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Yakubova R.M.
Department of Infectious Diseases Andijan State Medical Institute
VIRAL HEPATITIS A IN SCHOOL-AGE CHILDREN
Abstract: this article reflects on the various manifestations and prophylaxis of hepatitis in young children.
Keywords: viral hepatitis A, viral hepatitis B, immunomodulation, RNA, intoxication symptoms, cardiovascular.
The decrease in the incidence of acute viral hepatitis B and C, which has occurred in recent years, does not remove the problem of the relevance of viral hepatitis. This problem is especially relevant in pediatrics due to the high infection rate of women of childbearing age and the possibility of perinatal transmission of infection from mother to child, as well as due to the involvement of adolescents using narcotic drugs in the process.
The frequency of infection of children from mothers with viral hepatitis, according to the literature, varies widely and depends on laboratory methods.
The course of viral hepatitis in children infected in the first years of life has its own characteristics associated with the immune response, many aspects of which have not yet been disclosed. But the most difficult problem remains the treatment of viral hepatitis, since most antiviral drugs have age restrictions. An important role in reducing the incidence of viral hepatitis B in children belongs to the initiated vaccination. This is especially evident in children, whose indicators were 3-4 times higher than the national ones until recently, and today they have even become somewhat lower, However, the situation remains extremely
alarming, as the growth of chronic hepatitis continues, the numbers of HBsAg and anti - HCV carriers remain high. The basis of the modern approach to the treatment of HCV is the position that the course and outcome of the process (the degree and rate of development of fibrosis in the liver, the formation of cirrhosis
or hepatocarcinomas) is determined by the activity of replication of the
virus
of the causative agent of the disease In accordance with this, the primary
task
of treatment is to reduce the level of viral replication, up to the elimination of the pathogen. The administration of most of the already valuable antiviral,immunomodulatory drugs to children is being restrained due to the fear of possible adverse reactions.
Acute viral hepatitis The term "viral hepatitis" refers to diseases caused
by pathogens of viral hepatitis - A, B, C, D, E, G. The group of viral hepatitis with enteral infection mechanism includes diseases caused by hepatitis A and E viruses, the group with parenteral mechanism - diseases caused by hepatitis B, C, D, G.Hepatitis A virus is classified as RNA-containing viruses. The virus
is detected in feces, bile, hepatocytes, in blood serum In serum, already in the early stages of the disease, specific antibodies are detected first of class M, then - G. The appearance of IgG indicates the presenceof protective immunity. By physico-chemical properties, hepatitis L virus is resistant to acids, alkalis, ether; when heated to 60 ° C retains viability for 1 hour, at room temperature -up to
30 days. in water - up to 3-10 months. It is sensitive to chloramine, formalin and dies when boiled for 5 minutes.
Often, the cardiovascular, nervous, urinary and other systems are involved in the process, but these changes are notconsidered leading Forms of viral hepatitis Atypical jaundice.
■ heartless;
■ subclinical,
■ inapparant.
The disease can have a mild, moderate and severe course.
The criteria for the severity of the course are the severity of intoxication symptoms, the level of bilirubinemia, the serum prothrombin index and, to a lesser extent, indicators of transfer activity) at the height of the disease. The incubation period is from 7 to 45 days, on average 15-30 days Jaundice typical form They are registered in children in 10-30% of cases. The prodromal (pre-jaundice) period is 3-7 days, the onset of the disease is acute - the temperature rises to 38-39 °C for 2-4 days, symptoms of intoxication, nausea, vomiting, abdominal pain without clear localization, intestinal dysfunction. With mass food or water outbreaks, the onset of the disease is noted with dyspeptic or
mixed (dyspeptic + catarrhal) syndrome. With mixed syndrome, persistent nausea, vomiting, flatulence, and stool disorders are observed in the form of diarrhea or constipation. Abdominal pain may be of different nature (blunt,
diffuse, localized in the epigastric region and (or) in the righthypochondrium; acute or paroxysmal) and may mimic abdominal (false surgical) syndrome, this may causethe patient to be hospitalized in a surgical hospital.
Prevention consists in early diagnosis of the disease, isolation of patients for 10-20 days. Contact children are monitored for 35 days with mandatory daily thermometry, examination of the skin and mucous membranes, assessment of the color of feces and urine, palpation of the liver and spleen. Laboratory examination of contact persons, by determining the ALT content, is carried out twice with an interval of 10-15 days. The current and final disinfection is carried out using a 3% solution of chlorine-containing preparations and chamber
treatment. Passive immunization is carried out according to epidemic indications no later than 7-10 days from the expected contact with the patient.
References:
1. Lok A S. F., McMahon B. J. AASLD Practice Guidelines Chronic Hepatitis B // Hepatology. - 2007. Vol. 45, N 2.
2. Alter H. Beyond the C. New viruses and their relationship to hepatitis // Update on viral hepatitis. Postgraduate course. - AASL. - 2000. - P.
