What Every Parent Should Know About Hepatitis A

Kids often don't have symptoms when they have this liver infection
What Every Parent Should Know About Hepatitis A

Contributor: Kadakkal Radhakrishnan, MD

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Although parents may not hear about hepatitis A infections often, it’s important to know the signs and symptoms — as it’s more common than you might think.

Hepatitis A is an inflammation affecting the liver, due to a highly contagious viral infection caused by the hepatitis A virus. This virus only affects the liver, but other viruses can also cause infection of the liver, including hepatitis B, C and E.

Signs and symptoms

Hepatitis A has an incubation period of two to four weeks — from the time of acquiring infection to the start of symptoms.

The symptoms start with nonspecific signs that include fatigue, nausea and occasional vomiting. Subsequently, patients develop pain in the right part of the belly, corresponding to the position of the liver. Low grade fever, muscle aches, diarrhea and loss of appetite are common, as well as dark-colored urine and yellow discoloration of the eyes and skin, which is called jaundice. Symptoms last a few weeks, though rarely, patients will have more persistent symptoms that last longer. What makes things trickier is that some patients, especially young children, may not have any symptoms at all.

Unlike hepatitis B and C, hepatitis A infection does not become long-lasting or cause long-term damage. Rarely, patients develop fulminant liver failure that requires a liver transplant. Occasionally, patients with underlying chronic liver disease may develop sudden loss of hepatic function and acute liver failure.

How your little one can get hepatitis A

Patients acquire hepatitis A when they ingest an extremely small amount of virus from fecal contamination containing the virus.

This may happen from exposure to contaminated water or exposure to food handled by someone with the virus who may have not thoroughly washed their hands.

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The virus can also be transmitted from eating raw shellfish exposed to contaminated water, or from close contact with someone who has been infected — even if they have no symptoms. The virus can also be spread in childcare settings if the caregiver does not wash his or her hands after changing an infected baby’s diaper.

What to do

If you suspect your child may have contacted hepatitis A, either due to symptoms detailed above or exposure to someone with hepatitis A, you should seek the help of your pediatrician.

If suspicious, the pediatrician would run specific antibody tests to look for current or prior exposure to hepatitis A. Liver function tests can measure elevation of liver-specific enzymes. A prothrombin time test is a good way to evaluate liver functional capacity by indirectly evaluating clotting factors in the blood that the liver produces. This number goes up very high in acute liver failure.

Treatment of hepatitis A often is directed at easing symptoms and rarely requires hospitalization. The symptoms for most part resolve after a few weeks and so do the measures that diagnose the disease.

If your child is diagnosed with hepatitis A, make sure he or she gets plenty of rest and contact your medical provider if nausea is severe. Your child may need to be admitted to the hospital for acute liver failure or for vomiting and dehydration.

Most acute liver failure will resolve on its own, but rarely, patients may require a liver transplant.

It’s important to ensure that children wash their hands thoroughly with soap and water after using the toilet. As a parent with the infection, you should avoid cooking for others while actively infected.

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Medicine and supplements that can potentially affect the liver should be used carefully and only after discussing with your child’s pediatrician.

Prevention is key

Getting the hepatitis A vaccine can prevent the infection. The Center for Disease Control and Prevention recommends all children age 1 and older receive two vaccine shots, six months apart.

If your child is traveling to a region with elevated risk of hepatitis A virus infection, be sure to thoroughly wash all fruits and vegetables. Using bottled water is recommended, even for brushing teeth, and water should be boiled if the quality cannot be assured.

Raw or undercooked meat or fish should be avoided, and good hand hygiene is imperative.

If you are not vaccinated against hepatitis A and have been exposed to the virus, receiving the vaccine or antibody within two weeks of the exposure may prevent the infection.

If your child is not vaccinated and traveling to elevated risk area, either discuss it with your pediatrician or reach out to your local health department or travel clinic for information regarding prevention.

This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.

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