MDH Health Advisory: Adenovirus in Pediatric Patients

April 28, 2022

On April 26, the Minnesota Department of Health (MDH) released a health advisory recommending that clinicians consider adenovirus infection when evaluating pediatric patients, particularly those younger than 10 years, presenting with gastrointestinal illness with jaundice or hepatitis of unknown etiology. 

MDH also suggested testing patients with clinically compatible illnesses for adenovirus using NAAT (e.g., PCR) on respiratory specimens, stool or rectal swabs, or blood. Anecdotal reports on cases found in Alabama suggest that testing whole blood may be more sensitive than testing plasma. This testing may be available at some clinical laboratories or providers can contact MDH if testing is unavailable. Testing for hepatitis A, hepatitis B, hepatitis C, and liver function is also recommended.  

Hold unused specimens until consultation with MDH occurs. This includes respiratory specimens, stool or rectal swabs, and EDTA blood specimens that remain after recommended testing is complete. 

Clinicians should have heightened vigilance for pediatric patients presenting with symptoms of hepatitis, including fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice. Many of the cases reported worldwide have presented without fever.  

Report pediatric patients, particularly those younger than 10, with hepatitis of unknown etiology and with AST/ALT >500 or those with illness severe enough to be hospitalized since October 1, 2021, to MDH at 651-201-5414.