BALTIMORE, MD—The Centers for Disease Control and Prevention and the U.S. Food & Drug Administration have launched an investigation into “Real Water” brand alkaline water after cases of acute non-viral hepatitis and liver failure were reported by consumers.

The CDC and FDA were notified of five cases of acute, non-viral hepatitis in children by the Southern Nevada Health District on March 13, 2021. The cases occurred in children ranging in ages from seven months to five years who presented to a hospital between November 10, 2020, and December 3, 2020, with signs and symptoms of vomiting, poor intake, and fatigue.

Laboratory testing on the patients showed “elevated hepatic transaminases, hyperbilirubinemia, coagulopathy, and a negative viral hepatitis serology panel,” according to the CDC. All patients required transfers to a pediatric tertiary-care specialty liver unit because of concerns for acute liver failure and the possible need for liver transplants. All children recovered and were discharged home.

In addition to these cases, several adults and other children living in the cases’ households reported similar but mostly less severe symptoms including nausea, vomiting, anorexia, and fatigue.

The FDA says that consumption of “Real Water” brand alkaline water was the only common link identified among all of these cases to date. This brand of alkaline water is owned by Real Water Inc., headquartered in Mesa, Arizona.

As of March 31 2021, Real Water Inc. was still promoting the product via social media despite issuing a recall announcement.

The FDA is reiterating that it is crucial that consumers, restaurants, distributors, and retailers not drink, cook with, sell, or serve “Real Water” alkaline water.

The product is sold online nationwide.