The Centers for Disease Control and Prevention is now investigating 180 cases of children who suddenly developed severe hepatitis across 36 states and territories, an increase of 71 cases since the public health agency’s last update earlier this month.

The CDC, in a statement Wednesday, said the vast majority are not new cases of hepatitis. Rather, the number of patients under investigation have increased as the agency looks more closely at data that goes back to October of last year.

Hepatitis is an inflammation of the liver that is commonly caused by hepatitis viruses A, B, C, D and E. The cases the CDC is investigating are unusual because the children have not tested positive for those viruses and they have suffered severe symptoms, with 9% requiring liver transplants, which is rare.

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