Hepatitis in children

Many parents hear the term hepatitis and either worry or don't understand what it means for their child. Hepatitis is inflammation of the liver that can be caused by different diseases including a virus. Hepatitis A, hepatitis B and hepatitis C are the most common viruses causing hepatitis.

Despite the similar names, each of these viruses are different and often require different preventative measures to keep children (and adults) healthy.

Norberto Rodriguez-Báez, M.D., gastroenterologist at Children's Health℠ and Professor of Pediatrics at UT Southwestern, is an expert on hepatitis, conducting research and seeing patients at Children's Medical Center Dallas. He shares his insights on hepatitis A, B and C, and how parents can help reduce their child's risk of contracting what can turn into a serious illness.

What is hepatitis A?

"Hepatitis A is a highly contagious virus that lead to serious complications," says Dr. Rodriguez-Báez. "Because hepatitis A can spread easily, it's critical that parents protect their children against this preventable virus."

Hepatitis A is most often a food or water-borne illness. It can be spread by:

• Eating food prepared by someone with hepatitis A who did not properly wash his or her hands

• Water contaminated with the feces of someone with hepatitis A

• Touching an area contaminated by feces

• Sexual contact with someone infected with hepatitis A

• Sharing needles or syringes

The rates of hepatitis A have declined dramatically since 1995, when a hepatitis A vaccine became available in the United States. The Centers for Disease Control and Prevention (CDC) estimates that there are still roughly 4,000 new cases every year. Children under the age of 6 rarely show symptoms of hepatitis A, so it's important to contact your child's pediatrician if you believe your child has been exposed to the virus.

The CDC recommends that all children receive the hepatitis A vaccine when they reach 1 year of age. The vaccine is administered in two doses during your pediatric well-check appointments. The second shot is usually given six months after the first vaccine.

What is hepatitis B?

The CDC estimates that there were roughly 20,900 cases of acute hepatitis B in 2016. The hepatitis B virus can be transmitted:

• During birth when the mother is infected with the virus

• Through sexual contact with an infected individual

• By sharing contaminated needles, syringes and drug paraphernalia

• By sharing needles for tattoos and piercings

Some individuals with hepatitis B recover without any lasting liver damage. However, hepatitis B poses serious long-term health risks to individuals that remain infected. Roughly 15 to 25% of chronic hepatitis B cases will progress to a liver disease such as cirrhosis, liver failure or liver cancer.

Parents can help protect their children by following the recommended vaccine schedule for hepatitis B. The CDC recommends giving the first dose to newborns in the hospital, with two to three additional shots given between 6 and 18 months of age, depending on the type of vaccine your child receives.

What is hepatitis C?

Hepatitis C is a common type of viral hepatitis, though it is the least common type found in children. The CDC estimates that there were almost 41,200 cases of acute hepatitis C in 2016. Hepatitis C also poses more serious long-term health risks. Approximately 75 to 85% of individuals with acute hepatitis will develop chronic hepatitis, which often leads to liver disease.

Hepatitis C is transmitted by:

• Sharing contaminated needles, syringes or other drug paraphernalia used for injections

• Sexual contact with an infected partner

• An infected mother during childbirth

• Injury from a needle stick or other sharp instrument

• Sharing contaminated needles for tattoos or piercings

There is no vaccine for hepatitis C, so it's important for parents to educate their children on the risks of drug use, sharing needles and unprotected sex.

What to know about a rise in hepatitis cases in children

In April 2022, the CDC issued a health alert about unusual cases of hepatitis in children. In these cases, hepatitis A, B and C were ruled out as the cause. These hepatitis infections may be linked to an adenovirus (adenovirus 41), which is a virus that typically causes stomach flu symptoms such as diarrhea, vomiting and fever.

Currently, known cases in the U.S. remain low. If you are concerned about symptoms of hepatitis in your child, contact your pediatrician.

What are the symptoms of hepatitis?

Hepatitis A, B and C have similar symptoms, which include:

• Fatigue

• Fever

• Gray-colored bowel movements

• Jaundice

• Joint pain

• Loss of appetite

• Nausea

• Vomiting

"Occasionally, there are no symptoms of hepatitis. Children under age 6 may have no symptoms," says Dr. Rodriguez-Báez. "If you suspect you or your child has been in contact with someone infected with hepatitis A, B or C, it's important to contact your primary care provider right away for testing and treatment."

How can I protect my child?

"The best way parents can protect their children against the viral infection is by making sure they receive the vaccine for hepatitis A and B," says Dr. Rodriguez-Báez. "Hepatitis can turn into a very serious and even fatal disease – one that is completely preventable with the vaccine."

Parents should also have age-appropriate conversations with their children about the risks associated with drug use, sharing needles and having unsafe and unprotected sex.

Learn more

The Pediatric Liver Disease Program is at the forefront of research into new treatments for acute liver failure, viral hepatitis and other chronic liver diseases. We're helping to set the standard for the diagnosis and treatment of liver diseases in children. Learn more about our program and services.