ALABAMA (WHNT) — State health officials say nine children across Alabama have tested positive for adenovirus, with two of them requiring a liver transplant.

According to the Alabama Department of Public Health (ADPH), officials are investigating the rise of hepatitis in Alabama children, though a later analysis revealed Adenovirus 41 was associated with this type of hepatitis.

The nine children, all under 10 years old, presented to healthcare providers with symptoms of a gastrointestinal illness and variations of liver injury, including liver failure. None of them had any underlying conditions of note, according to health officials.

ADPH has not determined an epidemiolocal link between the nine children from across the state.

According to the Centers for Disease Control and Prevention (CDC), adenoviruses commonly cause a “mild, self-limiting flulike or gastrointestinal illness. In rarer cases, the virus can manifest as a severe illness that could require hospitalization or cause death.

The CDC says there are several ways that adenoviruses spread from an infected person, including:

  • Close personal contact
  • Airborne through coughs or sneezes
  • Touching an object or surface with adenovirus on it, then touching your mouth, nose or eyes without washing your hands
  • Contact with stool

The CDC says to avoid adenoviruses, you should:

  • Wash your hands with soap and water for at least 20 seconds
  • Avoid touching your mouth, nose or eyes with unwashed hands
  • Avoid close contact with those who are sick

For more information on adenoviruses and the studies on how it affects children, click here.