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How to manage viral hepatitis in a child?

Q: My 20 months old son has been diagnosed to be suffering from infective Hepatitis. His report on examination of urine sample shows Bile pigments and Bile salts, both are present. He has been advised syrup lornit. This is the only medication advised apart from normal daily diet that he is taking. Please advise as to the seriousness of Hepatitis A that my son has contracted. Also suggest the precautions & food intake that should be given to him. And if some other/additional medicine is required . He has been given all the required dose/shots until now on time as per the chart of Indian Academy of Paediatrics, Immunization & Health Record. As per the above IAP chart, he has been given Hepatitis B vaccine by 9 months. His Hepatitis A vaccine is due in October 2003 when he completes 2 years of age. However, we have now been told by another paediatric that Hepatitis A vaccine is to be given in the first year of a child. If so then why is the IAP chart not informing the same. The IAP that we are consulting is the new one. Why are the doctors and health clinics not informing parents about the time of change of Hepatitis A vaccine to be given to children?

A:Your child seems to be having viral hepatitis, make sure blood tests have been done to confirm Hepatitis A which is a viral infection of the liver and in majority of cases is self limiting, resolves over 10-14 days without any medications or treatment. She can have normal home made diet, what ever she feels like eating. Regarding the Hepatitis A vaccine, it can be given after one year of age, but better given at 2 years, so both recommendations given to you by the two pediatricians are right. Since it is a expensive vaccine it is not displayed in all vaccination charts universally, but I think the doctors and clinics should inform availability of this vaccine and leave the choice of having or not having the vaccine to the parents.

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