it?

In late May, Tarrant County Public Health reported its first case of a mysterious form of pediatric hepatitis that’s emerged in countries across the globe since October 2021. 

The child, a Tarrant County resident, was hospitalized, discharged and is doing OK, said Magaly Ayala-Perea, a spokesperson for the health department. 

She did not disclose the child’s age, but the U.S. Centers for Disease Control and Prevention is investigating cases in children under 10. As of Wednesday, the number of possible cases had climbed to nearly 275 nationwide.

Severe hepatitis, or inflammation of the liver, rarely affects kids, said Dr. Kenton Murthy, assistant medical director and deputy local health authority at the health department. 

Murthy has a 4-year-old and a 10-month-old. Because cases are “still so rare,” he and his family are aware of, but not worrying about, the disease, which comes on the heels of a nationwide formula shortage and an elementary school shooting

“It’s certainly been a very trying month for our parents,” he said. 

What’s going on? 

In October 2021, five children from different parts of Alabama were hospitalized with liver damage. They were previously healthy, with no underlying conditions, and between 1 and 6 years old. None had had a reported case of COVID-19, nor had they received the COVID-19 vaccine. All five also were sick with adenovirus, a virus that causes the common cold.

Although genetic disorders, alcohol abuse and certain medicines can cause hepatitis, the disease mostly comes from viruses. Each child tested negative for the most common hepatitis viruses in the U.S. 

The children recovered, but the CDC still doesn’t know why they were sick. 

More reports cropped up, and by early May, the agency was investigating the circumstances of more than 100 children with “hepatitis of unknown cause.” More than 90 of those children were hospitalized, about 15 had received liver transplants and five had died. 

The majority of these children also were sick with adenovirus.

What can caregivers do?

The CDC still doesn’t know if that virus is causing hepatitis, but preventive measures that work against COVID-19 — like hand-washing, avoiding touching the eyes and nose — also apply, Murthy said. 

Caregivers should keep an eye out for symptoms of hepatitis, he said. Telltale signs include jaundice, or yellowing eyes and skin, dark-colored pee or light-colored poop, along with abdominal pain, nausea, fever and fatigue. 

If a child experiences one of these symptoms, Murthy recommends caregivers contact a health care provider or visit the emergency room, if the illness is severe. 

Vaccines exist for the viruses that cause hepatitis A and hepatitis B. However, those viruses don’t seem to be related with the outbreak, said Dr. Nicholas Rister, a pediatric infectious disease physician with Cook Children’s Health Care System. 

He recommends the vaccines to protect against hepatitis A and B — they’re routinely included in childhood vaccinations. Still, he said, it’s unlikely those vaccines would prevent this type of hepatitis.

Symptoms of pediatric hepatitis:

  • Jaundice (yellowing skin or eyes)
  • Dark-colored pee
  • Light-colored poop
  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Joint pain

Source: U.S. Centers for Disease Control & Prevention


Rister and his colleagues haven’t yet treated any children with pediatric hepatitis of unknown cause, but he’s on the lookout.

If he were to suspect a patient had hepatitis, a simple blood test could determine whether the liver had been injured. Scans and biopsies could determine the severity. The spectrum of treatment stretches from IV fluids to blood transfusions to liver transplants, he said.

The liver is “one of the most important organisms in your body,” Rister said. The organ, located in the upper-right part of the abdomen, serves as a blood filter, processing toxins that enter the body. If only lightly damaged, the liver will typically heal itself

Despite the severity of inflammation in some of these newly reported hepatitis cases, the overall risk for children is “very low,” Rister said. He hopes caregivers are watchful for relevant symptoms while also maintaining that perspective.

“I don’t want families to lose too much sleep about this yet,” he said. 

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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