We all love the monsoon and the cool breeze and greenery it brings. The gentle pitter-patter of rain, a cup of hot chai, and a plate of spicy pakoras—what more can one ask of life? However, many common monsoon-related illnesses come as unpleasant and unwelcome accompaniments.

Hepatitis A, or common jaundice, is one of the most frequent illnesses in children, and its incidence is much greater in the monsoon.

How does my child get jaundice?

Hepatitis A is a virus that gets into the body when one ingests contaminated food (the most common foods implicated are fruits, vegetables, or shellfish) or water. The virus is excreted in a patient’s feces. If food is contaminated, either by direct contact or accidental contamination, the viruses may be ingested and may then cause hepatitis A (basically a swelling and inflammation of the liver).

What is the extent of the problem?

Exact figures of the incidence of disease in India are not known (many factors—poor reporting, undiagnosed, general apathy, etc.). However, a trend that is noted is that while 30 years ago, a majority of the patients were children, there is an increasing percentage of adolescents and adults who are suffering from this disease. This may be because of the widespread use of the Hepatitis A vaccine among children.

Doctor, my child, said that just last week, one of her close friends had absented himself from school for a week due to jaundice. Could she have acquired the disease from her friend?

The virus is excreted in the patient’s feces for 15 – 45 days before developing symptoms and for about a week after symptoms have started. It is pretty easy to contaminate surfaces of everyday objects and through direct contact unless the patient washes his hands meticulously with soap and water after going to the toilet.

I am worried now; what should I look for?

A person exposed to the virus and who contracts the infection starts showing symptoms about 15 -50 days after exposure. Most commonly, the child begins having fever, anorexia, nausea and vomiting, abdominal pain, or diarrhea. The parents may notice high-colored urine, and a little later, the whites of the eye start acquiring a deepening yellow tint. Remember, symptoms are usually mild and self-limiting, and unless there is a high index of suspicion, they may be passed off as a general tummy upset. All contacts of a proven case who have not received a single-dose, single-antigen Hepatitis A vaccine should be administered either a Hepatitis A vaccine or, in some cases, an immunoglobin as soon as possible. Do contact your doctor.

If any of these symptoms develop, what should I do?

Please schedule an appointment to see your pediatrician as soon as possible. On examination, the doctor may find that the child has an enlarged liver that may be tender to touch. Simple urine and blood tests are usually requested to confirm the diagnosis. The level of liver enzymes acts as a base level, and further treatment decisions can be made by comparing subsequent levels with the initial base level.

Doctor, are there any serious complications of the illness?

Almost all children have a mild, self-limiting illness that lasts, at most, a few weeks. In adults, however, the symptoms may last for months! Less than 0.3% of all children develop acute liver failure, as opposed to 1.7% in people > 60 years of age.

Are there any dietary restrictions for a child who is suffering from Hepatitis A?

In general, the patient should continue eating and drinking as usual. In the acute phase, it is better to avoid fatty foods, as the liver produces substances that help digest fats, and any increase in the liver’s workload would result in nausea and vomiting. If symptoms are severe, it is better to rest in bed. Please do not give Paracetamol to any child who is suffering from Hepatitis A, as it is known to cause injury to the liver.

Can I try some Ayurvedic or Homeopathic medicines? I am told that these systems of medicine have effective remedies.

Well, as a practitioner of modern medicine, I find it impossible to comment on the efficacy of these medications without studying the subjects themselves. In general, viral hepatitis does not have a known cure with any known drug. It is a self-limiting and relatively benign disease in the majority of individuals, and no known controlled trials exist that prove any advantage of any particular therapy over just waiting and watching for the disease to get better by itself.

Should I send the child to school?

The child should not attend school for at least one week after the onset of symptoms.

How can this disease be prevented?

Fortunately, Hepatitis A is easily preventable. In fact, in developed countries, the disease incidence has dropped dramatically from 12 cases per 100,000 to < 1 per 100,000 people. This can be achieved by combining simple hygienic measures and vaccinating all individuals with Hepatitis A vaccine.

Simple sanitary measures

Vaccinate your entire family – Hepatitis A vaccination is now on the list of mandatory vaccines in most countries.