Viral Hepatitis

What is viral hepatitis?

Viral hepatitis is infection and inflammation of the liver caused by a virus. Different types of hepatitis are caused by different viruses. Your child may have hepatitis A (most common), hepatitis B (second most common), or hepatitis caused by another virus. The exact type of hepatitis your child has cannot be known right away. Blood test results can usually determine exactly what type of hepatitis your child has, but the test takes several days.

What is the cause?

A person who has hepatitis A or B may not seem or look sick or unhealthy at all, so it may be hard to tell how your child got hepatitis. Sometimes there are outbreaks at day care centers or restaurants.

Hepatitis A is caused by exposure to another person with hepatitis A or from swallowing or eating something contaminated with the infected person's bowel movement (stool). This may happen, for example, if someone who does not wash his hands after using the bathroom then prepares food for others to eat. Symptoms may appear 2 to 7 weeks after exposure.

Hepatitis B is caused by exposure to an infected person's body fluids, such as blood and saliva, or by sexual contact. Unlike hepatitis A, hepatitis B is not passed through stool-to-mouth contact. Symptoms of hepatitis B may appear 6 weeks to 4 months after exposure.

What are the symptoms?

Children under 6 years old often have no symptoms. Teens and adults usually have symptoms.

Symptoms of hepatitis include:

• fever
• loss of appetite
• nausea, vomiting, and diarrhea
• tiredness
• muscle and joint aches
• yellow color of the skin (jaundice)
• darker yellow or orange color of the urine
• pain on the right upper side of the abdomen (belly).

What is the treatment?

• Fluids and diet

  The best treatment is to make sure your child drinks a lot of fluids and eats well. Your child should avoid eating fatty foods. The body has difficulty digesting fat when the liver is not working well because of the hepatitis.

• Rest

  Your child should rest while he or she has fever or jaundice. When fever and jaundice are gone, your child may gradually increase activity as with your health care provider's approval.

• Medications

  Your child should not take any medications, prescription or nonprescription, without consulting your doctor.

  There is no medicine that gets rid of the hepatitis virus or heals the liver. The body's immune system fights the infection.

  Once your child recovers from hepatitis A, the virus leaves the body. However, with hepatitis B, the virus may remain in the body for life. This chronic infection of hepatitis B can lead to other health problems such as cirrhosis of the liver or even liver cancer. There is also an increased risk of transmitting the disease to others. Some medicines are used to treat chronic hepatitis. Theses medicines provide some benefit, but do not cure the disease.

• Follow-up

  Your child will have blood tests at follow-up appointments to check on the condition of the liver and the progress of the illness. Keep all appointments as scheduled.

How long do the effects last?

Symptoms usually last 3 weeks to 2 months, but may last up to 6 months.

Children may return to day care facilities 1 week after symptoms first appear, with your doctor's permission.

Most children with hepatitis get better on their own without liver problems later on in life. However, some children do have liver problems later on. This is one of the reasons it is important to keep in close touch with your doctor and to keep all follow-up appointments.

Chronic, or relapsing, infection does not occur with hepatitis A, but it does occur with hepatitis B in about 5% to 10% of cases.

How can hepatitis be prevented?

The best way to prevent exposure to hepatitis is good handwashing. Children should wash their hands every time they go to the bathroom. Good handwashing should be enforced at home and at day care.

With hepatitis A, it is also important to keep a clean environment, such as clean toilets, bathrooms, and clothing.

After you know which type of hepatitis your child has, people living in the same house as the child should be treated to prevent spread of the disease. Your health care provider will help plan treatment for your family. This treatment is used only to help prevent the disease, it does not treat the actual infection.

Hepatitis B can be prevented by a vaccine that all babies should receive. If a child has not received the hepatitis vaccine as a baby, he or she may be vaccinated in childhood or adolescence.

A hepatitis A vaccine is available, but is not routinely given as part of a child's normal immunization schedule. Usually this vaccine is given to people in areas at high risk for getting the disease or to people (over age 2) traveling outside the US.

When should I call the doctor?

Call IMMEDIATELY if:

• Your child has changes in symptoms, is confused, is difficult to wake up, is lethargic (sluggish) or irritable.
• Your child is unable to drink fluids.
• Your child is getting much more yellow.
• Your child has signs of dehydration such as no urine in over 8 hours or a dry mouth.
• Your child starts to act very sick.

Call during office hours if:

• You have other questions or concerns.