(ATLANTA) — Parents are being asked to look out for symptoms of hepatitis in their kids as an unexplained outbreak of cases in children continues across the United States.

The Centers for Disease Control and Prevention (CDC) issued a health alert Tuesday aimed at educating parents on symptoms.

“Hearing about severe liver disease in children can be concerning. If you have any questions about your child’s health, call your child’s healthcare provider,” the CDC wrote, adding that parents should be aware of the symptoms associated with liver inflammation, including fever, fatigue, nausea, and jaundice, which is yellowing of the skin.

Hepatitis means inflammation of the liver. It can be caused by heavy alcohol use, toxins, some medications and medical conditions and is often caused by a virus, according to the CDC.

Here are five things to know about the CDC’s alert on hepatitis and kids and the outbreak.

1. The latest hepatitis outbreak in kids is global.

In April, researchers in the United States and Europe announced they were investigating small clusters of the cases emerging across the globe.

As of this week, the World Health Organization (WHO) says more than 340 probable cases of hepatitis in children have been reported in 20 countries.

In the U.S., there are at least 109 confirmed cases with five deaths in over 25 states and Puerto Rico, according to the CDC.

2. The cause of the outbreak remains unknown.

The cause of the reported cases of hepatitis in children in the U.S. remains unknown, according to the CDC.

“We do not know and are investigating what role other factors play in this illness, such exposure to toxins or other infections that the children might have,” the agency wrote in its latest health alert, also adding it is “not unusual” for the cause of hepatitis cases in children to remain unknown.

Some of the children who have had hepatitis also had adenovirus type 41, a type of virus that can cause severe stomach illness in kids, according to the CDC.

Adenoviruses are different types of viruses that can cause illnesses ranging from the common cold to acute bronchitis, pneumonia, pink eye and acute gastroenteritis, or inflammation of the stomach, according to the CDC.

3. The hepatitis vaccine is not protectant against this latest outbreak.

Hepatitis viruses are the most common cause of hepatitis in the world, including hepatitis A, B, and C, but they’ve been ruled out in the latest outbreak.

The strain of hepatitis seen in this vaccine is not one covered by the hepatitis vaccine that kids receive, according to Dr. Jennifer Ashton, ABC News chief medical correspondent.

“These cases of hepatitis are none of those [covered by the vaccine], so it’s really mystifying public health officials at this point,” Ashton said Wednesday on Good Morning America.

4. The hepatitis outbreak does not appear to be COVID-19-related.

Health officials do not believe the current outbreak in pediatric cases is linked to the novel coronavirus or the COVID-19 vaccine, according to Ashton.

“I just spoke to the CDC director, Dr. Rochelle Walensky, this morning,” Ashton said. “She wanted me to emphasize that the majority of these cases have been in children ages 2 to 5. These children, as we all know, are not eligible for the COVID vaccine, so this has nothing to do with the vaccine.”

5. Parents should call their pediatrician if symptoms appear.

The CDC has advised parents to be on the lookout for symptoms in their kids including fever and fatigue, nausea and vomiting, abdominal pain, joint pain, jaundice — a yellowing of the white part of the eyes or the skin — or a change in the color of urine or stool.

If any of those symptoms are present, parents should call their child’s pediatrician as quickly as possible, according to the CDC.

The agency also urges parents to make sure their child is up to date on all vaccinations and follow safety protocols, like washing hands often, avoiding people who are sick, covering their coughs and sneezes and avoiding touching the eyes, nose or mouth.

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(NEW YORK) — On wheels across the Mississippi Delta region, a group of three women is pulling up their sleeves and reaching underserved communities with free reproductive and sexual health care services.

Dr. Caroline Weinberg founded Plan A, a mobile health clinic, to offer free sexual and reproductive services, including mammograms, pap smears, contraception and STD testing, to patients regardless of insurance status, income or location. The first clinic opened in April 2021, providing health care services on wheels to the Mississippi Delta region.

“Something we have to accept [is] that we can’t solve every problem; like we can’t buy a mammogram machine, we can’t have a colonoscopy on-site, we can’t do surgery,” Weinberg said. “But we can add what we can, and if we’re able to get the resources to pull it off, then we just kind of expand whatever ways we can.”

The staff behind the clinic hopes to provide health care services to underserved communities across the area. By providing services around reproductive and sexual health care, Juliet Thomas, Plan A’s community health worker, hopes to destigmatize the conversation around those topics.

“It is [considered a taboo] when you talk about sex, birth control or anything like that’s really not talked about,” Thomas said.

Weinberg said she built the clinic on the belief that Roe v. Wade would one day be overturned. While the clinic does not offer abortions, Weinberg said they play a role by offering preventive measures to avoid pregnancies.

“I built the organization on the assumption that [Roe v. Wade] was kind of destined to be overturned,” she said. “Roe v. Wade being overturned in really any capacity doesn’t directly impact our day today, but it has an incredible impact on the community that we serve.

“As we seek to empower women and give them the options to kind of move forward with their reproductive health in whatever direction it is, that’s more challenging because their options are limited within the state.”

To fit the needs of the community, Plan A has expanded its operations to add primary care services like blood pressure screenings as well as COVID-19 vaccines. A 60-minute drive from where the mobile clinic is parked, Plan A has a brick-and-mortar clinic in Louise, Mississippi, to offer additional services to a broader community.

Mississippi is one of 12 states to not expand Medicaid since the passage of the Affordable Care Act in 2010 — a critical source of revenue for hospitals and a safety net for poor Americans. The federal government covers 90% of the costs for Medicaid, leaving 10% to be covered by the state.

Although at least eight expansion bills were proposed in the 2022 legislative session, not one was debated.

For Brock Slabach, chief operations officer of the National Rural Health Association, the issue with expanding Medicaid is around the arguments of federal involvement in state policy.

“The reason that they’ve given for their lack of participation in the costs that the federal government giveth and the federal government taketh away,” Slabach said. “At some point, if the federal government decided not to fund 90% of the cost of the expansion, then they would be stuck holding the bag in terms of the dollars it would cost to cover that expanded population.”

If expanded, the American Rescue Plan would provide an additional $600 million per year to the state and qualify more than 225,000 Mississippians.

The roadblocks, however, lie within its own government — with Gov. Tate Reeves and Speaker of the House Philip Gunn being two of Medicaid’s fiercest critics.

“I just don’t think Medicaid expansion is realistic, personally, I’m not for it,” Reeves said during a January interview with WAPT. “I don’t see that as a way forward in Mississippi. We need to be looking at ways to get people off Medicaid, not put them on Medicaid.”

But their stand on the issue is not what the majority population thinks. According to a Millsaps College and Chism Strategies poll, some 60% of voters believe that Medicaid should be expanded.

Patients like Lisa McCarty, who was formerly uninsured, sought the services of Plan A to access contraceptives.

The care and staff made McCarty a loyal patient. Without Plan A, McCarty told ABC News, she would be struggling with paying the doctor’s bill — or even have another child.

“Everyone knows each other and we’re so small here that it’s uncomfortable because you feel like, ‘OK, well, hey, this person may know what’s going on with me and I’m, you know, I don’t feel comfortable,’” McCarty said.

Now with insurance, McCarty said she will continue visiting Plan A, in part because of the wide variety of services outside reproductive health that are offered by the clinic.

As the clinic continues to expand, Desiree Norwood, Plan A program coordinator, hopes to reach more underserved communities across the state.

“I’m very excited because I know that there’s so much more great work that Plan A is going to do for the area, and I feel hopeful. Often the Mississippi Delta is looked at as one of the unhealthiest places, but we’re determined to change the narrative “

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