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All you need to know about paediatric hepatitis

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Dr Sufla Saxena, Gastroenterologist, Paediatric and Hepatologist, Manipal Hospitals Dwarka, New Delhi speaks on the causes of hepatitis and how it can be prevented

Worldwide July 28 is celebrated as World Hepatitis Day to raise awareness against this fatal but preventable disease hepatitis. Hepatitis- an inflammation of the liver, is a major public health threat and a leading cause of death worldwide. Annual mortality from viral hepatitis is similar to that of other major infectious diseases such as HIV and tuberculosis. This year’s theme being “Finding the missing millions”.

What causes hepatitis in a child?

  • Hepatitis can be caused by viruses like hepatitis Viruses A, B, C, D and E and other viruses.
  • Autoimmune liver disease can also cause hepatitis, your child’s immune system makes antibodies that attack the liver.

What is the mode of transmission?

Hepatitis A

This form of the virus is passed through faecal-oral contact. It’s spread to children in the following ways:

  • Eating food made by an infected person who didn’t wash their hands well after using the bathroom.
  • Drinking water that is contaminated by infected faeces.
  • International travel to areas where hepatitis A is common.
  • Using illegal drugs.
  • Blood transfusions (very rare).

Hepatitis B

Hepatitis B is spread when blood from an infected person enters another person’s body. It can be spread through needle sticks and sharp instruments.

The following children are at risk for hepatitis B:

  • Children born to mom’s with hepatitis B.
  • Children born to mothers who have come from a country where hepatitis B is widespread. These include South-east Asia and China.
  • Children who live in long-term care facilities or who are disabled.
  • Children who have a blood-clotting problem and need blood products. This can include haemophilia.
  • Children who need dialysis for kidney failure.
  • Teens who do high-risk activities. These include IV (intravenous) drug use and unprotected sex.

Hepatitis C

The following children are at risk for hepatitis C:

Children born to mothers who have the virus

  • Children who have a blood clotting problem, such as haemophilia.
  • Children who need dialysis for kidney failure.
  • Teens who do high-risk activities. These include IV (intravenous) drug use and unprotected sex.

Hepatitis D

This type of hepatitis can only happen with hepatitis B. Hepatitis D can’t be spread from a mom to her baby during pregnancy.

Hepatitis E

This form of hepatitis is like hepatitis A. It’s spread through faecal-oral contact.

What are the symptoms of hepatitis in a child?

Some children don’t have any symptoms. Symptoms of sudden (acute) hepatitis may include:

Flu-like symptoms

  • Yellowing of the skin or the whites of the eyes (jaundice)
  • Fever
  • Nausea or vomiting
  • Loss of appetite
  • Not feeling well
  • Stomach pain or discomfort
  • Diarrhoea
  • Joint pain
  • Sore muscles
  • Itchy red hives on the skin
  • Clay-coloured stools
  • Dark-coloured urine

Prevention of hepatitis

Education

  • Safe blood transfusion.
  • Screening protocols for transfusion of donated bloods.
  • Administration of safe injections.
  • Safer sex practices.

Improvement of socio-economic condition

  • Universal access to clean water.
  • Hygienic food handling.
  • Improved sanitation systems.

Screening and early detection

Screening, early detection and initiation of treatment (importance of testing for the virus).

Vaccination

Vaccination campaigns for HAV and HBV infections to eradicate hepatitis globally. Universal hepatitis B virus immunisation is recommended for all infants.

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