SPRINGFIELD, Ill. (WCIA) — The Illinois Department of Health said on Wednesday that it is now aware of nine potential cases of hepatitis in Illinois children under the age of 10, up from three in April.

The cases date back to January; five were detected in northern Illinois, two in western Illinois and one each in central and southern Illinois. All of these patients were hospitalized and one needed a liver transplant. No deaths have been reported.

Hepatitis is an inflammation of the liver, with symptoms including fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice. Cases nationwide – there have been 180 of them – appear to be linked with adenovirus type 41, a common virus that typically causes cold- or flu-like symptoms and can spread from person to person. Two-thirds of patients in Illinois have tested positive for adenovirus.

The CDC believes adenovirus is the cause for the cases, but investigators are still trying to learn more, including ruling out other possible causes and identifying other contributing factors. IDPH is working with Illinois healthcare providers to identify other suspected cases in the state and is working with local health departments to collect and send available specimens to the CDC for further laboratory testing to look more closely at the virus genome and other potential pathogens.

The CDC is encouraging parents and caregivers to be aware of the symptoms of hepatitis and to contact their healthcare provider with any concerns. The CDC is also recommending that children be up to date on all their vaccinations and that parents and caregivers take the same everyday preemptive actions it recommends for everyone: washing hands, avoiding people who are sick, covering coughs and sneezes and avoiding touching the eyes, moth or nose.