Hepatitis. Baby Hep and advice for parents – Parsley
Every year on 28 July, the international community drew attention to the need for prevention and control of viral hepatitis. On the need for treatment of these diseases, methods of diagnosis and prevention of more than one year and say in Ukraine. Read more about the relevance of this issue tells the doctor Olga Devonian.
– Let’s, again, what is hepatitis and are their types?
– Viral hepatitis – diseases caused by hepatotropic pathogens-viruses and lead to liver damage. There are 8 types of hepatitis viruses – A, b, C, E, Delta, ti-Ti, F and others. Any of them are dangerous to human life. The disease may not be noticeable to humans, and can lead to disability or death of the patient. Of hepatitis A is transmitted by the faecal-oral route, as with any intestinal infection. Often the increased incidence occurs in late summer – early autumn when the children return from recreation areas. Also the increase in the incidence of hepatitis a occur every 6 years. Primary prevention is the observance of sanitary-hygienic norms, isolation of source of infection and vaccination. This is especially important when the flash is fixed in organized team. After vaccination the healthy members of the staff of the epidemiological chain breaks. Hepatitis And mainly affects children between 5 and 16 years, hepatitis E – young people and adults. I must say that hepatitis E is not typical for our climate zone. It affects people of Tajikistan, Kyrgyzstan, Uzbekistan. However, it is particularly dangerous for pregnant women and can lead to serious pregnancy and death.
– More doctors are sounding the alarm on hepatitis b and C.
– It is in vain, because the incidence of viral hepatitis in the world and Ukraine is growing. In particular 300-400 million carriers of hepatitis b are registered in the world, 2 million patients with hepatitis b die annually from complications acute and chronic forms of this disease. Registered 175 million hepatitis C patients in the world. Also hepatitis b and C infected with 58.4 per cent of donors, 25% of pregnant women, 17.8 per cent of health workers, 21 percent gastroenterologica patients and up to 75 percent of oncohematologic patients. Passing Protocol treatment, such patients are subject to considerable transfusion of blood or its derivatives.
Back to the numbers, including full recovery in adults after acute hepatitis b occurs in 85-95%, chronic in 5-15 percent, the remote cirrhosis in 10-20 percent, carcinoma (a malignant tumor of the liver) – 3 – 6 percent. Fulminant (super acute) hepatitis b in children is 15 per cent, with deaths account for 95 percent. The recovery from acute hepatitis b in children is observed in 30-40%, chronic in 6-12%, fibrosis in 88%, cirrhosis of the liver via 3-15 years – 6-9 percent, carcinoma after 30-40 years – 4 percent. Among oncohematological patients infected With hepatitis C 49%, hepatitis b – 44 percent, and at the same time – 8% other – 1%.
– Differs for hepatitis C?
– Recovery after hepatitis C there are only 20-30 percent, chronic – in 70-80%, cirrhosis in 15-20%, carcinoma – in 3-8 percent. If the child has a diagnosed chronic hepatitis, you should look for opportunities to treat, because with age, increasing the likelihood of getting the disease from hepatitis to cirrhosis and fatal trace. Unfortunately, antiviral therapy is quite expensive. For example, the treatment of a child under the age of 13-14 years worth of from 35 to 60 thousand rubles per month. Full list of surveys (determining the type of virus, viral load, advanced biochemical analysis of blood) necessary for initiation of therapy and also is expensive. Certain types of tests we do in the hospital, but, unfortunately, a number of surveys done only in private laboratories. Now the regional administration of health created the program for coverage of patients with chronic hepatitis b and With modern antiviral therapy. In the Ministry of health has already sent letters with information about the number of patients with hepatitis b and C and the projected number of necessary drugs. From my own experience I will say that after six months of treatment of one of our patients, we achieved clinical and laboratory recovery. He is now at the dispensary and I hope that this child has a chance to be healthy.
– How many children, patients with hepatitis b and C, registered in your school?
– With acute hepatitis b, we occasionally encounter, but patients with acute hepatitis C was not. The fact that the latter is more frequently diagnosed in the chronic form from the moment of infection. This year, there were 4 cases of different hepatitis among children. Recently no new cases. This is because the population does not seek help. Parents need to carefully observe the child and time to bring her for a visit to the doctor. Symptoms such as loss of appetite, heaviness in the right hypochondrium, especially after exercise, skin rash, so-called vascular spiders, extrahepatic manifestations, particularly pain in the bones, often cause anxiety and are very common, so parents do not pay attention to them. If children go to the hospital for pathology of the gastro-intestinal tract, particularly the liver and biliary tract, they planned pass screening tests for hepatitis b and C. In case of positive initial tests, the child is examined further by using the exact method – polymerase chain reaction (PCR), when blood is detected in the genome of the virus of hepatitis b or C. to Begin specific antiviral treatment is possible only when the virus of hepatitis b or C is detected in the blood, known quantity, type of virus, when it comes to hepatitis C and if there is an increase in so-called liver function tests. Under this condition, the body’s response will be much better to therapy. If the virus of hepatitis b or C is detected in the blood, but there is an increase in transaminases, such children therapy not be because, as international experience shows, the possibility of a full recovery are much lower.
– What are the types of prevention of viral hepatitis for children?
– First of all, immunization. Of all the hepatitis prevention under the state program shall be subject to hepatitis B. I Appeal to all mothers and future mothers to reconsider their views on vaccination. Prevention is better than cure. Especially understand that after talking with parents of sick children. The acute question when the person was immunized against hepatitis b and is faced with the need massive surgery, blood transfusion or hemodialysis. Mother, refusing immunization, deprives their child’s right to be protected from many so-called “managed” infections, including hepatitis B. Vaccination against hepatitis b can pass the vaccines provided by the state program, starting with the hospital, or purchased at their own expense at the pharmacy (for example vaccine “Hexa” protects the baby soon from six diseases – whooping cough, diphtheria, tetanus, polio, Haemophilus influenzae and hepatitis b). They are all licensed and safe.
Finally I want to warn young people from injecting drug use, early sexual activity and frequent change of partners, unprotected sex. Also with great care need to be sensitive to such manipulations as manicure, pedicure, piercing and tattoo salons.