Hepatitis A, also known as Botkin's disease, is an inflammation of the liver caused by the hepatitis A virus. The main route of transmission of the infection is fecal-oral, as well as through food and water from an infected person to a healthy one. This virus has high immunogenicity, and after the infection, long-lasting immunity is formed. The average incubation period ranges from 15 to 30 days.
“Children under 18 years of age, especially preschoolers and schoolchildren, are most susceptible to hepatitis A. The spread of the infection often occurs through dirty hands, unwashed fruits and vegetables, as well as untreated water. In children's institutions, the virus can be transmitted through shared toys and objects that children may put in their mouths. Therefore, adherence to hygiene standards and thorough washing of products are important preventive measures,” notes Khalida Azimbaeva.
The clinical picture of hepatitis A can be diverse, which often complicates its timely diagnosis. As the doctor explains, several forms of the pre-jaundice period are distinguished: flu-like, dyspeptic, asthenovegetative, and mixed.
Flu-like type
This type begins suddenly and resembles ARVI. The temperature can reach 38–39°C, accompanied by weakness and loss of appetite. Fever usually subsides after 2–3 days, but then symptoms such as jaundice of the skin and sclera, dark urine, and abdominal pain appear. Antibiotics should not be used during this period, as they are ineffective against viruses and can harm the inflamed liver.
In this variant, digestive problems predominate: nausea, vomiting, bitterness in the mouth, and abdominal pain. The absence of jaundice in the early stages can lead to confusion with food poisoning or intestinal infection. The use of anti-diarrheal agents in this case can complicate diagnosis and delay proper treatment.
Asthenovegetative type
This variant manifests as general weakness, decreased performance, sleep disturbances, and lack of appetite. Jaundice may be virtually absent, making the patient an unnoticed source of infection.
Mixed type
This combines symptoms of all the above types, from cold-like signs to pronounced abdominal pain and nausea.
Until a diagnosis is established, the child may continue to attend kindergarten or school, thereby risking infecting others. If any suspicious symptoms appear, immediate consultation with a doctor and tests are required, avoiding self-medication.
Treatment Methods
In the acute period of hepatitis A, children often experience enlargement of the liver and spleen, as well as pronounced signs of intoxication. In such situations, hospitalization is necessary to ensure strict bed rest.
For successful recovery, strict adherence to a diet is required. Fried, fatty, and spicy dishes, carbonated drinks, and fast food are excluded. The diet should consist of light dishes: vegetable soups, cereals, boiled meat (separately from the broth), fresh vegetables, and fruits. It is important to ensure adequate fluid intake, including water and homemade compotes, to accelerate the elimination of toxins.
Additionally, in cases of severe nausea and lack of appetite, intravenous drips may be prescribed to relieve intoxication.
The main method of preventing hepatitis A is maintaining personal hygiene. In children's institutions, each child should be provided with individual towels and dishes, and toys should be regularly disinfected. It is important to consume only thoroughly washed fruits and vegetables.
Hepatitis A has a pronounced seasonality, with the highest number of cases observed in autumn and winter, which is associated with summer swimming in open water bodies and the consumption of unwashed fruits.
In our country, vaccination against hepatitis A is not included in the National Vaccination Calendar due to the stable epidemiological situation, unlike vaccination against hepatitis B. However, during outbreaks or at the request of parents, immunization can be carried out in private medical institutions on a paid basis, which is an effective method of protection, especially for children in large groups.
