BQ Journal Vol 48 - Q3 2022 - 24

Early Release
FIGURE 1. Emergency department visits with hepatitis-associated International Classification of Diseases, Tenth Revision, Clinical Modification
codes*,† by week§ of visit among children aged 0-4 years (A) and 5-11 years (B) - National Syndromic Surveillance Program, United States,
January 2018-March 2022
10
12
14
16
18
20
2
4
6
8
Jan MarMay JulSep Nov Jan MarMay JulSep Nov Jan MarMay JulSep Nov Jan MarMay JulSep Nov Jan Mar
2020
2018
10
12
14
16
18
20
2
4
6
8
Jan MarMay JulSep Nov Jan MarMay JulSep Nov Jan MarMay JulSep Nov Jan MarMay JulSep Nov Jan Mar
2020
2018
2019
Week of ED visit
Abbreviations: ED = emergency department; ICD-10-CM = International Classification of Diseases, Tenth Revision, Clinical Modification.
* ICD-10-CM Codes queried for hepatitis were as follows: B17.8 (other specified acute viral hepatitis); B17.9 (acute viral hepatitis, unspecified); B19.0 (unspecified viral
hepatitis with hepatic coma); B19.9 (unspecified viral hepatitis without hepatic coma); K71.6 (toxic liver disease with hepatitis, not elsewhere classified); K72.0 (acute
and subacute hepatic failure); K75.2 (nonspecific reactive hepatitis); and K75.9 (inflammatory liver disease, unspecified).
† To reduce artifactual impact from changes in reporting patterns, analyses were restricted to facilities with a coefficient of variation ≤35% and >70% discharge
diagnosis informativeness during 2018-2022. Visit data from a monthly average of 1,817 facilities were included in this analysis from state and regional jurisdictions
representing 44 states.
§ Weeks in baseline = January 2018-February 2020. Weeks excluded from analysis = March 2020-September 2021; this period was excluded from analysis because
of possible effects of the COVID-19 pandemic. Weeks assessed = October 2021-March 2022. Expected counts = expected visit counts calculated from weighted
regression model fit to baseline data. Exceedance threshold = upper bound defined as the 95th percentile of the negative binomial distribution with plug-in estimates
for the mean and dispersion parameter. Weeks with observed weekly counts falling above this threshold were considered to be anomalies.
when comparing 2022 with previous years (6), data from
multiple other European and non-European countries have
been inconclusive (7,8).
The percentage of specimens positive for adenovirus types
40/41 among children aged 0-4 and 5-9 years did not appear
to increase above prepandemic historical levels, although the
total number of specimens submitted for testing has increased
over time. The United Kingdom has reported an increase in the
number of adenovirus-positive stool specimen test results among
children aged 1-4 years compared with prepandemic levels.
However, United Kingdom data on testing volume and thus,
percentage positive for adenovirus, are currently unavailable (6).
MMWR / June 14, 2022 / Vol. 71
3
2021
2022
2019
Week of ED visit
B
Weeks in baseline
Weeks excluded from analysis
Weeks assessedExpected countExceedance threshold
Weeks excluded
2021
2022
A
Weeks in baseline
Weeks excluded from analysis
Weeks assessedExpected countExceedance threshold
Weeks excluded
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24
A Henry Schein Publication
No. of ED visits
No. of ED visits

BQ Journal Vol 48 - Q3 2022

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