Hepatitis B

This Kiwi Families article on hepatitis B in children provides clear information on different types of hepatitis, how they are spread and how they can affect your child.

What is Hepatitis?

Hepatitis means inflammation of the liver – an inflammation that in turn causes damage to the liver cells. There are three viruses involved with hepatitis – hepatitis A, B and C.

Hepatitis B is the most common serious liver infection in the world and is caused by the hepatitis B virus (HBV).

The liver is a vital body organ which helps detoxify and rid the body of waste, stores energy, makes bile for food digestion and fights germs. Hepatitis B can either be acute (short term) or chronic (long term).

Hepatitis B can also lodge in the body of some people causing them to become carriers – meaning they can pass the virus onto other people through blood borne/ sexual contact. Often people are unaware they are carriers because they have no symptoms of the disease.

The incubation period (the time from when someone is infected to when symptoms may appear) is 2-6 months.

• Hepatitis A – also known as infectious hepatitis and is caused by poor hygiene practices. The virus lives in the bowel motions of an infected person – and can be found in contaminated water, milk, foods and shellfish
• Hepatitis B – 90% of babies who contract this illness do so because their mothers are infected with the virus. Infection usually occurs during delivery, but HBV is also carried in breast milk. It is also believed that many previous infections of hepatitis B in New Zealand happened from direct playground contact with virus infection through open cuts and sores
• Hepatitis C – spread through sexual contact with an infected person and also through contaminated blood, sharing needles, tattooing or body piercing with contaminated instruments (all blood in New Zealand is now screened for the disease)

The incidence of hepatitis B is generally considered high in New Zealand and is why the hepatitis B vaccine has become part of the childhood schedule (see ‘Immunisation’ section). The highest prevalence in a 1985 study was found in the eastern Bay of Plenty. There is a higher rate of infection amongst Maori, Pacific Islanders, Chinese and South East Asian communities.

What are the signs and symptoms of hepatitis?

Symptoms of the acute illness in children include:

• Nausea – feeling sick
• Loss of appetite
• Vomiting
• Muscle aches
• Jaundice – where the skin and eyes take on a yellow colour
• Weight loss
• Itchy skin
• Possibly tenderness or pain on the right side of the abdomen
• Possibly dark brown coloured urine
• Possibly pale coloured bowel motion

Treatment for Hepatitis B

Diagnosis of hepatitis B is made by a blood test.

Generally there is no particular treatment for acute or short-term hepatitis B, apart from rest and measures to assist overall wellbeing.

Because hepatitis B is a highly infectious disease, children with the virus need to be isolated.

Bed rest is needed for a couple of weeks to nurse them back to health.

Give plenty of fluids.

It may take several months to return to full wellbeing and normal energy levels.

If your child is diagnosed with hepatitis B, other family members will need to be tested for the disease.

Babies born to mothers who are hepatitis B carriers are given antibodies and an additional vaccination at birth, plus a double dose of vaccine at six weeks and three months of age.

Most children who contract the infection will gain lifelong immunity to the disease. Some will become carriers of the disease.

There is no cure for chronic or long-term hepatitis B, though there are some treatments available including interferon. It is estimated there are around 45,000 chronic hepatitis B sufferers in New Zealand. Natural health practitioners may offer alternative treatments and support in these situations.

Risks & complications of hepatitis

It is possible that carriers of the virus will have no signs or symptoms at all of the disease – and yet they are still able to pass the virus to others. For this reason pregnant women in New Zealand are screened for the disease and, if found to be carriers, special care and extra vaccinations are given to their children.

Children who have contracted the virus may not show any symptoms at all, or may only have a short, mild flu-like illness. In 60 per cent of these cases, children spontaneously recover and develop lifelong immunity.

However, hepatitis can become chronic and continue to damage the liver without children or their parents being aware this is happening.

Later in life chronic hepatitis B can cause scarring in the liver (cirrhosis), liver cancer and even liver failure.

Primarily hepatitis B is a sexually transmitted disease and can also be transmitted through cuts and grazes. The virus is ten times more infectious than HIV virus and it can live outside on the body on dry surfaces for up to 10 days.

What can I do about hepatitis B?

The Ministry of Health in New Zealand recommends that all children are vaccinated against hepatitis B (see ‘Immunisation’ section). This is free of charge and available at your GP surgery.

The virus can be found in blood, saliva, semen, vaginal fluids, tears and urine.

Those at high risk of catching hepatitis B include:

• Intravenous drug users
• People with many sexual partners – especially homosexual partners
• Prisoners and prison workers
• Health care workers, laboratory workers, funeral workers, police who come into contact with infected people
• Travellers to underdeveloped countries

For this reason as your children grow up they need to be taught:

• To be aware to always take care around bloody or body fluids of other people
• Not to share items such as toothbrushes
• Ear piercing and tattooing should only be done by reputable trained practitioners
• Good health practices, such as washing hands regularly, washing and covering cuts, eating well and keeping their body’s immune system strong
• Safe sex practices to help them avoid the risk of exposure to the illness

This is an essential family health reference, covering over 100 common, important, potentially serious and often worrying symptoms and emergencies, such as headaches, chest pain, dizziness, fever, bleeding, tiredness or stress.

This classic bestseller has now been completely revised and updated to include the latest information on how to care for your sick child.

Helpful Websites & Articles

For more information on vaccination schedules in NZ, see our Kiwi Families article on the Immunisation schedule

www.hepfoundation.org.nz– This NZ website offers information about the disease and its treatment.