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How Do Children Get Hepatitis?

By: Christine Waasdorp Hurtado, MD, MSCS, FAAP & Laurie A. McCann, DO

When children have hepatitis, it means that they have an "inflammation of the liver." Hepatitis often is caused by a virus. In the United States, the most common viruses that cause it are hepatitis A, hepatitis B and hepatitis C. Other viruses can cause hepatitis. Medications, toxins, alcohol use, drugs and other medical problems can cause hepatitis, too.

Here's what parents should know about types of hepatitis, causes, symptoms and how hepatitis is treated.

What to know about the hepatitis outbreak in kids

Recently, there have been reports of severe hepatitis (inflammation of the liver) among children that may be associated with a common type of virus called adenovirus. Children in several U.S. states and other countries have been affected. These cases are very rare. Parents should ask their pediatrician if they are concerned about their child's symptoms.

Acute & chronic hepatitis: what's the difference?

Acute hepatitis occurs in a previously healthy child, without preexisting liver injury. Leading causes of acute hepatitis in children are due to medications and infections.

Chronic hepatitis occurs in children with underlying liver disease. Children may have signs of advanced liver disease such as cirrhosis, bleeding, fluid build-up and poor weight gain.

Common causes of acute hepatitis

Virus

How it spreads

Time between exposure and symptom onset

Prognosis

Is there a vaccine available?

Hepatitis A

Contaminated food/drinking water

15-40 days

Full recovery is expected

Yes

Hepatitis B

Blood, needles, sexual activity

50-180 days

  • 90% of newborns develop chronic infection.

  • 10% of older children develop chronic infection

Yes

Hepatitis C

Blood, needles

2-6 months

  • 70-80% of acute infections become chronic

  • New drugs are effective at curing the virus in 95%-98% of children.

No

Hepatitis D

Blood, needles, sexual activity

Unclear, since it is a co-infection with hepatitis B

  • Rare in the U.S.

  • Makes hepatitis B infection worse

No

Hepatitis E

Contaminated food/water

5-60 days

  • Rare in the U.S.

  • Full recovery is expected, but infection may be severe for pregnant people

No

Epstein Barr Virus (EBV)

Contact with bodily fluids, especially saliva

Weeks-months

  • Common infection that causes mononucleosis (also called mono or the kissing disease)

  • Can cause hepatitis in rare cases

  • Full recovery expected

No

Cytomegalovirus (CMV)

Contact with body secretions

Weeks-months

  • Very common, over 50% of adults aged 40 have had the virus, which sometimes causes hepatitis

  • Full recovery expected

No

Adenovirus

Droplets the air (e.g., coughing or sneezing); contaminated bodies of water – like swimming pools and lakes

Days-weeks

  • Common infection, that causes hepatitis in rare cases

  • Full recovery expected

No

Signs and symptoms of acute hepatitis in children include:

  • Dark urine

  • Light colored stools (pale)

  • Itchy skin

  • Yellow skin or eyes (jaundice)

  • Fatigue

  • Fever >100.4°F

  • Nausea or vomiting

  • Abdominal pain

  • Loss of appetite

  • Joint pain

Children may also be symptom free. If you are concerned that your child has any of these symptoms or your child has known contact with someone with active viral hepatitis, call your pediatrician.

To diagnose acute hepatitis, your pediatrician may order blood work to check for hepatitis. If the test shows that they have hepatitis, your child may need more blood tests and an abdominal ultrasound.

What is the treatment for hepatitis?

Treatment depends on the underlying cause of hepatitis. If your child has hepatitis from an infection, treatment generally is supportive: rest, staying well-hydrated and supporting their immune system so it can recover from the virus. Talk with your pediatrician before giving your over-the-counter medicine for pain or fever because medicines like acetaminophen (Tylenol) may cause problems. . If hepatitis is caused by a medication, then talk to your pediatrician about stopping that medication. Rarely, if liver inflammation is severe, it can cause liver failure which may require a liver transplant.

What are the long-term effects of hepatitis?

Most children with hepatitis due to viruses or medications recover fully. Although uncommon, chronic hepatitis can occur with hepatitis B or C infections, or if due to an underlying disease and the child will need to be monitored by a doctor.

How do I prevent hepatitis?

There are vaccines to protect children from two of the common virus types: hepatitis A and hepatitis B.

The hepatitis B vaccine (3-dose series) is given to infants at birth and twice again over the next several months. The Hepatitis B vaccine also protects against Hepatitis D, as you cannot develop hepatitis D unless a hepatitis B infection is present.

The hepatitis A vaccine (2-dose series) is recommended for infants once they are 12 months old. The hepatitis A vaccine is especially important because there are areas of the country with high hepatitis A infection rates and for anyone traveling to areas where it spreads.

Here are other ways to prevent or avoid hepatitis:

  • While eating and drinking: Wash hands with soap and clean water for at least 20 seconds when preparing food and drinks. Hepatitis spreads through food, making frequent hand washing during meal preparation especially important for children and caregivers. Don't share utensils or food, and avoid contaminated food and water.

  • At daycare: Check that your child's daycare center practices good hand washing, especially with diaper changes and food preparation.

  • Before traveling to other countries: Ask your pediatrician about the risk of hepatitis and what precautions to take. In some instances, your pediatrician may recommend a hepatitis A vaccine before traveling.

  • At home: Keep medications locked and out of reach from children, and always check the label and dosing instructions before giving medicine to your infant or child.

More information

About Dr. Waasdorp

Christine Waasdorp Hurtado, MD, MSCS, FAAP is a member of the American Academy of Pediatrics and North American Society of Pediatric Gastroenterology Hepatology and Nutrition. She is an Associate Professor of Pediatrics at the University of Colorado School of Medicine and practices in Colorado Springs.

About Dr. McCann

Laurie A. McCann, D.O., a member of the American Academy of Pediatrics and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN), is a second-year pediatric gastroenterology fellow at Children's Mercy Hospital in Kansas City, Mo.


Last Updated
5/10/2022
Source
American Academy of Pediatrics (Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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