B17.9
*Notifiable condition
DESCRIPTION
Acute inflammation of the liver with varying degrees of hepatocellular necrosis caused by hepatitis A, B and less commonly C, D and E viruses.
DIAGNOSTIC CRITERIA
Clinical
- Prodromal phase:
- nausea,
- malaise,
- vomiting,
- anorexia,
- fever, and
- right upper quadrant abdominal pain.
- Jaundice, tender hepatomegaly and dark urine.
Investigations
- Raised transaminases and bilirubin.
- Serological evidence of hepatitis virus infection. See Hepatitis B chronic , for Hepatitis B interpretation chart.
GENERAL AND SUPPORTIVE MEASURES
- Isolate patient if Hepatitis A for 7–10 after the onset of jaundice.
- Inform patient of infectivity risk if hepatitis B, C or D.
- Bed rest does not alter the course of the disease.
MEDICINE TREATMENT
Prophylaxis
- Hepatitis B vaccine, IM, 0.5 mL.
- If < 1 year: outer side of the right thigh.
- If > 1 year: upper arm.
Use opposite side to that for the DPT/Td injection.
Give at 6, 10 and 14 weeks as part of the routine expanded programme on immunisation.
Neonatal transmission:
Babies born to mothers with acute hepatitis B infection at the time of delivery or to mothers who are HBsAg-positive or HBeAg-positive:
- Hepatitis B immunoglobulin, IM, 0.5 mL within 12 hours of delivery.
PLUS - Hepatitis B vaccine, IM, first dose within 12 hours of delivery.
- Continue hepatitis B immunisation according to the recommended immunisation schedule.
REFERRAL
- Acute hepatitis with bleeding tendency and altered level of consciousness – isolation recommended.
- Prolonged jaundice or raised transaminases.
- Chronic hepatitis with/without cirrhosis.