Nine Alabama children hospitalized with hepatitis also had adenovirusa common disease that typically causes mild cold symptoms, strengthening the theory it is linked with the ongoing international hepatitis outbreak among children and possibly bringing investigators a step closer to understanding its origins, according to a study released Friday by the Centers for Disease Control and Prevention.

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Of the nine Alabama children diagnosed with hepatitis and adenovirus, five were diagnosed with adenovirus type 41, a variant that sometimes causes hepatitis in children with immune disorders, but is not known to cause hepatitis among otherwise healthy children, the CDC said.

Six of the children tested positive for Epstein-Barr Virus (EBV), a common and typically mild pathogen nicknamed “mono,” though the EBV infections had apparently subsided before the children were diagnosed with hepatitis, implying that the EBV infections and hepatitis infections were not connected.

As of Friday, all nine children had either recovered or were recovering, including two who underwent liver transplants, the CDC said.

At least 169 child hepatitis cases have been identified across the US and 11 European countries, World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus said Tuesday.

Of those at least 169 children with hepatitis, none had any of the viruses that typically cause hepatitis and at least 74 had adenovirus, though possible causes other than adenovirus are also under investigation, Ghebreyesus said.