7 Tennessee children identified as part of mysterious outbreak of severe liver disease

Mysterious cases of severe hepatitis have been reported in seven Tennessee children, according to the state Department of Health. Vanderbilt Children’s Hospital reported treating several pediatric patients with liver disease of unknown origin.

The first cases were identified in Alabama and reported in late April. Dr. Jay Butler, deputy director for infectious diseases for the Centers for Disease Control and Prevention, says the illnesses are noteworthy despite the low case count.

“One of the things that does seem to be unusual in this instance is that many of the children who are affected, all of them among the nine in Alabama, did not have immune-compromising conditions,” he says.

Nationwide, the CDC is looking into at least 109 cases in 25 states. In nearly every instance, the liver disease required hospitalization. Some needed liver transplants, and five have died.

So far, no kids being treated at Vanderbilt have required a liver transplant, though the hospital has an active transplant program.

Epidemiologists still don’t have a working theory about where the illnesses are coming from. They’ve ruled out any connection to the COVID vaccine, because almost all the children were too young to get it. But Butler says they are still looking at whether the COVID virus, itself, could play a role in the liver infections. The CDC is even looking at whether kids are having more severe illnesses because they weren’t exposed to as many viruses in the last two years due to masks and social distancing.

“If parents see signs of liver disease — yellowing of the eyes or skin (jaundice), dark urine, pale stool, itchy skin, vomiting and malaise — they should notify their child’s pediatrician,” says Dr. Anita Pai, assistant professor of pediatrics at Vanderbilt. “Our pediatric liver team at Children’s Hospital is available for consultation if community pediatricians have patients fitting this clinical profile.”