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Hepatitis A - children

Hepatitis A in children is swelling and inflamed tissue of the liver due to the hepatitis A virus (HAV). Hepatitis A is the most common type of hepatitis in children.

Causes

HAV is found in the stool (feces) and blood of an infected child.

A child can catch hepatitis A by:

  • Coming in contact with the blood or stool of a person who has the disease.
  • Eating or drinking food or water that has been contaminated by blood or stools containing the hepatitis A virus. Fruits, vegetables, shellfish, ice, and water are common sources of the disease.
  • Eating food prepared by someone with the disease who does not wash their hands after using the bathroom.
  • Being lifted or carried by someone with the disease who does not wash their hands after using the bathroom.
  • Traveling to another country without being vaccinated for hepatitis A.

Children can get hepatitis A at day care center from other children or from child care workers who have the virus and do not practice good hygiene.

Other common hepatitis virus infections include hepatitis B and hepatitis C. Hepatitis A is the least serious and mildest of these diseases.

Symptoms

Most children age 6 years and younger do not have any symptoms. This means that your child could have the disease, and you may not know it. This can make it easy to spread the disease among young children.

When symptoms occur, they appear about 2 to 6 weeks after infection. The child may have flu-like symptoms, or the symptoms may be mild. Severe or fulminant hepatitis (liver failure) is rare in healthy children. The symptoms are often easy to manage and include:

  • Dark urine
  • Tiredness
  • Loss of appetite
  • Fever
  • Nausea and vomiting
  • Pale stools
  • Abdominal pain (over the liver)
  • Yellow skin and eyes (jaundice)

Exams and Tests

The health care provider will perform a physical exam of your child. This is done to check for pain and swelling in the liver.

The provider will perform a blood test to look for:

  • Raised antibodies (proteins that fight infection) due to HAV
  • Elevated liver enzymes due to liver damage or inflammation

Treatment

There is no drug treatment for hepatitis A. Your child's immune system will fight the virus. Managing the symptoms can help your child feel better while recovering:

  • Have your child rest when symptoms are the worst.
  • DO NOT give acetaminophen to your child without first talking with your child's provider. It can be toxic because the liver is already weak.
  • Give your child fluids in the form of fruit juices or electrolyte solutions, such as Pedialyte. This helps prevent dehydration.

While rare, symptoms may be severe enough that children with HAV need extra fluids through a vein (IV).

Outlook (Prognosis)

HAV does not remain in a child's body after the infection is gone. As a result, it does not cause a long-term infection in the liver.

Rarely, a new case can cause severe liver failure that develops rapidly.

Possible Complications

The possible complications of hepatitis A in children can be:

When to Contact a Medical Professional

Contact your child's provider if your child has symptoms of hepatitis A.

Also contact the provider if your child has:

  • Dry mouth due to loss of fluids
  • No tears while crying
  • Swelling in the arms, hands, feet, stomach, or face
  • Blood in stools

Prevention

You can protect your child from hepatitis A by having your child vaccinated.

  • The hepatitis A vaccine is recommended for all children between their first and second birthdays (ages 12 to 23 months).
  • You and your child should be vaccinated if you are traveling to countries where outbreaks of the disease occur.
  • If your child has been exposed to hepatitis A, speak to your child's doctor regarding the possible need for treatment with immunoglobulin therapy.

If your child attends day care:

  • Make sure the children and staff at the day care center have had their hepatitis A vaccine.
  • Inspect the area where diapers are changed to ensure that proper hygiene is followed.

If your child gets hepatitis A, you can take these steps to help prevent the disease from spreading to other children or adults:

  • Thoroughly wash your hands before and after preparing food, before eating, and before giving food to your child.
  • Always wash your hands well after using the restroom, after changing your child's diaper, and if you come in contact with an infected person's blood, stools, or other body fluids.
  • Help your child learn good hygiene. Teach your child to wash his or her hands before eating food and after using the bathroom.
  • Avoid eating infected food or drinking polluted water.

Alternative Names

Viral hepatitis - children; Infectious hepatitis - children

References

Ferri FF. Hepatitis A. In: Ferri FF, ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier Saunders; 2016:598-599.

Jensen MK, William F. Balistreri WF. Viral hepatitis. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 358.

Robinson CL; Advisory Committee on Immunization Practices (ACIP), ACIP Child/Adolescent Immunization Work Group. Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years - United States, 2016. MMWR. 2016 Feb 5;65(4):86-87. PMID: 26845283 www.ncbi.nlm.nih.gov/pubmed/26845283.

Review Date 3/4/2016

Updated by: Liora C. Adler, MD, Pediatric ER, Joe DiMaggio Children’s Hospital, Hollywood, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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