According to STAT News, health authorities in North Carolina say they are investigating two cases of hepatitis in young children, making the state the second to report cases that appear to be linked to an outbreak that is being seen in a growing number of countries. Alabama first noticed a cluster of five cases last November and notified the Centers for Disease Control and Prevention, with which it has been working to try to determine the cause of the illnesses. Alabama has since recorded four more cases.

The number of countries reporting these unusual cases of hepatitis continues to rise, with reports that France is investigating two suspected cases in Lyon and Israel is studying a dozen children who had unexplained cases of hepatitis over the past four months, two requiring liver transplants.

The U.K., the U.S., Spain, Denmark, the Netherlands, and Ireland have all reported cases. To date the largest number has been reported by the U.K., which has now recorded 108 cases — 79 in England, 14 in Scotland, and 15 in Wales and Northern Ireland.

Health authorities in the United States and some European countries on Thursday cautioned doctors to be on the lookout for young children suffering from signs of hepatitis and urging parents to make sure their children wash their hands well and often as investigations continue into cases of unexplained hepatitis in kids.

The leading hypothesis at present is that infection with an Adenovirus, a virus normally associated with colds, may have triggered the liver inflammation in affected children.

Adenoviruses can cause a wide range of illnesses such as:

  • common cold or flu-like symptoms
  • fever
  • sore throat
  • acute bronchitis (inflammation of the airways of the lungs, sometimes called a “chest cold”)
  • pneumonia (infection of the lungs)
  • pink eye (conjunctivitis)
  • acute gastroenteritis (inflammation of the stomach or intestines causing diarrhea, vomiting, nausea and stomach pain)