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Wisconsin health officials are investigating four cases of severe liver inflammation in children, including one death, while health experts across the globe explore a potential link between adenovirus and pediatric hepatitis.

On Wednesday, the Wisconsin Department of Health Services announced one child has died and one child has received a liver transplant since the cluster of suspected adenovirus-associated hepatitis cases appeared in the state.

Similar cases are appearing in previously-healthy children all around the world. The sudden liver inflammation (hepatitis) is puzzling health experts as hepatitis viruses A, B, C, D and E have all been ruled out as the cause. 

Adenovirus type 41 is not a known cause of hepatitis in healthy children, however, health agencies across the globe are exploring a potential link. 

Last week, the Centers for Disease Control and Prevention issued a nationwide health alert to ask clinicians to be on the lookout and report any unusual cases of hepatitis to their local and state health departments. 

On April 21, the World Health Organization reported at least 169 cases of acute hepatitis of unknown origin have been reported in children globally, with most occurring in the United Kingdom, and mostly affecting children aged 5 and under.

For this reason, there's no link between the illnesses and the COVID-19 vaccine, which is not available to children under 5. The BBC reports that none of the UK cases happened in vaccinated children.

If confirmed, the Wisconsin child's death will be the first in the U.S. tied to the mysterious wave of cases.

Symptoms 

Adenovirus type 41 typically presents with respiratory symptoms, diarrhea, vomiting and fever, according to the CDC. 

Symptoms of hepatitis include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice. 

There is no specific treatment for adenovirus infections, but they are a common virus and the vast majority of those who contract it will not get particularly sick. 

Adenovirus resulting in hepatitis remains extremely rare, but the BBC reports scientists are investigating whether the pandemic-related restrictions may have resulted in some young children being exposed to the virus a little later than usual, resulting in a "more vigorous" immune response in some children.

U.S. cases 

In the United States, 9 cases of unusual hepatitis have been reported in Alabama in children ages 6 and under. 

Each child was previously healthy and had a laboratory-confirmed case of adenovirus type 41, according to the Alabama Department of Public Health. Two children required transplants but none died. 

On Monday, health officials in Illinois reported three potential cases in children younger than 10 with one child requiring a transplant. 

Two cases are also being investigated in North Carolina. 

On Thursday, a Minnesota Department of Health spokesperson told Bring Me The News no cases have been identified in Minnesota to date.

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