Investigations of Hepatitis of Unknown Etiology

The Centers for Disease Control and Prevention (CDC) recently released clinical, testing, and public health guidance for the investigation into hepatitis of unknown etiology in children. Patients meeting the following case definition should be considered persons under investigation (PUI) and reported to public health: 

Hepatitis of unknown etiology (with or without adenovirus testing) among children <10 years with aspartate aminotransferase (AST) or alanine aminotransferase (ALT) (>500 U/L) since October 1, 2021. 

As of May 11, 2022, the Utah Department of Health & Human Services has reviewed emergency room visit data from the last several months and has not found any unusual patterns related to hepatitis or liver problems in children. 

Providers should be aware of the following reporting and recommendations if a PUI is identified. Additional testing recommendations are attached:

·         The PUI’s healthcare provider should complete the “AdenoHepCRF_Provider” form as thoroughly as possible.

o    Completed forms should be sent to Amelia Salmanson via secure email (asalmanson@utah.gov) or fax (801-538-9923; attn: Amelia Salmanson).

o    The Utah Department of Health & Human Services (DHHS) will submit the necessary information to the CDC.

·         A standard diagnostic workup for hepatitis 

·         Diagnostic testing for adenovirus 

·         Collection of additional specimens for adenovirus typing of positive diagnostic samples.

·         PUI specimens positive for adenovirus should be sent to the Utah Public Health Laboratory (UPHL) for submission to CDC for typing. Note: specimens must be sent to CDC through UPHL. 

For questions/concerns, please contact Amelia Salmanson(asalmanson@utah.gov)