Hepatitis a symptoms and treatment in children. Viral hepatitis a in children

Viral hepatitis is a group of diseases that affect liver cells. The type of virus that enters the body depends on the symptoms and course of the disease. Hepatitis in children is a common infectious disease. More often children get hepatitis A because of the habit of pulling everything into their mouths. The danger for the child's body is the transition of pathology into a chronic form. Signs of hepatitis in children are disruption of the liver, skin staining in shades of yellow and intoxication. Treatment depends on the strain of the virus and the state of immunity.

general information

Hepatitis is a common group of viral diseases that affect the liver. Among children, the most common virus is group A, the common name is Botkin's disease. The disease, regardless of the type of virus, negatively affects children's cells and liver tissues. The role of the liver in the body is the formation of immunity and the removal of harmful substances, and the massive death of hepatocytes causes liver dysfunction. The chronic course of the disease is one of the main causes of infant mortality.

The children's body is most often affected by the group A virus.

The ways the virus enters the child's body are fecal-oral and through the blood. A child becomes infected directly from a sick person, through infected blood, or through household contact. Outbreaks of Botkin's disease occur when the virus enters the water supply. Children under one year old are less likely to get sick due to the presence of parental immunity. Only hepatitis A differs in seasonal distribution. Children from 3 to 9 years old are more often infected. Hepatitis C in children is often asymptomatic.

Causes of hepatitis in children

The causative agents of the disease are viruses that destroy liver cells. Each virus has its own mechanism of damage. The disease caused by different strains differs in clinical manifestations, mode of transmission and nature of the course. In medicine, there are 8 types of virus - A, B, C, D, E, F, G, SEN, TTV. 75% of infections are caused by type A virus, 20% - by viruses B and C, other types of hepatitis are still being studied.

Infection of the fetus can occur during fetal development.

The source of the disease is a sick person or a carrier of the virus who has no symptoms of the disease. The viruses that cause hepatitis in a child are easily adapted to life inside the liver and are stable in the environment. Remain viable for 30 minutes. when heated to 60 degrees. Viruses are unstable to ultraviolet radiation, temperatures above 60 degrees and chemicals. Reasons for the appearance:

• contact of the child with an infected biological fluid (blood, urine, saliva);
• breast-feeding;
• intrauterine infection;
• transplant of an infected liver;
• drinking contaminated water;
• use of other people's hygiene items (toothbrushes, manicure sets);
• poorly processed medical instruments;
• poisoning with toxic substances and medicines.

Types of disease

Forms of hepatitis

Table of indicators of the incubation period for different forms of hepatitis.

• Type A - the incubation period of hepatitis lasts from 7 to 50 days, the average is 15-30 days.
• Type B - 50-180 days. Usually up to 2 months.
• Type C - from 2 weeks to six months.
• Type D - 3-7 weeks.
• Type E - 2-10 weeks, 5-6 weeks on average.

Symptoms depending on the type

Infectious hepatitis A

Signs of Hepatitis B

• weakness;
• fever;
• loss of appetite;
• bitter taste in the mouth;
• bloating;
• yellowness of the skin;
• discoloration of urine and feces;
• nosebleeds;
• vomiting and nausea;
• pain in right side.

Symptoms of the C virus

• temperature up to 39 degrees;
• vomiting, nausea, lack of appetite;
• increasing fatigue in the evening;
• yellow sclera, mucous membranes and skin;
• liver enlargement, accompanied by severe pain;
• joint pain;
• dark urine and light stools.

Diagnosis of the disease

Laboratory studies will help determine the causes of the disease.

At the first meeting with the patient, the doctor carefully examines the symptoms of the disease and makes a thorough examination of the child. Based on the symptoms, the doctor draws up an epidemiological history, where he enters the results of the tests. The first thing that a child is given is a biochemical blood test, which, with hepatitis of any type, will show an increase in the content of bilirubin and liver enzymes. The severity of the disease is characterized by a decrease in the amount of prothrombin and an increase in the content of ammonia. Other diagnostic methods:

• a blood test for the presence of antibodies to the virus;
• enzyme-linked immunosorbent assay, showing the rate of immune response to a disease;
• PRC test for the presence of traces of the virus;
• Ultrasound of the abdominal cavity, helps to find out the size of the internal organs and assess the degree of damage.

Liver damage in a child can develop as a result of a variety of reasons. The danger of this condition is that it can lead to the development of numerous complications.

What it is?

Violation of the liver cells or hepatocytes as a result of various provoking factors is called hepatitis. In most cases, different subtypes of viruses lead to the development of this condition in babies. Such forms of the disease are called viral hepatitis. They meet in children's practice most often.

The number of children who suffer from hepatitis is growing every year. In America, the increase in the incidence is up to 400,000 new cases annually. Among the most common variants registered in children in Russia are hepatitis B and A. They occur in the vast majority of cases. Hepatitis C is much less common.

Scientists identify several types of viruses that have a detrimental effect on liver cells. They are called using Latin letters - A, B, C, D, E, F, G, SEN, TTV. They differ not only in special differences in the cellular structure, but also have different properties.

Once in the body of a child, hepatitis viruses, together with the blood, penetrate into the liver cells, where they begin to actively multiply and exert their destructive and toxic effect.

The liver performs over 40 different functions in the body. It is the main organ in which detoxification (neutralization) of toxic metabolic products occurs. It also performs a barrier function, protecting the internal environment of the body from the penetration of foreign microorganisms. The liver also synthesizes important hormones and biologically active substances that are involved in most of the chemical reactions that are very necessary for life.

Once in the child's body, hepatitis viruses have a damaging effect on the liver cells. In acute course - the child manifests very bright clinical symptoms. In the chronic form, the manifestations of the disease may be erased or expressed slightly. In this case, additional diagnostic methods are required to establish the correct diagnosis.

How is it transmitted?

Hepatitis viruses are very well preserved in the external environment. For a long time they can be in conditions of cold temperatures, and they die only with a sufficiently long treatment, which is carried out when heated above 60 degrees.

It is important to note that most hepatitis virus subtypes are quite sensitive to ultraviolet radiation.

A child can become infected in various ways:

• Direct contact with body fluids containing viruses. These include: urine, saliva, blood. Viruses enter the bloodstream through various microdamages. They are small in size and spread well throughout the bloodstream.

• Congenital. This method of infection is also called fetal. In this case, hepatitis viruses are transmitted to the baby from the mother. Also, the child can become infected from the father, if he was already sick before conception. Microorganisms pass through the placenta in different ways. For example, hepatitis C viruses have a much harder time crossing the blood-placental barrier than subtype B.

• Through breastfeeding. World studies confirm the fact that some types of hepatitis viruses reach the mammary glands very easily. They are able to penetrate into mother's milk. If a nursing mother suffers from hepatitis, especially in an active form, then her baby can become infected.

• Through drinking. The source of infection in this case is poor-quality water. It usually contains a huge concentration of viruses. This method is most likely for hepatitis A. This form is also called Botkin's disease. A baby can also become infected with hepatitis A by swimming in a pond, when he accidentally swallows water from it while swimming.

• Due to violation of the rules of personal hygiene. Using someone else's personal hygiene products increases the chances of infection many times over. Someone else's toothbrush, towel or washcloth for the shower can lead to infection of the child with hepatitis.

• during medical interventions. Of course, this is quite rare. However, cases of infection through the blood are still recorded annually after surgical interventions or even when performing simple injection measures. Most often, this variant of infection leads to the appearance of viral hepatitis B or C in a child.

• After liver transplant. In some situations, with various severe congenital or acquired diseases, replacement of damaged tissue with a new one is required. For this, doctors use a liver transplant from a donor. Before carrying out this procedure, the entire necessary range of tests is carried out, which should prevent a possible infection with hepatitis. However, there are cases when viruses are found in the blood of a child after a liver transplant.

• After poisoning with toxic substances. The liver, performing a neutralizing function, must eliminate all dangerous components from the body. Some toxic substances have a detrimental and destructive effect on liver cells. Usually such acute conditions develop quite rapidly. This leads to an almost complete blockage of the liver and significant disturbances in its work.

• As a result of unprotected sex. This form of infection is quite often recorded in adolescents. Lack of information and neglect of the simplest methods of contraception leads to a huge number of cases of infection with hepatitis B or C.

• Through dirty hands. After playing outside, kids often forget to wash their hands. Particles of dirt or earth can contain a huge variety of viruses, including hepatitis. While eating, the child introduces an infection into his body. Viruses very quickly enter the saliva, and then into the blood.

It is important to note that any person who has hepatitis viruses in the blood can be a carrier of the infection.

In some cases, the diagnosis fails to detect them. However, this does not mean at all that there are no more viruses in the body. Often, an extended set of diagnostic measures is required to identify chronic forms of the disease.

The risk of transmission of hepatitis is quite high. In children aged 3 to 12 years, hepatitis A is more often recorded. Congenital variants of the disease most often cause viruses of subtype C. In school-age children, as well as adolescents, hepatitis B is detected in the vast majority of cases. It occurs in about 80% of cases. The remaining subtypes of viruses cause hepatitis in babies quite rarely.

Kinds

Each hepatitis proceeds with varying degrees of severity of symptoms. This largely depends on which subtype of viruses caused the disease. This circumstance also determines how difficult the disease will be in a particular baby.

The most severe variant of the disease is fulminant. It is characterized by complete death of liver cells (necrosis). This condition is irreversible and rather worsens the prognosis. It can occur at any stage of the course of the disease. With a fulminant course, a large number of antibodies can be detected, which is a consequence of an autoimmune lesion of the liver tissue.

Most often, such a dangerous form of hepatitis is recorded in children in the first months of life.

This is due to the imperfection of the structure and functioning of the immune system in such babies. Immunity in infants is not able to cope with the toxic and destructive effect of viruses on liver cells. With the development of a fulminant course of hepatitis, doctors usually reveal a large number of rather massive foci of a destroyed liver.

Nonspecific reactive hepatitis is characterized by diffuse dystrophic changes in the liver tissue. This form of the disease appears, as a rule, due to chronic diseases of the internal organs. Typically, such variants of the course of the disease are manifested by the appearance of minor symptoms. The most common of them: fatigue, impaired taste and appetite, some dryness of the skin. In severe cases, jaundice may develop.

Different clinical forms of the disease require the appointment of special treatment. For each form of the disease it is different. In some cases, the treatment of the disease is still imperfect. This can be said mainly about hepatitis C. Scientists around the world are working daily to create new effective drugs that would lead to a complete recovery from this disease. Such difficulty in the selection of treatment makes hepatitis C close to type 6 herpes, from which specific therapy has not yet been found.

Incubation period

The time from the beginning of the pathogen entering the bloodstream to the onset of the first clinical symptoms may be different. This largely depends on the subtype of viruses and its infectious properties.

Different types of hepatitis are characterized by different duration of the incubation period:

1. Option A- from 8 to 49 days. In most cases, two weeks.
2. Option B- from 51 to 180 days. In the vast majority of children, the first signs of hepatitis B appear, on average, 3 months after the pathogen enters the bloodstream.
3. Option C- from 1.5 to 2 months. In some situations, the incubation period can be from two weeks to six months.
4. Option D- usually in the first week after the penetration of the pathogen into the blood. In some cases, the appearance of the first symptoms may develop after 2-3 months from the moment of initial infection.
5. Option E– from 20 days to 1.5 months.
6. Variant F- Never seen separately. Babies can become infected with them only when infected with viruses A, B and C. When combined with these viruses, it can shorten their incubation periods by several times.
7. Variant G- mostly from two weeks to a month. In some babies, the first symptoms appear only after 35-45 days.

Symptoms

These diseases are characterized by a gradual appearance of clinical signs.

The severity of the symptoms in the baby will directly depend on his initial data. In more weakened children with concomitant diseases, the course of the disease can be quite severe, and the symptoms manifest themselves quite clearly.

In the development of the disease, several stages are successively replaced:

• Preicteric period. It can manifest itself in several forms: catarrhal, gastric, asthenovegetative or rheumatological. For hepatitis A, it is usually about a week. The remaining forms, which are characterized by hematogenous infection, occur with the development of symptoms for 2-3 weeks.
• period of jaundice. It is characterized by the appearance of the most specific marker of liver disease - yellowing of the visible mucous membranes and skin. Botkin's disease is characterized by a gradual increase in jaundice and its rapid disappearance. Other forms of hepatitis are accompanied by a rather long icteric period.
• Recovery or transition to a chronic form. The outcome of the disease depends on many data, including the characteristics of the virus that caused the disease. Botkin's disease in the vast majority of cases leads to complete recovery. To achieve the absolute disappearance of hepatitis B and C viruses is quite difficult. This requires an intensive course of treatment, which can last for several months and even years.

The preicteric period can proceed in different ways. The catarrhal form is accompanied by all the symptoms that would also occur with any common cold. These include: a cough without sputum, a runny nose with a liquid and watery discharge from the nose, an increase in body temperature to subfebrile or febrile numbers, an increase in general weakness and fatigue, as well as an incoming headache.

Quite often, in babies during this period, doctors make an incorrect diagnosis, considering these clinical signs as manifestations of an acute respiratory disease or influenza.

Only laboratory tests that easily show the causative agent of the infection help to identify the disease. However, this period remains without a correct diagnosis for quite a long time.

The gastritis or dyspeptic form is characterized by the appearance of adverse symptoms from the organs of the gastrointestinal tract. The child may experience discomfort and pain in the epigastrium. The baby hiccups more often, complains of nausea or vomiting. As a rule, during this period, the sick child's appetite decreases. Misdiagnosis leads doctors to misdiagnose, implying that the baby has simple food poisoning.

Asthenovegetative variant - also not accompanied by the appearance of bright and specific symptoms. The child becomes a little lethargic, gets tired quickly even after performing his usual actions, eats without appetite, and may complain of a headache. Usually parents during this period think that the baby is not sick, but simply very tired or naughty. It is quite difficult to suspect a disease at this stage, even for an experienced doctor.

The rheumatological variant of the preicteric period is quite rare. Toddlers usually begin to complain of pain in the legs when walking. During visual examination, the area of ​​​​the joints may not be changed in any way. However, even the child's gait begins to change. Usually the baby tries not to step on the painful leg, as this significantly increases his pain. Some autoimmune forms of the disease are accompanied by the appearance of rashes on the child's skin, which in appearance may resemble allergic ones.

The preicteric period gradually subsides, and the baby has bright and specific signs of liver damage, which are well known to every mother. This is jaundice. It usually builds up over a couple of days. The sclera of the eyes, visible mucous membranes, and then the skin becomes yellow. It can be from bright lemon to olive. This is determined by the infectious characteristics of the causative agent of the disease.

The severity of this symptom also depends on age. In newborns and infants, yellowing of the skin may be slightly pronounced. Some forms of jaundice are accompanied by the appearance of intolerable skin itching. When viewed from such babies, numerous traces of scratching are visible on the skin.

With a severe course of the disease, the child may experience various hemorrhages.

This is due to the fact that normally the liver synthesizes substances that have a positive effect on blood vessels and capillaries. In case of violation, their ruptures occur, and the outflow of blood outward. The baby may develop nosebleeds or various bruises on the skin. At this time, as a rule, the child becomes more excitable.

By the end of the icteric period, all the main functions of the liver are gradually normalized. This leads to the fact that the negative symptoms of the disease disappear. The child begins to feel much better. On average, this period lasts only a couple of weeks. However, in more severe cases of the disease, it can be up to several months. These situations indicate the development of a protracted period of the disease.

Also in pediatric practice, there are alternative forms of the course of the disease:

• Anicteric. With this option, the child's skin remains a pale pink color. Bilirubin levels may be normal or slightly elevated. The borders of the liver usually do not exceed the norm. The examination can reveal the causative agent of the disease, as well as a slightly elevated level of special liver enzymes - transaminases.
• Erased. Practically does not cause discomfort in the baby. When examining doctors, they find some enlargement of the liver. Diagnosis of the disease in this form of the disease is most difficult.
• Subclinical. With this variant of the disease, the baby does not have any clinical manifestations of the disease. The child feels well. To identify the disease in this course is very difficult. To establish a diagnosis, special laboratory tests are required that determine the pathogen in the blood, as well as antibodies to it that have been developed by the body.

The first signs in newborns and infants

Doctors call congenital forms of the disease fetal. In this case, infection occurs in utero: from mother to child. If a pregnant woman is infected with hepatitis viruses, as well as if she has an acute form of the disease, she can easily infect her unborn baby.

Congenital hepatitis has become increasingly common in the neonatal practice of attending pediatricians and infectious disease doctors. This is largely due to the lack of all the necessary vaccinations for expectant mothers. Hepatitis in newborns can also be called serum hepatitis. This means that the virus got to the baby through the liquid component of the blood - serum.

The development of the disease in newborns and infants can be quite rapid. In some cases, this leads to the development of numerous complications. Many of them are even capable of contributing to life-threatening conditions: shock or coma. In these cases, intensive treatment in the intensive care unit is already required.

But not always in a newborn child, viral hepatitis occurs in a severe form. If a child was born with a good weight, as well as without various concomitant pathologies of the internal organs, then the development of the disease in him can be quite easy. Such children necessarily require increased attention from parents and medical personnel.

Among the distinguishing features in babies of the first year with hepatitis are the following:

• In some cases, the disease can proceed with erased symptoms.. This option is also called anicteric, since the baby does not develop jaundice.
• A sharp increase in liver enzymes. Liver transaminases can increase several times. This indicates damage to the liver cells. With the development of a cholestatic variant of the disease, which is accompanied by a violation of the outflow of bile, an increase in the level of bilirubin is also observed.
• Enlargement of the liver. Its limits can significantly exceed the maximum allowable for a given age. With autoimmune variants of hepatitis, an enlargement of the spleen also occurs. The doctor will be able to determine these deviations during the examination, as well as when performing an ultrasound examination.

• Frequent transition of the disease to a chronic form. This is usually characteristic of those forms of the disease that developed with a subacute course. Prolonged and detrimental effect of viruses on hepatocytes leads to their damage and disruption of the basic functions of the liver.
• Mixed forms of the disease. In some weakened babies, viral hepatitis is combined with bacterial hepatitis. Most often - with streptococcal. Such forms of the disease are quite difficult and require the appointment of not only antiviral agents, but also antibiotics.

• Course without symptoms. Doctors also call this form latent. It is possible to suspect its presence in a child only with careful observation of the baby. Observant parents will be able to spot dark urine stains on the diaper that result from elevated levels of liver enzymes. Babies suffering from a latent form of the disease may spit up food too often, as well as refuse to breastfeed.
• Possible development of fulminate forms of the disease. Such hepatitis is most dangerous in babies of the first six months of life. If this disease is detected in a newborn child at this age, then he is usually hospitalized in the infectious diseases department for intensive treatment.

• Violation of the course of the main periods of hepatitis, as well as changing the timing of the incubation period. In this case, the baby may not have a period without jaundice at all. The child's temperature rises sharply. Usually it grows to febrile figures.
• Prolongation of the icteric period. It can even last up to a month and a half. During the examination, the child reveals a very high level of bilirubin. In some cases, it can even exceed the norm several times. When examining such children, doctors usually reveal a large size of the spleen. At the same time, the borders of the liver can remain within the age norm for a long time.
• Frequent development of complications. The risk of possible negative consequences of the disease in newborns increases several times. The younger the child, the higher the risk of developing complications. Usually the most severe course of the disease in babies of the first 3-6 months of life.

Basic diagnostics

In the vast majority of cases, the diagnosis of viral hepatitis is fairly easy to establish. In 75% of babies with jaundice, doctors find signs of this disease. A doctor can suspect a disease already during a routine examination and determination of the size of internal organs. After such a clinical examination, the doctor writes out several tests and studies that allow you to accurately establish the diagnosis.

The following tests are used to detect hepatitis in a child:

• General and biochemical blood tests.
• Examination of urine for the detection of bile pigments in it.
• ELISA blood test to search for the causative agent of the disease. A positive analysis indicates the presence of viruses in the child's body. However, the test has insufficient specificity. This leads to a false positive result. In such situations, repeated control after a few months is required.
• A serological test that detects antibodies. It takes some time for their formation, so it is impossible to detect them at the initial stage of the disease.
• PCR. A fairly accurate study that helps to detect various viruses inside the body.
• Ultrasound examination of the abdominal organs. It helps to establish the actual size of the liver and spleen, and also gives a qualitative description of the existing anomalies in these organs.

Can a mother with hepatitis have a healthy baby?

The risk of intrauterine infection during pregnancy is quite high. This question is most often asked by women who have hepatitis B or C. The type B virus is small and crosses the placenta very easily. In mothers with viral hepatitis B, according to statistics, already infected babies are born in the vast majority of cases.

You can influence it. To reduce the risk of intrauterine infection, it is very important to plan a pregnancy. Before the onset of conception, the expectant mother can be given all the necessary treatment. It will help reduce the concentration of viruses in the body. In the future, during pregnancy, this will help to significantly reduce the risk of possible infection of the baby.

All expectant mothers who are planning a child should definitely get vaccinated.

The hepatitis B vaccination schedule is approved in Russia by an official document. Information on vaccination dates can be found in the National Immunization Schedule. Only three doses of the vaccine are required for reliable protection against hepatitis B. Such a simple preventive measure will protect the unborn baby from possible infection with a dangerous disease.

Hepatitis C is also a fairly common threat during pregnancy. Scientists have proven that the viral pathogens of this disease practically cannot cross the placenta. However, the risk of infection still exists. Most cases of infection are recorded during childbirth. Passing through the birth canal, the child can become infected.

There is currently no vaccine for hepatitis C. Therefore, every mother during pregnancy should follow the elementary rules of prevention. It is necessary to limit and minimize all possible contacts that can lead to infection of her and the unborn baby. In some situations, it is possible to become infected with viral hepatitis C even in a beauty salon during a trimmed manicure.

Complications

Many forms of hepatitis end in complete recovery. 90% of babies who have had Botkin's disease in childhood never remember it again. Parenteral forms, which occur when infected through the blood, usually do not have such a good course and prognosis. Quite often, from an acute course, they turn into a chronic form.

With hepatitis B, adverse complications may develop already during the preicteric period. According to statistics, they are observed in babies in 5-15% of cases. The most common complications include: hemorrhagic bleeding, the appearance of a rash on the skin, pain in the joints, the appearance of blood in the urine.

After hepatitis C, a child may develop an autoimmune disease.

Some babies develop some rheumatological diseases. Doctors note the appearance in such children of symptoms of tardive cutaneous porphyria, lichen planus and other pathologies. Until now, scientists have not given an answer to why these conditions develop in children with viral hepatitis C.

Fulminant forms of hepatitis, accompanied by mass death of liver cells, occur in 1-5% of cases. Such a rapid development of the disease is accompanied by abundant necrosis in the liver. The baby's condition is rapidly deteriorating. In some cases, even shock or coma may develop. Treatment requires urgent hospitalization and massive infusion therapy.

Chronization of the process occurs in about 40-50% of babies. Chronic hepatitis significantly impairs the quality of life of a child. The kid can suffer from increased fatigue, study poorly and get tired very quickly. In such children, as a rule, appetite is reduced or disturbed. Some babies have difficulty falling asleep or often wake up in the middle of the night.

How to treat?

Each clinical form of viral hepatitis is treated differently. Botkin's disease resolves on its own in a few weeks. This form of the disease requires only symptomatic treatment. The use of any special antiviral agents to eliminate the virus is not required. Usually, the children's body copes well with the elimination of microorganisms and the normalization of its work.

Therapy of parenteral viral hepatitis is a rather difficult task. The choice of a drug treatment regimen is carried out by an infectious disease specialist. A child who has been found to have infectious pathogens in the blood is put on a dispensary record. The baby must undergo mandatory consultations with doctors and pass all the necessary tests. During the acute period of the disease, hospitalization is usually not required.

The only exceptions are cases when the child suffers hepatitis in a severe and especially fulminant form. In this situation, the baby is hospitalized in the infectious diseases department of the children's hospital for all the necessary treatment.

The complex of therapy for the acute period of the disease includes:

• Antiviral treatment. It is prescribed for parenteral forms of hepatitis. Various drug regimens are used. Sofosbuvir therapy is used to treat hepatitis C. This tool has a fairly high efficiency and a good range of tolerability.

To eliminate high fever, it is better to choose drugs based on paracetamol, since they do not have a toxic effect on the liver.

• Immunomodulating. Helps restore the normal functioning of the immune system. Immunoglobulin therapy has beneficial effects in the treatment of hepatitis C. Interferon drugs may also be used.

• Cholagogue. They are prescribed for severe cholestasis syndrome. In this case, there is stagnation of bile and a violation of its outflow through the biliary tract. As such a treatment, suitable: Hofitol, Cholenzim and other means. The appointment of drugs is carried out only after an ultrasound examination of the liver and gallbladder. In the presence of stones in these organs, choleretic agents cannot be used.

• Hepatoprotectors. They are prescribed to eliminate and prevent the death or severe damage to liver cells. The choice of drug depends on the age of the child, as well as taking into account the variant of the pathogen.
• Medical nutrition. Babies with chronic hepatitis must follow a diet throughout their lives. Fried and fatty foods are strictly prohibited for them. Also, all fast food products and those cooked with a lot of oil are excluded from the menu. Proper nutrition with a sufficient intake of lean meats and poultry, as well as cereals and dairy products, is a successful guarantee of the normal functioning of the liver for many years.
• Bed rest during jaundice. This simple measure helps to reduce the risk of complications in the future. To achieve a faster recovery, the baby should be given enough fluids. This will help to quickly cope with the negative symptoms of the disease.

Forecast

Even the transition to the chronic form of the disease does not have a significant impact on the life expectancy of a child. Toddlers maintain an active lifestyle for many years. Only 2% of children can have quite dangerous complications. They usually develop in newborns and infants. The quality of life largely depends on the form of the disease.

Viral hepatitis C usually occurs without severe symptoms for a long period of time. If left untreated, they can lead to the development of long-term consequences in the child. Already in adulthood, he develops total damage and death of liver cells - cirrhosis. In this case, a person must already receive therapy for life, sometimes this is even an indication for establishing a disability group for him.

Viral liver disease can only be prevented through prevention. To date, there are excellent and effective vaccinations against hepatitis B and A. They will help protect the child's body from dangerous parenteral infections. Vaccination against hepatitis B begins to be carried out already in the maternity hospital. The vaccination schedule is strictly regulated and included in the National Calendar.

Dr. Komarovsky will talk about viral hepatitis in the next video.

Hepatitis A in children is a form of viral disease of the liver tissue, also known as infectious hepatitis. It is a highly contagious disease due to its ability to spread through personal contact. It is a milder disease of the liver than hepatitis B. The disease very often occurs without external symptoms and deterioration of well-being, especially in children. Hepatitis A does not cause liver failure or chronic liver disease. Once the infection is completely sanitized, all symptoms disappear and no destructive consequences remain.

It should be borne in mind that often in medical practice there are relapses of the disease. Their symptoms appear mainly 1 month after the complete healing of the sick child.

Ways of transmission of the hepatitis A virus

Since the onset of the disease, the hepatitis A virus has been found in large numbers in the stool (feces) of persons infected with this pathogen. It is usually transmitted from person to person by ingestion of objects or particles of matter contaminated with faecal fragments from an infected person. This route of transmission is called the fecal-oral route. Thus, it spreads more easily in areas where sanitary conditions are poor or where personal hygiene is not respected. Most viral hepatitis infections occur in children through contact with another family member who is infected with the disease. Transmission of the virus through blood is possible, but extremely rare.

Common routes of hepatitis transmission:

• consumption of food products that are made by a person in contact with infected excrement;
• drinking water contaminated with infected feces (a problem more common in areas with poor sewage treatment facilities);
• contact with the feces of an infected person, which can occur due to poor handwashing;
• overcrowding of children in children's institutions, kindergartens, where there are children who are not accustomed to the potty, are especially susceptible to the spread of infection.

Hepatitis A has a uniform distribution in children throughout the world and is endemic in most countries. However, the incidence is declining in developed countries. There is a very high risk of infection and morbidity in developing countries and rural areas. For example, in rural areas of South Africa, the infection rate is 100 percent.

Hepatitis affects up to 200,000 young Russians every year, according to the Centers for Disease Control. The highest frequency of viral hepatitis A is observed among children from 5 to 14 years. Nearly 30% of reported infections occur in children under the age of 15, mainly because they are often in close contact with other children at school and kindergarten. About 15 percent of registered cases of diseases are recorded among children and employees in kindergartens.

In our country, hepatitis most often occurs among children in the central regions and the Volga Federal District. To a lesser extent, the virus is found in Siberia and the Far East. The probability of infection is high in the southern regions and regions of the North Caucasus.

Symptoms of hepatitis A in children

Hepatitis A is caused by an enterovirus that was identified in 1973. It has an incubation period of three to five weeks. After entering the body through the oral cavity and intestines, it multiplies in the gastrointestinal tract and spreads to the liver parenchyma, where its vital activity and further reproduction takes place. The hepatitis A virus is shed in the child's stool for two weeks prior to the onset of clinical symptoms.

People with hepatitis A may not have any signs or symptoms of the disease. A full clinical picture often develops in elderly or debilitated people. Symptoms are in many cases non-specific and usually include fever, fatigue, loss of appetite, nausea, abdominal discomfort, dark urine, and (yellowing of the skin and eyes). Viral hepatitis A symptoms in children gives out after the end of the incubation period. In some cases, the clinical picture may develop 6 months after infection.

What signs of hepatitis A require immediate medical attention

Parents should seek medical attention immediately if any of the following symptoms are observed:

• the child shows changes in his behavior, becomes distracted, has difficulty waking up in the morning, becomes lethargic or irritable;
• the child begins to drink a lot of fluids;
• the sclera of the eyes and the skin of the child are yellow;
• the child has signs of dehydration, such as no urine for eight hours or dry mouth;
• the child begins to look very ill;
• appetite is disturbed;
• the urine of the child turns red;
• periodically there is vomiting, and refusal to eat;
• The child complains of skin itching.

Diagnosis and testing for hepatitis A

To establish an accurate diagnosis of type A viral hepatitis in children, a combination of anamnesis, clinical symptoms and specific analysis is required.

The disease can be suspected by biochemical tests for hepatitis A, which include an increase in liver tests and transaminases. There is also a special blood test that allows you to determine antibodies to the hepatitis virus in the child's blood. According to laboratory data, the diagnosis is finally established, and in the infectious diseases department. Complete isolation from other children is necessary to prevent transmission of the infection to others.

It is not always possible to establish a diagnosis on the basis of complaints and clinical symptoms due to the blurred picture of the manifestation of the disease in children. Yellowness of the sclera and skin can be caused by mechanical causes. Redness of the urine can also be observed when changing the diet of the baby. For example, red urine may be associated with eating beets.

1. Hepatitis is an infectious liver disease that often occurs in children due to a virus. The disease can be asymptomatic for a long time, but in most cases it manifests itself with pronounced signs that are hard to miss. The disease is classified into several types: viral, transfusion (serum), infectious jaundice, autoimmune, Botkin's disease, infectious (epidemic), reactive.

The occurrence of hepatitis in children is characterized by a violation of the functionality of the liver, which leads to the staining of the skin and mucous membranes in a yellow tint.

The occurrence of hepatitis in children occurs due to viral infection. The virus can be transmitted from the father (at the time of conception) or mother. From the mother, the disease can be transmitted both through the placenta and during childbirth, when the child moves through the mother's birth canal. Infection can also occur in the future, through the damaged skin of one of the carriers.

• A (infectious);
• B (serum);
• C (chronic);
• D (deltavirus, which affects people who are already ill with chronic or acute hepatitis);
• E (the most dangerous virus during pregnancy);
• viruses: F, G, SEN, TTV - are not well studied and vaccination against them is not carried out.

The most common hepatitis: A, B, C, but in children most often occurs hepatitis A. All of them affect the liver cells, but differ in symptoms and severity of the course of the disease. Viruses are very sensitive to high and low temperatures, chemicals and ultraviolet light.

A, B, C

Hepatitis A is transmitted through infected stool or urine. A child can drink contaminated water, eat food that a person has touched with unwashed hands after using the toilet. In the maternity hospital, the infection of the child occurs when changing the diaper on the changing table, on which the infected baby was previously swaddled.

Infection with hepatitis B in children occurs through infected blood (during transfusion) or semen. A large number of cases among adolescents and newborn babies born from an infected mother. The appearance of hepatitis B in children is provoked by a chronic or acute course of this type of disease in the mother (intrauterine infection of the child). Infection also occurs during childbirth. Teenagers can become infected through unprotected sex.

Hepatitis C is transmitted through infected blood. At the moment, all donated blood is examined during blood transfusion, so the risk of infection through this route has been reduced. The use of disposable syringes also reduces the risk of virus transmission. The disease in a child can proceed with implicit signs: reduced activity and a weak course of jaundice. This form of the disease can become chronic.

Chronic hepatitis in children causes serious liver damage, which often causes the death of a child.

autoimmune hepatitis

The form of the disease is manifested by inflammation of the liver. Autoimmune hepatitis is characterized by a high level of serum autoantibodies and a positive effect of immunosuppressive therapy. Autoimmune hepatitis appears due to a failure in the primary violation of the immune response. Possible factors in the manifestation of the disease are viruses or drugs. Autoimmune hepatitis can occur due to a genetic predisposition to this type of virus. Most often, the disease occurs between the ages of two and fourteen.

Autoimmune hepatitis is an acute manifestation of:

• Pain in the right hypochondrium;
• The manifestation of jaundice (in the last stages of the disease);
• Temperature rise;
• Expansion of small vessels on the neck, face and hands;
• The palms become bright red;
• Expansion and thickening of the liver and spleen;
• Adolescent girls may stop menstruating;
• In boys, a painful enlargement of the mammary gland is possible;
• Inflammation of the joints without their deformation.

Autoimmune hepatitis is detected using laboratory tests:

• Blood test for biochemistry;
• Antibody tests;
• enzyme immunoassays.

Toxic hepatitis

This type of disease appears due to an oversight of the parents. Toxic hepatitis develops as a result of toxic substances that have entered the body. These can be toxins of medical preparations, toxic poisons of industrial production (household chemicals), toxins of poisonous mushrooms.

Toxic hepatitis exhibits the following symptoms:

• Pain in the right hypochondrium;
• Temperature rise;
• Nausea and vomiting;
• Bleeding from the nose and gums;
• Expansion of small vessels;
• Relaxed or agitated state;
• Yellowness of the skin and mucous membranes.

Chronic

Chronic toxic hepatitis shows a gradual character.

Symptoms:

• poor appetite;
• Nausea;
• Taste of bitterness;
• Slight increase in body temperature;
• Pain in the abdominal region;
• Allergic rashes;
• Enlargement of the liver and spleen.

Chronic toxic hepatitis is accompanied by signs that fade away for a while. Toxic hepatitis in pregnant women is extremely rare. The woman undergoes therapy, and after that the pregnancy is terminated. Toxic hepatitis will leave no chance for the fetus to survive and develop safely.

The virus responds well to immunosuppressive therapy. Appropriate medications are prescribed. Autoimmune hepatitis is cured completely, until the signs of inflammation and histological data of the disease are eliminated.

Reactive hepatitis

Reactive hepatitis in children is quite common, and occurs due to disturbances in the functioning of the body, provoked by many factors:

• Lung diseases:
• Disorders in the endocrine system;
• Dermatological skin diseases;
• Infectious diseases;
• Neurological diseases with congenital character.

Reactive hepatitis is manifested by weakness, malfunctions of the gastrointestinal tract, the child feels a taste, the skin acquires a yellow tint.

Reactive hepatitis, unlike viral hepatitis, does not cause serious disorders. There is no chronic stage of the disease.

Diagnostics

The child in strict order should be examined by specialists if hepatitis is suspected. Required tests:

• Blood biochemistry tests;
• Blood test for antibodies;
• enzyme immunoassays.

An ultrasound examination of the abdominal cavity is prescribed. During the study, the dimensions of the internal organs and blood vessels, and the pathological phenomena occurring in them, are revealed. With the help of ultrasound, a suitable puncture area is selected for examining the liver for a biopsy. The procedure is absolutely safe and is able to find out in detail the ongoing changes in the liver.

Symptoms

The disease begins to manifest only after the expiration of the incubation period. For hepatitis A, it ranges from 7 to 50 days; for B - from 7 to 12; for C - from 49 to 56 days.

BUT

Hepatitis A is called differently, but this type of virus does not always occur with signs of this disease. Symptoms depend on the form of the disease. The usual icteric form of the disease provokes a temperature that stops at 38-39 degrees for a certain time. A sick child feels pain in the abdomen, which is localized in different places, on this part of the body.

Appear: nausea, profuse vomiting, low physical activity, poor appetite. Urine becomes dark in color, and feces lose their normal color. The liver and spleen are enlarged.

A sick child cannot always show where it hurts, this applies to newborn children. In the second week of the disease, symptoms of jaundice appear, which stain the sclera, mucous membranes, ears, and skin. After a while, jaundice maximizes and gradually subsides. FROM the symptoms of the disease gradually fade away, but the urine remains dark, and the liver is enlarged.

• Jaundice with a cholecystic component has more pronounced and prolonged symptoms than the usual icteric form of the disease. Skin itching is added to the signs.
• Atypical icterus occurs in adolescents. Symptoms of intoxication of the body are absent, but the form is accompanied by increased skin itching and icteric signs.
• The anicteric form of the disease provokes minor symptoms of apathy and poor appetite. The asymptomatic manifestation of the disease does not arouse suspicion in the mother of the child, which leads to a neglected form.
• The hardware and subclinical form has an asymptomatic course. Only enlargement of the child's liver is observed.

The duration of the disease ranges from 1 week to 2 months. Often, the disease ends spontaneously. The rehabilitation period lasts about 6 months.

IN

Symptoms of hepatitis B in children during the weakening of the disease do not appear at all. With an exacerbation of the disease are observed:

• Nausea and vomiting;
• poor appetite;
• Bitter taste in the mouth;
• Flatulence and pain in the epigastric region;
• Coloring in a yellow tint of the mucous membranes and integument;
• Enlargement of the liver and spleen;
• Urine becomes dark in color, and feces lighten.

With a prolonged course of hepatitis B in children, bleeding from the nose or gums is observed.

FROM

Signs of hepatitis C in a child largely depend on the nature of the disease. It is chronic, acute or protracted. The disease lasts at least three months and ends up to six months. The child during illness feels:

• Nausea, possible vomiting;
• Apathy;
• poor appetite;
• Dyspeptic phenomena in the epigastric region;
• The temperature rises to 39 degrees;
• Urine darkens and loses its usual shade of feces;
• Painful enlargement of the liver.

Only in a part of the diseased, staining of the cover and mucous membranes in a yellow tint is observed. In the chronic course of the disease, there are often no signs, but the disease directly acts destructively on the child's liver, which provokes cirrhosis and other severe disorders of the liver and kidneys.

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Treatment

The method of therapy depends on the cause of the disease. Treatment of hepatitis in children occurs in conjunction with diet. The doctor selects medications to maintain liver function. Choleretic and antiviral agents, vitamins are prescribed. To eliminate intoxication, sorbents and mineral water are used. With the permission of the doctor, a course of phytotherapy is carried out.

Hepatitis in babies

Infection of an infant often occurs through the blood, and such a disease for a baby is severe. Infection occurs in utero from the initiated mother or father of the baby. Infection of the expectant mother in the early stages of pregnancy leads to complication of childbirth and pathology of fetal development. The intrauterine development of the virus leads to the fact that the child is born as its carrier.

In newborns, the anicteric form of congenital hepatitis is characterized by an increased increase in liver enzymes and enlargement of the liver and spleen. Congenital hepatitis is subacute or chronic. It is extremely rare for newborns to develop cirrhosis of the liver and blockage of the bile ducts.

Viral hepatitis in a child occurs in an infectious and microbial form. Often, tests during examination show a staphylococcal infection. The development of the disease in children occurs in latent, anicteric or with mild manifestations of jaundice.

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The following signs should arouse suspicion in the mother of the baby:

• Dark urine, which can be seen from the dark marks on the diaper;
• Anxiety;
• Profuse regurgitation;
• Refusal to eat.

Often, the disease in infants is diagnosed already at the stage of exacerbation. Viral hepatitis in newborns differs in the nature of the course of the disease. Preicteric signs of hepatitis in children may be absent. The acute period of the disease begins with a sharp increase in temperature, catarrhal phenomena are possible. The icteric period lasts about a month: tests show an increase in bilirubin, the liver and spleen increase sharply. The course of the disease provokes inflammatory complications in the body in the baby.

Prevention

The basis for the prevention of hepatitis A is personal hygiene. It is necessary to isolate patients for the entire period of the disease. Prevention is carried out with the help of vaccination against this type of virus.

Prevention of viruses B and C is much more difficult:

• Use of disposable medical devices;
• Treatment of medical instruments;
• Elimination of contact of children with medical devices;
• Donor blood testing;
• Examination of pregnant women for viruses;
• Awareness of adolescents about the ways of transmission and prevention of hepatitis;
• Vaccination.

Vaccination is carried out in families with chronic hepatitis. Vaccination against hepatitis in children is very important. Prevention of the disease takes place already in the first day after the birth of the baby. Parents are worried about how the child will tolerate the vaccination. Vaccination is accompanied by itching and pain in the injection area, possibly fever. Allergic reactions occur (very rarely).

The child must receive immunity against the hepatitis virus in due time:

• Six months after the first vaccination - the third vaccination.

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Prevention in some cases has an alternative scheme:

• In the first twelve hours after birth - the first vaccination.
• A month after the first vaccination - the second vaccination.
• Two months after the first vaccination - the third vaccination.
• Twelve months after the first vaccination - the fourth vaccination.

This vaccination scheme is used for children born to carriers of the virus or to women who have been ill during pregnancy. This vaccination schedule is used for blood transfusions. This prevention of hepatitis in children increases immunity against the disease by 95%.

One of the most severe infectious diseases of the liver is hepatitis. This pathology also occurs in children.

The problem is that the situation is not fully understood, often experts call hepatitis in children Botkin's disease, infectious jaundice, etc.

The disease most often has a latent course, but can make itself felt in the form of symptoms, by which it is possible to establish the likelihood of infection of the body.

Hepatitis in children is manifested by an enlarged liver. The organ is affected, and therefore its functionality is impaired.

The first symptoms are the very signal that should make adults pay attention to deviations in the child's health.

An important step in the treatment of the disease is the timeliness of the therapy started. Otherwise, the probability of transition of hepatitis in a child from acute to chronic form is high.

What viruses cause hepatitis

The causative agent of hepatitis in a child is not one virus, but as many as 8 species. Each of them has special abilities to inflict striking blows on the liver tissue.

This becomes an important stage in the development of the disease. Diseases caused by different types of viruses differ among themselves in accordance with the mechanism of infection, as well as the symptoms, severity of the course of the disease and all kinds of outcomes.

Viruses C, B and A provoke hepatitis most often. The younger category of the population often encounters the A form.

In 75 percent of cases, this pathology manifests itself. The remaining types of the virus are still not fully understood, but experts note that they are highly resistant in the environment.

All viral hepatitis are not sensitive to temperature changes, both with low and high rates.

They are able not to lose their viral elements even when heated to 60 degrees Celsius, which can last for half an hour.

In addition, an important characteristic is the fact that all of them are able to withstand drying, UV radiation and many chemicals.

Only there are some differences between them, consisting in the difference in the resistance of hepatitis viruses.

Sources of hepatitis viruses in children

The virus carrier is the main factor that spreads the disease. But there is one "but" - the mechanism of infection will be different for different types of viral hepatitis.

The route of transmission of A and E forms of viral liver disease can be fecal-oral. In such a situation, the virus will leave the human body with urine or feces.

It is also worth mentioning the fact that a child can become infected if the virus gets to him through dirty hands.

Children put something in their mouths all the time, and the digestive tract is a gateway for infection.

Hepatitis is also transmitted through water. The liquid in water bodies can be with the presence of outbreaks of the virus, and therefore the child becomes infected if he drinks water from a poor-quality water supply system.

The variant of transmission of the food way is not excluded. When hygiene rules were not observed by the cook.

There is also an opinion among scientists that the hepatitis A virus can be transmitted by airborne droplets, but not all experts agree with this statement.

Features of pathology in children

Children in the first year of their lives rarely get hepatitis form A. This is due to the fact that they have innate immunity.

Only after a year does it begin to slow down. Hepatitis a symptoms are more common in children aged 2-10 years.

In fact, from 3 to 9 years of age, a peak in liver disease is observed in the pediatric category of patients.

The explanation for this fact is that hygiene rules are not observed. It is not always easy for parents to keep track of their children.

Seasonality should also be attributed to the features of childhood hepatitis. Most often, the disease manifests itself in the autumn-winter time.

This can be attributed to hepatitis A viruses, as other species do not have seasonal signs.

Infection of a child can occur through the blood if it is a hepatitis B and C virus. Most often, such cases were recorded when it was necessary to do a transfusion or the medical staff used an undisinfected instrument.

You should carefully choose medical centers and dental offices for children. These types of hepatitis are indeed a big problem.

The thing is that, unlike how hepatitis A manifests itself, the symptoms in children with virus C and B are erased.

The child may not even suspect that a dangerous pathology is developing inside him, and he is the main spreader of the infection.

As for the susceptibility of children to the type of hepatitis B virus, it is worth noting a high percentage. It can be found in blood, feces, feces, saliva.

Most often, a child can become infected through maternal saliva. Although it is worth noting that there were cases when children succumbed to infection using the same washcloth or toothbrush with a sick person.

The hepatitis C virus is transmitted through blood or drugs, the source in this case will be not only a sick person, but also a healthy person who is a virus carrier.

Unfortunately, in practice, cases have been recorded when a child in the womb picked up a virus from her.

Also, infection can occur when using medical instruments, cutting and stabbing objects, where there was even a negligible amount of blood.

Older children begin to dream of piercing their ears, nose, or getting a tattoo. But this also carries a threat, if sanitary and hygienic standards are not observed, then the fact of infection is very high.

It is possible that adolescents can catch C and B viruses during intimate intercourse with a sick partner.

For this reason, it is important to use condoms, and also not to resort to the use of drugs.

About the liver

The liver plays an important role in the human organ system. It is a natural filter that purifies the blood from harmful and toxic elements that have entered the body.

The body will work at a normal pace if there are no inflammations and viruses in the body.

If hepatitis a manifests itself, the symptoms in children and adults must be recognized as quickly as possible, then the liver is seriously affected.

In this case, you can not hesitate. The aggravation of the situation will not be in the hands of the treatment course. It is urgent to consult a doctor who will prescribe competent treatment.

About hepatitis A in children

This type of viral hepatitis has its own characteristics and manifestations. It is important to stop its development as soon as possible so that there are no complications in the future.

If we consider form A hepatitis in a child as an infectious disease, then first of all it is worth noting that the cells of the organ suffer greatly.

The disease has a cyclic course, and the signs of hepatitis in a child are manifested in the form of intoxication and various types of abnormalities in the state of the organ.

Phases of hepatitis

All viral pathologies of the liver are characterized by a cyclical nature. It is for this reason that the acute stage of hepatitis is divided by physicians into the following phases:

1. Incubation.
2. Preicteric.
3. Icteric.
4. The last one is convalescence.

What are the symptoms of hepatitis

All symptoms will depend on what type of hepatitis has overtaken the child. If it is A virus, then the incubation period will stretch from a week to 7 weeks, B - from 4 to 6 weeks, C - from a couple of days to 8 weeks.

In the next phase, the child may feel unwell. You can write off the condition as a cold, because the baby will have a fever, there will be a cough, a stuffy nose, and there may be a lack of appetite.

It is possible that the signs will be of a gastritis type, manifested by pain in the region of the right side under the ribs.

The child will also complain about weakness, lack of desire to eat. It can get bouts of vomiting or nausea.

Most often, no one rushes to treat a child for hepatitis, because parents think that he just blew up his stomach. Only in fact the situation is extremely complicated by the inflammatory process in the liver organ.

There is another type of hepatitis A, in which there is pain in the joints, a rash on the skin also appears, and the general condition will be accompanied by the urge to vomit.

The doctor at this stage notes an increase in the organ and darkening of the urine.

Phases of hepatitis in newborns

As we mentioned a little higher, hepatitis rarely affects infants, but it is not possible to say for 100% that there is no pathology.

Often, infection occurs in infants through the blood, which already indicates a severe form of the pathology.

The peculiarities of this process include the fact that the infection of the body occurred inside the womb or transplacentally.

If infection is observed in the first trimester of pregnancy, then it is possible that there will be a risk of premature birth, as well as the identification of the occurrence of anomalies in the development of the child.

When intrauterine infection is observed, a child may be born already with a disease that is actively developing.

By prescribing an examination, the doctor can detect an increased activity of liver enzymes in a child, an increase in the size of the organ and spleen, which can confirm that the newborn has an anicteric form of pathology.

It can be both acute and chronic form. Rarely, but it is possible that a child may even have an infection of the biliary tract at the stage of cirrhosis formation.

It can also happen when a baby has viral hepatitis in the form of a staphylococcal or other other viral-microbial infection, which is confirmed by the data of a laboratory study of the baby's materials.

The course of hepatitis of different types in newborns is severe, exacerbations and complications of the pathology with an inflammatory nature can often appear.

It is important to detect the pathology in time in order to avoid serious problems with the child's health later.

Diagnostic measures for determining hepatitis in children

As in the case of adult patients, the doctor first of all conducts clinical examinations of the child.

In this case, it is extremely important to make the correct diagnosis in order to take the right course for treatment.

It is possible to recognize pathology in a child on the basis of laboratory, epidemiological, clinical data.

If there is any suspicion, a hepatitis test should be taken. Thanks to laboratory tests, it is possible to detect viral hepatitis RNA in the blood of a child using PCR and ELISA.

With the help of non-specific indicators, it is possible to establish the degree of damage to the liver organ, assess the pathology and the degree of its course, and also make a prognosis for the outcome of the disease.

In the case of tests for hepatitis, it is necessary to pass a special test that will determine the activity of hepatocellular enzymes and indicators of pigment metabolism.

When the diagnosis is clarified, you can proceed to the treatment course of therapy. It is very important that it is prescribed by a highly qualified doctor.

If this is the initial stage of the development of the pathology, parents are advised to pay attention to the child's symptoms and consult a specialist for help as soon as possible.

Above were signs of pathology that all adults should be aware of.

Outcomes of Hepatitis in Children

Each type of viral hepatitis has its own characteristics, respectively, and outcomes. If we talk about the A virus, then it should be noted that the pathology is characterized by a moderate and mild form.

All this leads to the recovery of the child, and cases of transition to the chronic form are very rare, almost never.

But B hepatitis, in addition to moderate, also has a severe form. The doctor will prescribe tests, the performance of which will improve no earlier than six months later.

There are also 5 percent of cases when the disease develops into a chronic form. As for the C type of hepatitis, the pathology is somewhat easier, but still the chance of transition to a chronic form is high - this is 80 percent of cases.

The outcome in the form of recovery is most often recorded in cases with an icteric form of pathology.

To sum up under the outcomes of the pathology, it should be noted that for children's cases the chances of recovery are high.

There is a 1 percent death rate in children, and in infants it is slightly higher. As for the unfavorable course of the pathology, not only death is possible, but also the development of coma.

After discharge from the hospital, you need to follow a diet and adhere to preventive measures, which will be indicated in the article a little lower.

Let the recovery in children come and slowly, and most of those who have been ill have residual effects, but the outcomes are still favorable.

The signs of post-hepatitis syndrome should include the child's complaints of discomfort and discomfort.

The doctor during the examination will not notice significant changes. The best recommendation in this situation would be compliance with the regimen.

Gradually, the residual effects will become less, and therefore the child will fully recover.

Although there were cases when such complaints persisted for several years.

There is another case when the residual phenomenon will mean an increase in the level of bilirubin in the blood.

This analysis confirms the manifestation of functional liver failure, but the pathology proceeds benignly.

Residual effects can also include cholangitis, cholecystitis and dyskinesia, i.e. deviations in the development of the biliary tract.

These pathologies should be identified as early as possible so that they do not have time to reach the peak of development of hepatocholecystitis.

A child who has had hepatitis can also suffer from pathologies in the gastrointestinal tract. Frequent cases are malfunctions of the digestive tract, for example, pancreatitis or duodenitis.

But the worst thing is that cirrhosis of the liver can develop from a chronic form of hepatitis. Such cases occur in 80 percent!

Features of observation by a child's doctor

When a child has had hepatitis, he must be examined by a doctor for six months or more. Everything will depend on the type of pathology and the severity of its course.

Examinations of a specialist will allow you to determine the complication of the pathology in time and cure them. Children will have to be released from physical education and sports classes for the next 6 months.

Measures to prevent the spread of the virus

It is important to conduct an early diagnosis of the infected organism. This will remove him from other members of society in order to stop the spread of the virus.

In the case when the child had contact with a patient with hepatitis, you need to look at his eyes every day, examine the skin in order to determine the icteric tint. Also one of the important measures will be palpation of the liver.

In cases of detection of a focus of the virus, it is necessary to take examinations every 2 weeks. This measure will be appropriate until the outbreak has been eliminated.

In order to prevent the spread of the virus of various types, it is worth monitoring the quality of the food consumed, observing the rules of hygiene, both public and personal.

Of course, if a child has caught a virus, the house needs to be disinfected, these tips should not be neglected.

As a rule, these measures will be appropriate during the seasonal activity of the pathology virus, this is August - October.

Do not skip vaccinations. All family members, both children and adults, need to be vaccinated at local medical facilities.

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