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May 20 (UPI) -- Centers for Disease Control and Prevention officials said Friday that a sixth child in the United States has died after contracting acute hepatitis. The child was among 71 additional cases of hepatitis among children nationally identified in the past two weeks, bringing the total number of infections to 180 in the past seven months, agency officials said Friday.
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However, 90% of the additional cases actually occurred before May 1, so they do not necessarily represent "new cases," they said.
Since October, cases of acute hepatitis in children have been reported in 36 U.S. states and territories, according to the agency.
As of Thursday, six of the children have died, while another 15 have undergone liver transplants, it said.
Agency officials emphasized that these cases do not constitute an "outbreak" yet, but that clusters of illness, such as the one first reported in Alabama earlier this month, are "unusual," Dr. Umesh Parashar, chief of the agency's Viral Gastroenteritis Branch, said on a Friday call with reporters.
"The vast majority of what would appear to be new cases are actually retrospectively identified cases reported since October," Dr. Jay Butler, the CDC's deputy director for infectious diseases, said on the call.
Despite the numbers, the country is "not seeing a dramatic increase in the number of cases" of acute hepatitis in children, Butler said.
The reported cases to date have occurred in children ages of 1 month to 16 years, all of whom have had typical symptoms of acute hepatitis, including jaundice, abdominal pain and diarrhea, according to the CDC.
Most of the cases have been reported in "preschool-age" children, Butler said.
The cause of these cases remains unknown, which is not unusual, given that historically up to 50% of acute hepatitis cases among children "are of unknown cause," he said.
The CDC is investigating the case reports to determine whether they represent a true increase nationally or are the result in "improvements in detecting cases," according to Butler.
In a typical year, about 1,500 to 2,000 children are hospitalized with acute hepatitis across the country, Parashar said on the Friday call.
Many of the children involved in these cases did not have significant medical problems prior to their acute hepatitis diagnosis, though several had a prior illness with adenovirus type 41, which is known to cause the common cold and has been linked with acute hepatitis in the past, according to the CDC.
This common virus is the "leading hypothesis" of the cause of these cases, though the agency is exploring potential links with past COVID-19 infection and multisystem inflammatory syndrome, or MIS-C, a complication in children with the latter virus, Butler said.
MIS-C causes inflammation in multiple organs, including the heart, lungs and liver.
The agency is also exploring potential drug and food exposures among the children involved, but has not found a "specific pattern," he said.
However, there is no known link yet between acute hepatitis and any COVID-19 vaccine, Butler added.
Globally, there have been more than 200 cases of acute hepatitis of unknown origin in children, with the vast majority in Britain and Ireland, according to the World Health Organization.
