Hepatitis is the swelling of the liver. A child who eats food or drinks water that is contaminated with the virus may contract the disease. It is estimated that around 400,000 people die of hepatitis in South-East Asia every year. On the occasion of World Hepatitis Day, ParentCircle spoke to Dr Ajith K N, Medical Director, Clinical And Imaging Services, Anand Diagnostic Laboratory who discusses the causes, symptoms and treatment of the disease in children.
What causes hepatitis?
The causes can be infectious and non-infectious.
a) Toxins and drug induced
b) Autoimmune disorders
How does hepatitis infection spread?
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur when a person comes in contact with the body fluids of an infected person by means other than the mouth or alimentary canal. Common modes of transmission for these viruses include receipt of contaminated blood or blood products and invasive medical procedures using contaminated equipment. For Hepatitis B, causes include transmission from mother to baby at birth and from family member to child.
What are the types of hepatitis?
There are five types of hepatitis viruses, identified by the letters A, B, C, D and E.
How are they diagnosed?
Diagnosis of hepatitis is based on a patient’s signs and symptoms, medical history, blood tests, imaging and liver biopsy. In general, most viral and acute hepatitis are diagnosed with patient’s blood tests and clinical examination.
The typical battery of tests used for initial assessment of liver diseases includes measurement of:
1. Serum aminotransferases
2. Alkaline phosphatase
3. Bilirubin levels
4. Prothrombin time
5. Hepatitis serology: HbsAg, Anti HBc IgM, HBeAg, Anti HCV, Anti HAV IgM
6. Anti-nuclear antibody (ANA), anti-mitochondrial antibody (AMA), P – ANCA
7. Drug history
8. Ímaging studies: Ultrasound, CT and MRI scans
9. Liver biopsy remains the standard criterion, particularly in evaluation of patients with chronic liver disease.
What are the signs to look for in people with hepatitis?
Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. A small subset of persons with acute hepatitis can develop acute liver failure, which can lead to death.
In some people, hepatitis can also cause chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer.
What kind of symptoms do toddlers with hepatitis exhibit?
Most common symptoms of acute hepatitis in toddlers include:
- Flu-like symptoms
- Nausea and/or vomiting
- Decreased appetite
- Abdominal pain/discomfort
- Clay coloured stools
- Dark urine
Is hepatitis contagious?
Infectious causes of hepatitis are usually but not always contagious. For example, hepatitis caused by viruses are usually contagious.
Most non-infectious causes of hepatitis are non-contagious.
For how many days does the infection last?
In general, the incubation period from the time of initial viral infection to development of symptoms ranges widely from about two weeks to six months.
Chronic hepatitis is a series of liver disorders of varying causes and severity in which hepatic tenderness and necrosis continue for at least 6 months.
Milder forms are non-progressive, while the severe forms may be associated with scarring of the liver ultimately leading to liver cirrhosis, for example, viral hepatitis, drug-induced hepatitis and autoimmune hepatitis.
Is there a vaccine for hepatitis?
There are no vaccines for Hepatitis C, D and E. However, there are safe and effective vaccines for Hepatitis B and Hepatitis A.
Looking for simple tips to keep your child's liver healthy? Click the article below.
What are the treatment options?
In most cases of acute viral hepatitis, no specific treatment is required. Hospitalisation is required for clinically severe illness.
Note: Please consult a Hepatologist/Gastroenterologist for further advice on treatment modalities.
What kind of food should a child with hepatitis eat? Are there any dietary restrictions to follow?
A high calorie diet is desirable. Though food may not be appealing to a Hepatitis patient, it is important to eat healthy food at regular intervals. Try eating a substantial meal in the morning followed by lighter meals later in the day. It is of utmost importance to keep your body well-hydrated in case of hepatitis B. Nausea and appetite loss can get worse with time. In case your child has persistent vomiting, intravenous fluids may be necessary.
The liver is one of the most important organs in the entire human body. All the food we consume passes through it. An umhealthy liver can lead to a host of diseases. We bring you some tips to keep your liver healthy.