The Department of Public Health is investigating two cases of pediatric hepatitis in Massachusetts.
Few details about the cases were released Tuesday afternoon by the department, citing patient privacy and the ongoing nature of the investigations.
Hepatitis in children is typically rare, but about two dozen states in the last eight months have flagged dozens of mysterious and severe liver infections in children. The U.S. Centers for Disease Control has requested state health departments report any cases of pediatric hepatitis.
As of last week, more than 100 possible cases in children under age 10, including some dating back to last October, have been reported. At least five children have died.
A total of nine cases, all in Alabama, have been confirmed. The first five of those cases were identified in children at a hospital last October, the CDC said in a statement, with each experiencing significant liver illness while testing negative for the most common forms of hepatitis: hepatitis A, hepatitis B and hepatitis C.
"The CDC is casting a wide net to identify potential cases," the Department of Public Health said in its statement, "and is asking for health departments to report cases of hepatitis in children under 10 years of age with markedly elevated liver function tests but without a known cause for their hepatitis."
Both of the Massachusetts cases tested negative for adenovirus, a more common virus that causes cold- or flu-like symptoms, the department said in its statement Tuesday. The CDC has said its "investigators are examining a possible relationship to adenovirus type 41 infection." The five children who fell ill in Alabama all had tested positive for adenovirus, were previously otherwise healthy and came from different parts of the state.
Health officials said parents and guardians should screen children for the following symptoms of liver inflammation or hepatitis: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain and jaundice.
Any child with symptoms should seek medical treatment, state health officials said, adding that health care providers also should report any suspected cases of pediatric hepatitis to the state.
In a statement last week, the CDC said it's aware of an increase in similar cases in other nations and hopes to learn more from health officials around the world. Adenovirus was detected in some patients in Europe, but not all of them.
"During this investigation, it may seem like there is a growing number of children with hepatitis, but this might not be the full picture," the CDC said. "These may not be new cases of hepatitis, and they may not be linked to this current investigation."
With reporting from The Associated Press