News Scan for Apr 28, 2022

Wisconsin, California reports peds hepatitis cases
More avian flu in 6 states

Wisconsin and California probe unexplained hepatitis cases, 1 fatal

The Wisconsin Department of Health Services (WDHS) in an alert to clinicians said it is investigating at least four unexplained hepatitis cases in children, including one who needed a liver transplant and one who died. Also, California officials said today that they are investigating seven cases

The WDHS said it launched the investigation following a report from Alabama of nine similar cases, of which all five sequenced samples showed a possible connection to adenovirus type 41. Two of the Alabama children required liver transplants. News of the California cases was reported by the San Francisco Chronicle, which cited the California Department of Health.

The developments brings the number of US states reporting similar cases to five, which also includes North Carolina and Illinois.

In an update last week, the World Health Organization (WHO) said as of Apr 21, it had received reports of at least 169 cases from 12 countries, mostly in Europe.

In a related development, the European Centre for Disease Prevention and Control (ECDC) posted a risk assessment on the hepatitis cases, noting that 111 cases have been reported from the United Kingdom, along with 55 from other European countries, 12 from Israel, 12 from the United States, and 1 from Japan. They note in most cases, children had gastrointestinal symptoms before the illness progressed to jaundice. The most common pathogens found were adenovirus and SARS-CoV-2.

So far, no common exposure has been found, but the leading hypothesis is a cofactor involving young kids with adenovirus infection, which may trigger a more severe infection. Subtyping testing on samples from 11 cases in the United Kingdom identified type 41F, which has also been identified in several US cases.
Apr 27 WDHS health alert
Apr 28 San Francisco Chronicle tweet
Apr 25 Illinois Department of Public Health announcement
Apr 21 Stat story on North Carolina investigation
Apr 15 Alabama Department of Public health statement
Apr 28 ECDC risk assessment


Six states report more avian flu outbreaks, poultry losses top 35 million

Six states reported more highly pathogenic avian influenza outbreaks in poultry, including Nebraska, where the virus struck a large layer farm housing 2.1 million birds, according to the latest notifications from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS).

Nebraska's outbreak, the state's seventh, occurred in Knox County, located in the northeast corner of the state. Elsewhere in the Midwest, three states reported more outbreaks, all involving backyard birds. They include Kansas (Republic County), Michigan (Saginaw County), and North Dakota (Richland County).

Elsewhere, Pennsylvania reported another large outbreak at a commercial farm in Lancaster County, the state's sixth. The latest outbreak struck a commercial broiler breeder farm housing 18,000 pullets. Also, Montana reported its fifth outbreak in backyard birds, this time in a Missoula County flock that had 40 birds.

The outbreaks, part of ongoing spread involving the Eurasian H5N1 strain, have hit poultry in 29 states and have now led to the loss of 35.5 million birds. The event is the nation's worst since 2015 when outbreaks, mostly from highly pathogenic H5N2, wiped out more than 50 million chickens and turkeys.
USDA APHIS poultry outbreak page

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