In young people, hepatitis usually begins like most viral infections, with nonspecific symptoms such as fever, headache, general achiness, loss of appetite, and fatigue. Within several days, the symptoms begin to hint of gastrointestinal disease with nausea (at times vomiting) and abdominal pain. Finally, symptoms suggestive of liver disease become apparent. The most dramatic is jaundice, which refers to the yellow discoloration of the skin and eyes due to the accumulation of the chemical bilirubin which is normally metabolized by the liver. Many with hepatitis, however, may not become jaundice but are still highly contagious. The urine may darken as the kidneys excrete the excess bilirubin. In severe cases of hepatitis, the build up of poisonous substances normally cleared by the liver can cause coma, convulsions, and death. Blood tests will confirm the diagnosis and determine which virus is responsible for the infection.

Except for hepatitis B infections, most with hepatitis recover without serious complications. Unless loss of appetite and vomiting causes dehydration, people with hepatitis do not need to be hospitalized. As with most viral infections, there is no specific antibiotic treatment for hepatitis. Therefore, prevention is the most important therapy. With the recent development of a safe and effective Hepatitis B vaccine for people, world-wide elimination of this most serious form of hepatitis is a realistic goal. People should call their doctor if they have not received the three dose immunization series. A Hepatitis A vaccine is anticipated to be available sometime next year.

The chart below should help you better acquaint yourself with the "hepatitis alphabet."

How do you get Hepatitis?

HEPATITIS A: Hepatitis A virus is excreted in the feces and people usually get infected from poor sanitary practices. It can also be spread by direct contact with infected people. Other sources of exposure are by eating or drinking virus-contaminated food or water.

HEPATITIS B - The virus is spread by contact with infected blood, saliva, urine, and semen. The virus is transmitted to infants from their infected mother during pregnancy. In 37% of kids with hepatitis B infection, there is no known history of exposure to body fluids from someone else infected with the virus. Hepatitis B is more prevalent and 27 times more contagious than AIDS.

HEPATITIS C - Virus is spread by contaminated blood, blood products and needles. In 40% of infections, it is not known how the person acquired the Hepatitis C virus.

HEPATITIS D & E - Hepatitis D is spread in the same ways as the hepatitis B virus. The hepatitis D virus cannot initiate an infection by itself, and a person must have acquired hepatitis B before becoming infected with hepatitis D.

Hepatitis E virus is acquired when water or food contaminated with the virus is ingested in foreign countries. Travelers and adoptees can import the virus.

What is the Incubation Period?

HEPATITIS A - 10-50 days after exposure

HEPATITIS B - 45-160 days after exposure

HEPATITIS C - 14-150 days after exposure

HEPATITIS D & E - Incubation period for hepatitis D not known; 6 weeks for hepatitis E.

Is there a vaccine to prevent the disease?

HEPATITIS A - Not Yet, Treatment aimed at prevention and developing a hepatitis A vaccine

HEPATITIS B - YES, Three doses of Hepatitis B vaccine is 90-95% effective

HEPATITIS C - No

HEPATITIS D and E - Immunization with hepatitis B vaccine will prevent the most serious form of hepatitis D. No vaccine for hepatitis E

What are the Long-Term Effects?

HEPATITIS A - Fortunately, almost all cases resolve on their own and long term side effects are rare. Rarely life threatening and recurrences are uncommon

HEPATITIS B - 10% of kids become lifetime carries of the virus; 10% progress to chronic liver disease with an increased incidence of liver cancer. (25 people die each day from Hepatitis B-induced chronic liver damage or liver cancer)

HEPATITIS C - 50% of kids become carriers of the virus and are at risk for chronic liver disease and liver cancer

HEPATITIS D and E - Hepatitis D with hepatitis B is the most severe form of viral hepatitis and usually progresses into chronic disease or death. Hepatitis E is the most common form of hepatitis in young people from developing countries.

How is the Infection Diagnosed?

HEPATITIS A - Blood tests to the Hepatitis A virus, if positive, indicate a recent infection or immunity

HEPATITIS B - Blood tests to the Hepatitis B virus can identify who is infected, recovering from an infection, or a carrier (infected without symptoms)

HEPATITIS C - Blood tests to the Hepatitis C virus can indicate who is currently infected or has been infected with the virus in the past

HEPATITIS D and E - Blood tests to hepatitis D can indicate early or late stage infection. Diagnosis of hepatitis E made by excluding the other causes of viral hepatitis since no test currently available.

What to do if you are exposed?

Note: Hepatitis is not spread by casual contact with an infected person, like being in the same room or talking to them.

HEPATITIS A - It is wise for all close contacts (family members, close friends, schoolmates) to receive an injection of immune gamma globulin. Given within one week of exposure, in the past it was 80-90% effective in either preventing or modifying the disease

HEPATITIS B - Immediately begin the hepatitis B vaccine. A single injection of hepatitis B immune gamma globulin is of some benefit if given soon after exposure to blood, bodily fluids, or excretions of a person with hepatitis B

HEPATITIS C - An injection of immune gamma globulin can be given but the protection is not as good as with hepatitis A immune gamma globulin

HEPATITIS D and E - None proven to be effective

How serious are the symptoms?

HEPATITIS A - Kids under five may have no symptoms. Jaundice usually last 1-3 weeks

HEPATITIS B - The long term consequences are more serious than the symptoms

HEPATITIS C - Most cases are mild and many with the infection have few symptoms. Rare in U.S. kids

HEPATITIS D and E - Most cases of hepatitis D infections are serious