DOTHAN, Ala. (KFOR) – The Centers for Disease Control and Prevention is issuing a health advisory after nine Alabama children suffered from severe liver damage. Two of those children need a liver transplant.

Two other cases have been identified in North Carolina.

All of the Alabama children are under 6-years-old but each had similar symptoms.

“We don’t know why this particular type of the virus is causing this liver injury,” Dr. Stubblefield told WDHN. “Although like I said there have only been a few cases, scattered out over a few months. We can’t really find a link between any of the cases, the cases have really been separated by distance and time.”

Officials with the Alabama Department of Public Health say none of the children in Alabama had received a COVID-19 vaccine, and the two with liver failure did not test positive for COVID-19.

The United Kingdom is also investigating at least 74 cases with six of those children needing a liver transplant. 10 cases have been reported in Scotland with a few being discovered in Spain and Ireland as well.

On Thursday, the CDC issued a Health Alert Network Health Advisory to notify clinicians and public health authorities about the children with hepatitis and adenovirus infections.

Signs and symptoms of hepatitis include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.

Adenoviruses most commonly cause respiratory illness but depending on the adenovirus type they can cause other illnesses such as gastroenteritis, conjunctivitis, cystitis, and, less commonly, neurological disease.

There is no specific treatment for adenovirus infections.

At this time, medical professionals say it’s important that parents stay up to date on their children’s vaccinations. They also say it’s important to practice good hygiene like washing hands for at least 20 seconds.