Hepatitis A in children: symptoms and prevention 2019
- Stages of Hepatitis A Development in Children
- Typical manifestations of the disease in a child
- Basic principles of treatment of the disease
- Prevention and features of vaccination
Hepatitis A is a viral disease characterized by damage to the liver cells. It is transmitted by the fecal-oral route from a sick person. All segments of the population suffer from this disease. In many countries, the largest number of cases is children. And this is not surprising, since this disease is called the "disease of dirty hands."
Stages of Hepatitis A Development in Children
Just as in adults, the disease develops cyclically and consists of an incubation period, prodromal, icteric, and convalescence. Each of these phases has its own symptoms and duration.
The incubation period lasts from the moment the virus enters the body until the first signs of hepatitis And in children. This is usually about 1 month. At the same time, no clinical changes in this period are noted.
Further symptoms develop in such a way that The child has the temperature may rise to subfebrile numbers or higher, there is malaise, nausea, flatulence, constipation, diarrhea, heaviness in the right hypochondrium.
After 7-10 days of such a development of the disease, symptoms such as jaundice of the sclera, of the soft palate appear, and in a day - of the entire skin. At the same time, a change in urine color is noted. It becomes like a beer, just as dark and frothy. As for such symptoms of the disease as malaise, dyspeptic disorders, during this period they increase.
When examined by a doctor, an enlarged liver is detected, its edge can be compacted and painful on palpation. There are also changes in laboratory parameters that allow to diagnose hepatitis. This increase several times the level of transaminases, bilirubin, especially due to the indirect fraction. The icteric period usually lasts about ten days, gradually reducing its manifestations.
Then comes the stage of recovery, characterized by a decrease in the effects of intoxication, appetite, improvement in overall condition. Yellowiness is also reduced. Longer In all, it remains on the ears and scleras.
The recovery period can last for 2-3 months, during which the child has an enlarged liver, in some cases the spleen, as well as changes in blood counts. And although the child’s condition is not particularly disturbed, abdominal pain and fatigue during exercise are periodically noted.
A child who has had hepatitis A is placed on dispensary registration with repeated follow-up examinations and tests done 3 months after recovery and 6 months. It is recommended to abstain from doing physical exercise and sports until full recovery.
Typical manifestations of the disease in a child
Viral hepatitis A can occur in mild, moderately severe and severe form. The severity is judged by the symptoms of intoxication, the degree of jaundice and laboratory parameters. For 50% of sick children, hepatitis A is mild, the symptoms of which are manifested by insignificant catarrhal symptoms, short-term fever.
The yellowness may affect only the sclera, and the liver is slightly enlarged. The general condition is also a little disturbed.
In some children with a mild course of the disease, the prodromal stage is completely absent. The first symptom in this case is darkening of the urine.
There is a large number of evidence and asymptomatic course of hepatitis A, diagnosed only by laboratory.
Basic principles of treatment of the disease
Due to the fact that specific treatment of hepatitis A has not yet been developed, pathogenetic therapy is carried out, which implies the following:
- Use of hepatoprotectors;
- The appointment of sorbents;
- Vitamin therapy.
A large role is given to the prevention of the disease in children. It includes two directions:
- vaccine prevention,
- a set of measures aimed at breaking the mechanism of transmission of the virus from an infected patient to a healthy child.
Prevention and features of vaccination
Vaccination, depending on the use of different vaccinations, can be carried out for children from one year or three years. To do this, use the vaccine GEP-A-in-HAC of Russian production, which is a formalin-inactivated virions. It is introduced twice in 0.25 ml with an interval of 1 month, with repeated administration after 6 months and revaccination after 10 years.
There are also vaccines from other manufacturers, such as Havriks (Belgium), Vakta (USA), Avaxim (France). Their introduction occurs once in a dosage of 0.5 ml with repeated administration in 6-18 months and revaccination in 10 years.
As a rule, vaccination is well tolerated by children. In rare cases, malaise, fever, allergic reactions in the form of a rash or itching of the skin may occur.
Such changes do not need special correction, and they pass on their own after a few days. If the symptoms increase or persist for a long time, it is necessary to consult a pediatrician.
Hepatitis A vaccination is not a compulsory vaccination. The need for it are the following indications:
- unfavorable situation in the epidemic, when there are 12 sick children per 1000,
- the child has a concomitant liver disease (for example, hepatitis of a different etiology),
- in the presence of hemophilia,
- close contact with an infected patient,
- in cases where it is planned to send the child to an endemically unfavorable region.
Vaccination is a reliable way to protect a child from hepatitis A. At the same time, a durable, long-lasting immunity is developed for 10-15 years. Conducting vaccination, it is necessary to consider that immunity will develop only in 3-4 weeks.
In cases when it comes to emergency vaccination, immunoglobulin prophylaxis is performed, consisting in the use of human immunoglobulin. However, this method is effective only for two weeks after the alleged infection.
It does not make sense to introduce immunoglobulin at a later date, since the disease is already beginning to develop. The dosage of the drug is 0.75 ml for patients from one to six years, 1.5 ml - from 7 to 10 years, 3 ml is administered by the eldest.
One more direction of preventive measures is the observance of sanitary and hygienic norms both by children and by government and medical services. These events will help prevent the virus from entering the liver.
They include the following:
- Improving the sanitary conditions of the children,
- the implementation of the child's ability to use purified drinking water and the same food,
- be able to use reservoirs and pools that comply with regulatory indicators,
- all necessary measures should be taken in the outbreak of infection by doctors and the health service,
- routinely, vaccination of risk groups for hepatitis A should be carried out.
Children, for their part, should strictly adhere to the rules of personal hygiene, which will not allow infection to enter the body, and cause harm for long months. Any disease is easier to prevent than to cure.