A mysterious international outbreak of severe hepatitis in children has spread to at least 10 U.S. states.

Pediatric hepatitis cases have been reported in New York, Minnesota, Alabama, North Carolina, Delaware, and Louisiana.

Officials from M Health Fairview in Minnesota said that one of their two patients — an infant and a 2-year-old — had to undergo a liver transplant.

“Why this kid had such severe acute hepatitis is unknown,” said Dr. Heli Bhatt, a pediatric gastroenterologist and transplant hepatologist at M Health Fairview.

Bhatt said that the Minnesota Department of Health would investigate further.

“I pray for that kid to turn around, which they might,” she said.

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NY among 10 states reporting mystery childhood hepatitis cases