“Hepatitis” is the term used for inflammation of the liver. Mostly caused by viruses, this condition disrupts the body’s ability to process toxins and can be life-threatening. Recent reports indicate that an unusual number of cases of hepatitis among children aged 2-5 years are emerging. The European Center for Disease Prevention and Control noted about 450 affected over 25 countries as of the week of May 11, 2022. About a quarter of these come from the United States.

More than 90% of the children diagnosed in the United States required hospitalization, and five have succumbed to the disease. Liver failure caused organ transplantation to be required in 14 percent of cases.

There are several main types of Hepatitis: A, B, C, D, and E. The most frequently seen are Hepatitis A, Hepatitis B, and Hepatitis C. Hepatitis B and C can become chronic inflammations with long-lasting ill effects. The recent pediatric cases, however, seem to be of unknown origin or related to the presence of a virus known as “adenovirus 41.” The relationship between the hepatitis cases and the virus is not yet known, although the CDC noted its presence in half the patients.

SYMPTOMS OF LIVER INFLAMMATION

In hepatitis, the liver becomes enlarged and tender to the touch. Other signs and symptoms include:

• Jaundice (yellowing of the eyes and skin)
• Dark urine
• Light-colored stool, whitish-gray or clay-colored in some cases
• GI symptoms such as nausea and vomiting, abdominal pain, and appetite loss
• Fever
• Fatigue, weakness
• Muscle and joint aches

Parents who note the above in their children should take them for medical evaluation immediately.

HEPATITIS A, B, AND C

Here are what you should know about the main types of hepatitis:

Hepatitis A: The hepatitis A virus is found in the bowel movements of infected individuals. You get it by ingesting something contaminated with microscopic feces containing the virus. This is known as “oral-fecal contamination.”  It can also be passed sexually.

Expect symptoms to start 2-6 weeks after infection. Hepatitis A could be severe enough to require hospitalization in about 20 percent of cases, but most cases are self-limited and resolve in two weeks or so. Long-term damage is rare.

Hepatitis B: This type can be spread by exposure to contaminated needles, blood products, semen, and vaginal fluids. The virus also can pass from a mother to her newborn child at birth or soon afterward.

Symptoms are usually indistinguishable from Hepatitis A. Unlike Hepatitis A, however, hepatitis B may cause achy joints. In some circumstances, Hepatitis B may lead to a chronic condition known as “cirrhosis” that leads to permanent liver dysfunction.

Hepatitis C: About 200 million people are chronically infected with hepatitis C virus throughout the world. It is a blood borne virus (there are several subtypes) contracted by intravenous drug use, transfusion, contaminated tattoo needles, and unsafe sexual practices. A percentage of these patients will progress to cirrhosis over time and, sometimes, liver failure. It is also the primary cause of liver cancer.

In cirrhosis, the functioning cells of the liver are replaced by nodules that do nothing to help metabolism. The signs and symptoms may be striking, and include:

•          Accumulation of fluid resulting in a swollen abdomen (called “ascites”).

•          Varicose veins, especially in the stomach and esophagus.

•          Jaundice.

•          Swollen ankles and legs.

Cirrhosis can also be caused by prolonged alcohol or drug abuse. Luckily, most hepatitis cases don’t develop cirrhosis and improve over 4-8 weeks. Victims are contagious, however, and can spread infection through close contact with others even before feeling sick or when their own symptoms disappear.

WHY IS HEPATITIS OCCURRING IN CHILDREN?

Hepatitis in children is very rare, so why is this occurring now?

The answer is “no one knows for sure,” at least at present. Is a normally mild virus like adenovirus 41 mutating into something more serious? Usually, you’d just see a few days of flu-like symptoms, GI complaints, or perhaps bladder discomfort or conjunctivitis (pink eye).

Some are concerned about a COVID-related origin, but there were no current SARS-CoV-2 infections in the reported cases. There is, however, a multi-system inflammatory reaction that can occur in children after COVID known as “MIS-C.” It’s possible that a prior COVID infection might have made the liver “triggered” by an adenovirus into a major inflammatory response. Other hypotheses suggest the presence of toxins in the environment or, perhaps, a different infectious agent. As for the vaccine, liver specialists have stated that few if any of the 2–5-year-old victims had been vaccinated.

HEPATITIS IN SURVIVAL

Antiviral treatment for some forms of hepatitis, such as hepatitis C, has been rapidly improving, with more than 90 percent cure rates. It should be noted that vaccines also exist for Hepatitis A and B, but not C. Unfortunately, these options won’t be available to the austere medic.

What, if anything, can be done for a hepatitis victim off the grid? Once hepatitis is diagnosed, the austere medic can prescribe rest, assure proper nutrition, and give plenty of fluids while the patient’s body fights the infection.

At one point, medications run out and the medic is left with only natural alternatives. There are a few “detoxifying” and anti-inflammatory herbal remedies that may help support a liver afflicted with hepatitis. Some of these supplements include:

•          Milk Thistle

•          Artichoke

•          Dandelion

•          Turmeric

•          Licorice

•          Red Clover

•          Green Tea

Be aware that these aren’t cures and are lacking hard data as to their effectiveness. They might assist your other efforts by having a restorative effect.

Nutritional strategies that may help recovery:

•          Avoid fatty foods and alcohol

•          Increase zinc intake

•          Emphasize lean proteins (fish, egg whites, skinless chicken)

•          Improve hydration status, especially with herbal teas, vegetable broths and diluted vegetable juices.

Hopefully, the number of children developing hepatitis will not increase, but it’s important to know the signs and symptoms. Armed with knowledge, the family medic can recognize the problem and begin efforts, in normal times, to seek help from qualified professionals.

Joe Alton MD