HONOLULU (KITV4) -- A pediatric hepatitis outbreak with mysterious origins is continuing to grow.
The Centers for Disease Control and Prevention (CDC) is investigating five deaths linked to the outbreak, which includes 109 cases in 24 states and Puerto Rico.
And now, the Hawaii State Department of Health (DOH) is reporting a case on Maui.
Many of the infected children required hospitalization, and eight needed liver transplants.
At Kalihi-Palama Health Center, Pediatrician Dr. Michael Walter says Hawaii has a high prevalence for Hepatitis B and C in the Asian American Pacific Islander communities.
Hepatitis B is spread to a newborn if the mother is infected with the virus.
Walter says experts are exploring whether a type of adenovirus, which causes intestinal symptoms, could be a factor in these new Hepatitis cases.
"It’s hepatitis of unknown cause. So, it’s not really a variant. Hepatitis will present in children with fever, vomiting, diarrhea, jaundice, yellowing of the eyes and the face and abdominal pain," Walter said.
“Viruses are constantly changing just like we have seen with the coronavirus. They are constantly changing, evolving mutating, so we don’t know if this is due to a mutation or change, in the virus that causes typically a mild intestinal infection in most children, it could have mutated to cause this problem with the liver. So most viruses are spread like a typical cold, thru saliva, droplets and contaminated materials," he added.
The child on Maui was hospitalized for several days with stomach pain and fever at the end of April. That child has now been released from the hospital, according to a DOH spokesperson.
The DOH says an extensive medical investigation was performed and they are waiting for lab test results to confirm the cause of that hepatitis case.