Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0

Viral Hepatitis

Description

Viral hepatitis is infection and inflammation of the liver caused by a virus.

Symptoms of hepatitis include:

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

Cause

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

Hepatitis A is caused by exposure to another person with hepatitis A or from swallowing something contaminated with the infected person's bowel movement (stool). Symptoms may appear in the exposed person 2 to 7 weeks after the 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.

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.

Home Care

The treatments for hepatitis A and hepatitis B are the same.

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

  1. 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.

  2. Rest

    Your child should rest while he or she has fever or jaundice. When fever and jaundice are gone, your child may gradually resume and increase activity as tolerated with the consent of your doctor.

  3. Medications

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

  4. 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.

Recovery

Your child may feel sick with any of the symptoms listed above for several weeks.

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.

Prevention

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 maintain a clean environment, such as clean toilets, bathrooms, and clothing.

After the type of hepatitis your child has is determined by the blood test, household contacts will be treated to prevent spread around the house. Your doctor will be in charge of treating the rest of your family.

Hepatitis B can be prevented by a vaccine that all babies should receive (three shots by 18 months of age). If a child has not received the hepatitis vaccine as a baby, he or she may be vaccinated in childhood or adolescence.

Call Your Child's Doctor 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 Your Child's Doctor During Office Hours If:

  • You have other questions or concerns.

Written by the Section of Pediatric Emergency Medicine, The Children's Hospital, Denver.
Copyright 1999 Clinical Reference Systems