Physician: Hepatitis A and International Adoption

What is hepatitis A?

Like hepatitis B and C, hepatitis A is a viral infection that affects the liver. It generally results in lifelong immunity to the virus. Most children in developing countries are exposed to it early in life. In textbook cases, people can easily recognize the symptoms.

A lot of children, however, can have anicteric hepatitis (without any yellowing of the skin). In those cases, you might not notice when someone has the virus.

The majority of children with hepatitis A will recover completely. Only a few will develop a more aggressive form of the virus.

How do people transmit it?

The fecal-oral route is the primary way people transmit the virus to each other in an orphanage or daycare. Eating food or water that is contaminated with the virus is the secondary way it is transmitted. Hepatitis A is such a contagious virus because the virus can shed in a child’s stool for one to two weeks before the child presents any signs or symptoms.

What happens after diagnosis?

Once hepatitis A symptoms appear and someone makes an accurate diagnosis, people don’t transmit it through stool as much. In an orphanage, the virus can run rampant. It can infect many people in a short period of time. Since a majority of children are asymptomatic during the first two weeks of the illnesses, these children spread the virus to other children. In turn, the virus then spreads to the caretakers who change diapers.

What are the signs and symptoms of hepatitis A?

The signs and symptoms of this virus include:

How do you prevent the spread of this virus?

Caretakers usually try to isolate an infected child as soon as he or she is diagnosed with hepatitis A. Unfortunately, however, the child is usually no longer contagious by the time he or she is diagnosed. Thus, it is important for caregivers to always handle diapers, stool, and soiled clothing with care so they don’t become infected, too.

How do you treat hepatitis A?

People who are exposed to or in direct contact with hepatitis A should get vaccinated. A local clinic might have an immunization with hepatitis A immunoglobulin in it. There is no specific treatment for this infection, however. Generally, doctors recommend a very light diet that is low in fats. This reduces some of the gastrointestinal symptoms. The virus has to run its course, though.

Nevertheless, the overall prognosis for children is excellent. Children very rarely die from fulminant hepatitis.

How do people handle this virus in the U.S.?

Currently, there is a new hepatitis A vaccine in the U.S. Doctors recommend children get the vaccine between 12 and 23 months. Older children should get a primary dose and then a booster dose six months later.

The primary role of any vaccine is to provide immunity to whoever the doctor immunizes. A secondary goal is to achieve something called “herd immunity”. This means that once enough of the population is vaccinated, everyone is protected. This includes people who may not be vaccinated themselves.

Unfortunately, most countries don’t have the hepatitis A vaccine. If you adopt a child from outside the U.S., he or she will most likely have already contracted the virus. So, they will be immune to it.