Today the world knows a million different diseases, most of which people have learned to successfully fight. Of course, in our lives we encounter only some diseases. One of these is Botkin's disease. How this disease is transmitted, how to treat and prevent it, every mother should know. After all, the infection often affects the child’s body.

The liver is one of the main human organs. It synthesizes proteins and bile acids, accumulates and breaks down glucose. The main function of the liver is to filter all incoming substances. Of course, if the liver’s function is impaired, the entire human body suffers.

There may be several causes of disease in this organ:

1. Infections (hepatitis A, B, C, E, D).
2. Diabetes.
3. Long-term use of antibacterial drugs and other medications.
4. Alcohol abuse.
5. Heredity.
6. Ecology.
7. Lifestyle and unacceptable working conditions.

Liver diseases include:

1. Viral hepatitis (A, B, C, etc.). Each form has its own developmental characteristics, treatment methods and consequences. All forms of viral hepatitis are transmitted through household contact, through semen, and also from mother to child.
2. Toxic hepatitis is a reaction to taking medications.
3. Alcoholic hepatitis occurs as a result of alcohol abuse.

All hepatitis, except form C, are treatable. Hepatitis C is cirrhosis of the liver. There is no cure for this disease. The disease always ends in death.

Or as it is also called - Botkin's disease (in honor of the doctor who discovered the disease) - an acute viral disease that primarily affects the liver. The nervous system, digestive system and kidneys are also affected.

The disease can be called an epidemic, outbreaks of which are typical for countries in Africa, Asia, and South America.

A large percentage of hepatitis A patients are children, adolescents and the elderly. The main symptoms of Botkin's disease are icteric complexion, headaches, diarrhea. Hepatitis A is a curable disease. It is enough to go to the hospital for help in a timely manner. There are, of course, deaths - 0.1 - 0.3%.

The virus that causes hepatitis A is very resistant to the external environment. It has an acid-resistant shell, as a result of which the protective barrier of the stomach is not afraid of it. Hepatitis bacteria persist in water for a long time. Therefore, the main cause of epidemics is contaminated drinking water sources. Botkin's disease is also transmitted through contact and household contact, sometimes by airborne droplets, and also through blood. The virus can be carried by flies. Bacteria, entering the body, are absorbed through the intestines into the blood, after which they spread throughout the body and affect the liver.

The incubation period ranges from 10 to 40 days, after which the first symptoms of the disease begin. Having had jaundice once, a person receives stable immunity for life. Such people can no longer be blood donors.

Hepatitis A can occur in the body in several forms: mild (most cases), moderate (about 30%) and severe (1-3%).

Depending on the form of the disease, symptoms may also be different. Mainly:

1. Increased body temperature, lethargy, fatigue.
2. Nausea, vomiting, upset.
3. Pain in the liver area. When palpated, this organ is noticeably enlarged.
4. Disturbed sleep, lack of appetite.
5. A runny nose and cough may occur.
6. The skin and membranes of the eyes acquire a characteristic yellowish color. The icteric period lasts from three to six weeks.
7. Urine becomes dark, feces, on the contrary, become discolored.

Often the signs of the disease are perceived as a common cold (flu, ARVI), and not as Botkin’s disease. Symptoms worsen, jaundice appears, and only then do patients consult a doctor.

On average, the disease lasts about forty days. The course of the disease depends on age, immunity, concomitant diseases and treatment methods.

One-year-old children and the elderly are more susceptible to infection. Therefore, everyone should know what Botkin’s disease is, how it is transmitted and what its symptoms are. After all, the disease often affects entire families. Timely diagnosis can protect against severe forms of the disease.

Hepatitis A, unlike its other forms, is completely curable. After therapy, liver function is restored. People gain lifelong immunity.

In rare cases, Botkin's disease causes health problems. The causes and symptoms of complications can only be associated with non-compliance with doctor’s instructions, violation of bed rest and poor diet.

Patients may complain of continued pain and vomiting for another two months after therapy. This is normal, no need to panic.

You can minimize the complications and consequences of hepatitis with the help of proper dietary nutrition.

1. Food should be consumed in small portions, but often.
2. During illness, a person loses a large amount of vitamins, so it is imperative to replenish them. The diet should include fresh vegetables, fruits, juices, and dairy products.
3. The consumption of fatty, salty, smoked, pickled and spicy foods is prohibited.
4. “Fasting” days are welcome. Dairy products, vegetables and fruits are good for this.
5. Fans of alcoholic beverages will have to give them up for a while.
6. All food products must be thoroughly processed.

First of all, to establish an accurate diagnosis, you should go to the hospital. Only a doctor, after examining and passing all the tests, can give an opinion to the patient. Considering that Botkin’s disease does not always have pronounced symptoms, it is impossible to talk about the presence of infection in the body without additional diagnostics. For research you need: blood (general and biochemical analysis is performed), urine and feces. If class M antibodies were detected in biomaterials, this indicates the presence of infection in the body. Antibodies of class G – immunity to the disease.

Determine how to treat Botkin's disease and symptoms. Treatment of mild and moderate forms of the disease can be done at home. The main thing is bed rest and dietary nutrition. Drinking plays an important role, which is necessary to reduce intoxication. Treatment of severe forms of hepatitis A is carried out inpatiently, in infectious diseases departments.

To improve liver function, in addition to vitamins, specific drugs such as Gepabene and Essentiale can be prescribed.

It is no secret that proper and healthy food is the best assistant in the fight against diseases and infections. For each type of disease there are therapeutic nutrition schemes developed by Soviet nutritionist Mikhail Pevzner.

Diet No. 5 is designed specifically to improve liver function. The essence of the diet is to limit the consumption of fatty and unhealthy foods. So, during illness you need to exclude:

1. Smoked, fatty, marinades, pickles and offal.
2. Fresh baked goods and confectionery.
3. Hot herbs and spices.
4. Carbonated drinks, strong coffee and alcohol.

Allowed:

1. Yesterday bread, dried flour products.
2. Cereals, soups, porridges.
3. Vegetables fruits.
4. Low-fat dairy products.
5. Lean meat and broths.
6. Teas, juices, coffee with milk.
7. Vitamins.

It is better to cook food by steaming. This preserves a large number of useful microelements.

Botkin's disease refers to acute intestinal infections. You can become infected with the disease through food, water, and also from infected patients.

The incubation period averages 28 days, after which the disease itself begins, which consists of three stages: pre-icteric, icteric and convalescent. Each period has its own symptoms.

At the first stage of the disease, the child becomes very capricious and loses appetite. Sleep may be disturbed and the temperature may rise. Nausea, vomiting, and diarrhea appear. This period is also characterized by the appearance of cough and runny nose.

The symptoms of Botkin's disease in adults and children are initially the same and can often be mistaken for another disease (for example, influenza). When the icteric period begins, the patient’s condition improves. However, yellowness appears on the eye membranes and skin. Pain in the liver may also occur. At this time, the patient begins to perceive the symptoms of Botkin’s disease correctly and seeks help from a doctor.

The recovery period is characterized by the gradual extinction of all symptoms. Liver functions are restored, the patient's condition is stabilized. Sometimes nausea and pain may persist for a month or two after recovery.

Considering how complex Botkin’s disease can be and how the pathogen is transmitted, it is better to treat in hospitals. This applies in particular to families with young children or elderly people.

Botkin's disease is a very dangerous disease for expectant mothers. While most people suffering from hepatitis A suffer from mild to moderate forms of the disease, pregnant women almost always suffer from a severe form.

Botkin's disease during pregnancy causes liver dystrophy. The infection also penetrates through the placenta to the baby. Children born from infected mothers often have various defects and pathologies. The woman herself may die during childbirth. This is because the disease affects blood clotting. Caesarean section is also contraindicated.

At all stages of pregnancy, the cause of miscarriages, premature births and stillborn children is Botkin's disease. Every woman should know the symptoms, treatment and signs of Botkin's disease. Proper preventive measures will help her protect herself from the sad consequences of this disease during pregnancy.

Of all types of hepatitis, the easiest to prevent is hepatitis A (Botkin's disease), which is transmitted by the fecal-oral route. To do this, it is enough to observe the rules of personal hygiene, as well as educate people about this disease.

Symptoms of Botkin's disease can be different, but the main ones are jaundice, vomiting, headaches and diarrhea. If people sought help in a timely manner, perhaps the number of patients would be significantly reduced. After all, the incubation period of hepatitis A lasts quite a long time, and all this time the person is already a carrier of the pathogen.

To protect yourself and your loved ones from this disease, you should follow these simple rules:

1. Always and everywhere you need to wash your hands with soap.
2. Handle food carefully. Vegetables and fruits should only be washed under running water.
3. It is better to boil tap water. The pathogenic bacteria are resistant to the aquatic environment, and boiling kills them in a matter of minutes.
4. Food products should be purchased in specialized stores, and not in spontaneous markets.
5. If possible, it is better to get vaccinated against hepatitis A.

“Botkin’s disease, symptoms, treatment, complications” is a topic that everyone should become familiar with. The cause of many diseases and infections is ignorance!

When a person is aware and consults a doctor in a timely manner, there will be fewer complications. It should be remembered that severe forms of hepatitis A can cause cirrhosis and liver cancer, although this happens very rarely.

Botkin's disease is a disease whose pathomorphological manifestations are localized exclusively in the liver, characterized by a favorable course and viral origin. Not only every adult, but also a child should know how Botkin’s disease is transmitted and how to avoid infection, since this category belongs to a risk group for infection. The causative agent of Botkin's disease is prone to rapid spread through contaminated food and household items, therefore the most favorable conditions for its life are inadequate sanitation and lack of personal hygiene.

The fundamental difference between Botkin's disease and other viral liver diseases is that this pathology is not prone to chronicity due to the absence of a degenerative effect on the liver parenchyma. The development of a fatal outcome in Botkin's disease is possible only in the case of a complicated course, which is extremely rare and is rather an exception to the rule.

Cases of Botkin's disease have recently been observed in the form of outbreaks, although previously there were entire epidemics of this infectious pathology throughout the world, which developed with some cyclicity.

Among all toxic infections, Botkin's disease makes up the overwhelming majority. The causative agent of Botkin's disease exists for a long time in environmental conditions and is resistant to most food production processes that are routinely used to inhibit bacterial pathogens.

Botkin's disease leads to economic and social losses, due to the fact that treatment and recovery of patients usually take a long period of time, so the issue of preventing this infectious pathology is an extremely important link.

The main source of the spread of infection in Botkin's disease is a person who has a clinical picture of this pathology and, along with infected feces, releases virions into the environment. The causative agent of Botkin's disease is pathogenic in humans and is extremely resistant to environmental factors. It should be taken into account that not only the sick person, but also the virus carrier can act as a source of spread of the virus in Botkin’s disease.

In addition to the presence of the virus in the stool of patients with Botkin's disease, the pathogen is concentrated in large quantities in the blood. Infection with Botkin's disease can be carried out by almost any method, however, the predominant ones are fecal-oral and water. The maximum danger in relation to the epidemiology of the spread of the Botkin disease virus is hidden virus carriers, which include patients with a latent course of the clinical picture.

The pathogenesis of the development of Botkin's disease is that the virus spreads hematogenously throughout the body and concentrates in the liver, provoking inflammatory changes in its parenchyma. Botkin's disease leads to disruption of the bilirubin-excreting function of hepatocytes, which is accompanied by excessive accumulation of bilirubin in the circulating blood, provoking the development of jaundice. In Botkin's disease, viral particles multiply in the cytoplasm of hepatocytes, after which they enter the intestine en masse with bile, moving along the bile ducts. Persons who have recovered from this disease acquire a lifelong immune response, which does not protect convalescents from infection with other types of viral hepatitis.

Botkin's disease can be confidently classified as a childhood infection, although most cases of this pathology in children are not registered, as they occur in an asymptomatic form.

The classic course of Botkin's disease develops in stages. This pathology is characterized by the presence of a long prodromal period, which is manifested by febrile and dyspeptic syndrome, which are manifested by malaise, a feeling of weakness, decreased appetite, belching, nausea and vomiting of eaten food, pain in the right hypochondrium, and an increase in body temperature to 38.5 ° C.

The development of clinical manifestations of the icteric period in Botkin's disease is very rapid and is accompanied by an improvement in the general condition of the patient. First of all, jaundice appears on the mucous membranes and sclera, and later spreads to the skin of the entire body. The increase in jaundice occurs gradually, in contrast to the manifestations of the incubation period, and takes about a week. Jaundice in Botkin's disease is most often accompanied by the development of adynamia, headache, insomnia, skin itching, and irritability.

Objective signs of Botkin's disease are considered to be a slight or significant increase in the size of the liver, the edge of which is somewhat compacted and sensitive to palpation. In some situations, hepatomegaly is combined with an enlarged spleen. Darkening of urine in Botkin's disease is caused by the concentration of urobilin in the urine, and due to insufficiency of bilirubin in the intestines, stool becomes discolored. Laboratory criteria for the icteric period in Botkin's disease are leukopenia and a slight increase in the concentration of bilirubin in the blood serum to 8 - 10 mg%. With a protracted course of Botkin's disease, an increase in the icteric period to several months is noted.

The duration and intensity of clinical manifestations in Botkin's disease can vary significantly. The incubation period of Botkin's disease, as well as jaundice, with a mild course, is short-lived. In this situation, a good help is the use of laboratory diagnostic methods in the form of determining aldolase activity, which increases several times.

The severe course of Botkin's disease is characterized by the development of neuropsychic disorders in the form of lethargy, drowsiness, as well as pronounced intensity of jaundice, and the appearance of a diffuse petechial rash on the skin. Laboratory signs of severe Botkin's disease are an increase in the level of bilirubin in the circulating blood to 20 mg%, the thymol test to 20 - 24 units and a simultaneous decrease in the mercuric test to 1.4 - 1.1 units.

The malignant course of Botkin's disease, which is called “acute liver dystrophy,” is accompanied by the development of diffuse massive necrosis of the liver and the formation of irreversible dystrophic changes in its parenchyma. Clinical markers of this form of Botkin's disease are progressive liver shrinkage, jaundice, general severe intoxication syndrome, profound disturbances in the activity of the structures of the central nervous system with the development of hepatic coma.

Signs of toxic liver necrosis, which is one of the forms of Botkin’s disease, are the development of persistent anorexia, nausea, repeated episodes of “coffee grounds” vomiting, increasing general weakness, lethargy, apathy, drowsiness during the day and insomnia at night. Hepatomegaly gives way to sclerotic changes in the liver, and the consistency of the parenchyma becomes soft. Pathognomonic signs of the development of neurological changes are the appearance of patient agitation, increased tendon reflexes and tremor, and with progression, coma develops.

Botkin's disease develops equally often in children of different ages. The incubation period of Botkin's disease in children ranges from 15 to 40 days, and the duration of the prodromal period is much shorter than in adults. It is characterized by general malaise, dyspeptic disorders in the form of loss of appetite, nausea, vomiting, belching, constipation, pain in the epigastric region, as well as signs of catarrh.

The development of jaundice in Botkin's disease in children is gradual and manifests itself in the form of a icteric coloration, first of all, of the mucous membranes, and then of the skin, which is accompanied by mild skin itching. Botkin's disease in children is always accompanied by the development of hepatosplenomegaly, and the liver with this pathology is not only enlarged, but also painful. A decrease in the intensity of clinical manifestations occurs after the jaundice is relieved. How Botkin's disease is transmitted in children, which manifests itself as acute liver dystrophy, is not reliably known and, fortunately, this pathology is extremely rare in this category of people.

Early diagnosis in children is possible in the presence of pathognomonic clinical symptoms and verification of contact with an adult or child suffering from this pathology within 15-45 days, since the incubation period of Botkin's disease is precisely this period of time. For early verification of Botkin's disease, routine laboratory examination of children is important for the concentration of bilirubin in the blood serum, the content of bile pigments, urobilin in the urine, as well as determining the activity of enzymes such as aldolase and transaminase. Before prescribing treatment for children with Botkin's disease, it should be taken into account that the clinical picture of this disease can be simulated by influenza, obstructive jaundice, and food poisoning.

Treatment of Botkin's disease in children should be carried out exclusively in an infectious disease hospital, subject to bed rest during the entire icteric period. A diet for Botkin's disease in children involves eating high-calorie foods with limited animal fats and enriching the daily diet with cottage cheese, vegetables and raw fruits. With this infectious pathology, there is an increased need for vitamins, which cannot be met by rationalizing eating behavior, and therefore it is recommended to use oral administration of vitamin complexes in the form of vitamin C in a daily dose of 0.1-0.3 g, Nicotinic acid in a daily dose of 0. 04 g, B vitamins 0.003 g per day.

Children suffering from Botkin's disease are advised to use a 25% solution of Magnesium Sulfate in a volume of 5-10 ml depending on age, and Borjomi mineral water 100 ml before meals at room temperature. The severe course of Botkin's disease, accompanied by the development of intoxication syndrome, is the basis for parenteral therapy with a 20% glucose solution.

Prevention of Botkin's disease in childhood is carried out only if the child has reliable contact with a person suffering from this pathology and involves intramuscular administration of gamma globulin in a dose appropriate to the child's age.

Botkin's disease belongs to the category of infectious pathologies for which antiviral therapy is not a fundamental element in treatment. The primary treatment measure for Botkin's disease is the use of symptomatic drug therapy, which involves the administration of infusions of crystalloid solutions, vitamin complexes, hepatoprotectors, which contribute to the rapid restoration of all liver functions.

Bed rest should only be observed by children in the active icteric period, while adult patients should only limit physical activity. A diet for Botkin's disease involves enriching the patient's daily menu with high-calorie foods with the obligatory consumption of raw vegetables and fruits, as well as herbs in sufficient quantities. Treatment of Botkin's disease, even if it is mild, should be carried out in an infectious diseases hospital with an emergency notification sent to the local sanitary and epidemiological station.

Prevention of Botkin's disease in a medical institution consists of treating household items, as well as the patient's natural excrement, by boiling, mechanical cleaning and soaking in chlorine-containing disinfectants.

Severe intoxication in Botkin's disease is an indication for prescribing an intravenous infusion of Glucose solution in a volume of 250 ml, hemodez, oxygen therapy, as well as taking glucocorticosteroid drugs. The absolute indication for the use of steroid hormones in a dose of 30 mg for Prednisolone is Botkin's disease, which occurs in the form of acute liver dystrophy. Hormone therapy for Botkin's disease must be carried out under the control of blood clotting indicators, and at the first signs of increased bleeding, it is necessary to prescribe a 1% Vikasol solution intramuscularly in a dose of 2 ml for a course of 2-3 days.

The complicated course of Botkin's disease, in which the formation of inflammatory infiltrates of the liver and liver abscesses is noted, must necessarily be supplemented with drug therapy with antibacterial agents in the form of Penicillin in a daily dose of 100,000,000 units, Erythromycin, 200,000 units four times a day orally.

Specific prevention of Botkin's disease is used only when indicated using gamma globulin in a dose of 2 ml. A protective reaction after immunization is observed in 100% of cases within one month. Even when the causative agent of Botkin's disease enters the human body, a sufficient immune response develops within two weeks after vaccination. In order to ensure the development of long-term immune protection against the Botkin disease virus, double vaccination is recommended. The administration of the vaccine against the Botkin disease virus is well tolerated by patients of all ages.

Hepatitis A(second name - Botkin's disease) is an intestinal infection that is common in children. During its development, general intoxication of the body occurs, but the human liver is mainly affected. As a rule, hepatitis A develops not in one child, but in a whole group of children who are in close contact with each other. The disease most often affects children aged three to seven years. However, adults also suffer from hepatitis A. As a percentage, more than 60% of cases of the disease occur in children. The disease is very rare in infants, who are reliably protected by their mothers.

Hepatitis A virus

Hepatitis A is an acute infectious disease that develops under the influence of a virus.

The hepatitis A virus is resistant to a number of substances - acids , broadcast , chlorine . At the same time, it shows sensitivity to, and when boiled it dies after 5 minutes.

The virus is excreted from the human body along with feces, and a person is contagious from the end and during the pre-icteric period. The virus is not detected in the stool of a person with already developed jaundice. The virus enters the body through the mucous membranes of the gastrointestinal tract.

With viral hepatitis A, the duration of the incubation period can vary markedly and range from 7 to 50 days. But generally it ranges from 15 to 30 days.

Reproduction of viral particles occurs in the cytoplasm of liver cells. After they leave the liver cells, they immediately enter the bile ducts and then, together with bile, end up in the intestines.

Hepatocytes (liver cells) are damaged due to inflammation that develops in the liver. In turn, the inflammatory process is a consequence of an attack by the body’s immune system on liver cells affected by the virus. As a result, infected hepatocytes die, Botkin's disease manifests itself and the functioning of the liver is disrupted.

How does infection occur?

The source of infection is a person infected with the virus. Its feces release billions of viruses into the environment. If a person consumes water or products that have been contaminated with the hepatitis A virus, the virus enters the person’s intestines, and then, along with the bloodstream, it moves to the liver and invades hepatocytes.

Thus, the mode of transmission of the hepatitis A virus is fecal-oral . Very often, infection with the disease occurs in countries with hot climates on different continents.

Hepatitis is also called the “disease of dirty hands.” In civilized countries, due to the normal functioning of sanitary and communal services, as well as due to the observance of hygiene rules by the population, people rarely suffer from hepatitis. Consequently, very few people develop antibodies to this disease. When in contact with a carrier of the virus, people who do not have antibodies run the risk of becoming infected. Therefore, during trips to Asian and African countries, cases of infection among our fellow citizens are relatively common.

A healthy person can have contact with a sick person without risking infection. It is more important to strictly follow all hygiene rules. But it is best to isolate children from patients with hepatitis A.

To determine the degree of risk of contracting the disease in order to decide on the advisability of vaccination, a special blood test can be carried out, which determines whether there are antibodies to the hepatitis A virus in the human body. If they are detected, this means that the person has the virus, and no vaccination needed. People practically never get sick with hepatitis A again. In the absence of antibodies, the risk of infection exists, which means vaccination is needed.

Before a possible infection or after it, a person can be administered for two weeks, which during this period will protect against infection or the development of an illness in the body.

Classification of hepatitis A

There is a division of hepatitis A into several types according to different criteria. Depending on the manifestations of the disease, it is distinguished typical option (the patient has jaundice) and atypical variant (no jaundice observed). If the latter option occurs, then sometimes the disease goes unnoticed, since the child in this case suffers only from a short-term bowel disorder.

When assessing the course of Botkin's disease in a child, doctors distinguish light form (most cases) medium-heavy form (approximately 30% of cases), severe form (rarely, approximately 1-3% of cases).

Symptoms of hepatitis A

During the incubation period, Botkin's disease gradually begins to manifest itself with some characteristic signs. A person may also be bothered by dyspeptic symptoms (vomiting, nausea, heaviness in the stomach and right hypochondrium). The child's body temperature may increase slightly in the first few days. In addition, symptoms of Botkin's disease include weakness and darkening of the urine. Later, the patient develops jaundice - the sclera and skin acquire a characteristic yellow color, and at the same time the feces become discolored. Jaundice appears on the body very quickly, almost overnight. This condition lasts for three to six weeks. Moreover, after the onset of jaundice, the patient begins to feel a little better. On average, the illness lasts approximately 40 days. At this time, adequate treatment is carried out. But the duration of the illness can be influenced by various factors, for example, age, the correct approach to therapy, and the presence of other chronic diseases.

Hepatitis A is most severely affected by children under one year of age, adult patients, and elderly people. In preschool children, viral hepatitis A occurs in a milder form, while in adult patients, the symptoms of hepatitis A are severe, with severe intoxication. The illness can last up to three months, despite treatment.

It should also be taken into account that all hepatitis, of any origin, manifests itself with similar symptoms. Therefore, it is very important to consult a doctor in a timely manner and undergo a comprehensive examination.

Diagnosis of hepatitis A

To diagnose hepatitis A in a patient, the doctor must carefully study the patient's epidemiological history. In this case, we are talking about which countries the person visited, what he ate, whether he had contact with patients, etc. In addition, tests are required - general and biochemical blood tests, analysis for markers of viral hepatitis, general urinalysis, etc.

The main criterion for diagnosing the acute form of Botkin's disease is the isolation of antibodies to hepatitis A from a person's blood. They can be detected in the blood only during the acute period of the disease.

Treatment of hepatitis A

If a person is diagnosed with hepatitis A, then specific therapy is not practiced, since the patient recovers without treatment. In modern medicine, the efforts of specialists are concentrated on reducing the content of harmful substances in the human body and removing them. Such substances begin to appear in the human body at a time when the liver is damaged and its basic functions are disrupted. Consequently, patients are administered detoxification solutions, as well as glucose. They are advised to take vitamins and hepatoprotective drugs (these drugs protect liver cells). With Botkin's disease, there is no need for antiviral therapy. If doctors are dealing with a severe case of the disease, the principle of treatment does not change, but the volume of prescribed medications increases.

During the treatment process, it is important to adhere to a certain dietary diet. Food should be high in calories and balanced. It is necessary to include proteins in the daily diet in the form of lean meat and fish, eggs, and low-fat cheese. Carbohydrates should be consumed in the form of cereals, potatoes, bread, sugar. Fats should be chosen from vegetable sources, and butter should also be consumed periodically. In addition, it is important for the child to eat a lot of vegetables, fruits, and drink juices. At the same time, it is prohibited to introduce refractory fats, fatty meats, fish, sausage, spicy foods, legumes, chocolate, smoked meats, etc. into the diet.

Equally important is proper rest and a state of emotional and physical peace. Children who suffer from the disease easily need to limit physical activity. But if a child constantly feels unwell, then he should adhere to bed rest.

After recovery, children are required to remain under medical supervision. If, after two examinations, no health problems are found in the child, then he is removed from the register.

With hepatitis A, the prognosis is favorable; a person experiences complete restoration of liver function. In rare cases, the liver remains enlarged, but its function is not affected.

The doctors

Medicines

Prevention of hepatitis A

The main preventative measure is vaccination from Botkin's disease. Modern ones are highly effective and have high immunogenicity. The vaccine must be administered twice, with an interval of six months to one year. After administration of the vaccine, a person is protected from infection by the virus for up to 10 years.

Vaccinations are given to children over three years of age, as well as to adults who have never had hepatitis A. It is also important to vaccinate those people who are at increased risk of infection.

Several categories of people are identified who need to be vaccinated against hepatitis A. First of all, these are family members of a patient with hepatitis A and people in close contact with him. Persons who have had sexual contact with patients should receive vaccinations. Vaccination is also necessary for those who live in regions where many cases of the disease are recorded; people planning to visit countries where hepatitis A is common; homosexuals; those who use drugs.

Hepatitis vaccinations should also be given to workers in infectious diseases departments of hospitals, all staff of children's institutions, employees of the water supply and public catering sectors, and people suffering from chronic liver diseases.

If someone in the family has contracted Botkin's disease, it is recommended that all family members be examined for the presence of antibodies to hepatitis A. In addition, as a preventive measure for the disease, everyone should follow the simplest rules of hygiene: wash your hands as often as possible, and always use soap. It is very important to teach children to follow the rules of prevention from a very early age.

Hepatitis A and pregnancy

If a woman is planning, she needs to be vaccinated against hepatitis A, as the disease can cause pregnancy complications and even premature birth. If vaccination has not been carried out, then the pregnant woman should clearly know how Botkin’s disease is transmitted, since prevention in this case is a very important point.

Diet, nutrition for Botkin's disease

List of sources

• Infectious diseases. National leadership. Ed. N.D. Yushchuka, Yu.Ya. Vengerova. M.: GEOTAR-Media. 2009;
• Uchaikin V.F., Nisevich N.I., Cherednichenko T.V. Viral hepatitis from A to TTU. - M., 2003;
• Esaulenko E.V., Gorchakova O.V., Chernov M.Yu. Clinical course of hepatitis A during periods of varying intensity of the epidemic process. Medline Express. 2004;
• Mayer K-P. Hepatitis and consequences of hepatitis. Practical guide. Per. with him. / Ed. A.A. Sheptulina. - M.: Geotar Medicine, 1999;
• Treatment of viral hepatitis. A.A. Klyuchareva, N.V. Goloborodko, L.S. Zhmurovskaya and others / Ed. A.A. Klyucharevoy – Minsk: Doctor Design LLC, 2003.

It occurs in the form of both epidemic outbreaks and sporadic cases and is characterized by seasonality, increases in incidence in the autumn and winter months. The source of infection is a sick person. Significant epidemic outbreaks are especially often observed during wars and immediately after them. Small, closed epidemics of the disease have been described among schoolchildren of one school, among medical personnel and patients of a certain hospital, residents of a barracks or dormitory, etc. Outbreaks and diseases have been described when using drinking water from unsafe sources; After the wells were cleaned, the epidemic stopped. The infection can be transmitted both by contact and through contaminated food. The basis of Botkin's disease, according to the currently generally accepted view, is a viral infection, in particular infection with the icterogenic virus A. The development of the disease after the introduction of this virus occurs within 2-6 weeks.

There is another group of jaundices also of viral etiology, namely the so-called serum hepatitis, associated with the parenteral introduction of the B virus, which causes the disease after 2-6 months. It should be noted, however, that attempts to isolate these viruses from the blood and urine of patients have so far given uncertain results, at least in so-called common sporadic diseases. Botkin's disease affects both men and women equally often, especially often at a young age.

The pathogenesis of the disease is currently presented as follows: a virus entering the liver from the blood invades the liver cells and leads to the development of dystrophic and, in severe forms, necrotic changes in them.

The essence of the disease is damage to the epithelial tissue of the liver. It is possible that at the very beginning of the pathological process, changes affect the walls of the intrahepatic capillaries, which become extremely permeable not only to fluid from the bloodstream, but also to plasma proteins, resulting in serous edema and protein infiltration of the liver parenchyma. Liver cells suffer from insufficient supply of nutritional material; from compression by serous exudate, their function is impaired, including the function of secreting bile pigments from the blood into the bile ducts. In the experiment, such serous hepatitis was reproduced with the help of unsaturated amines, in particular histamine. Using a study of intravital puncture or liver biopsy, it was possible to prove beyond doubt that with this disease the same degenerative changes in liver cells occur as with acute liver dystrophy, but only to a lesser extent and with less intensity.

Along with dystrophic changes in liver cells, reactive phenomena are also detected in the form of the development of foci of regeneration of liver cells and a proliferative mesenchymal reaction in the periportal spaces. Signs of enhanced regeneration and mesenchymal secondary reaction are especially pronounced during the period of recovery from Botkin's disease. With its prolonged course, hyperplasia of reticuloendothelial tissue and proliferation of fresh collagen fibers are observed in the liver, i.e. some degree of fibrosis. There are no permanent deviations from the norm in the bile ducts.

Symptoms of Botkin's disease

The clinical picture of Botkin's disease consists of the initial preicteric and icteric stages. The disease begins with general malaise, loss of appetite, sometimes pain in muscles and joints, sometimes with “flu” symptoms, most often with gastrointestinal disorders (nausea, vomiting, diarrhea, constipation), which, by the way, at one time served as a reason consider the cause of this disease to be food inaccuracy or gastroenteritis. Usually during this early period there is a slight increase in body temperature, which stops after a few days, like the other symptoms mentioned above.

The pre-icteric period lasts about 1-2 weeks, rarely more. Often, along with general weakness and especially loss of appetite, during this period there is mild pain in the abdomen, or rather discomfort in the upper part and in the right hypochondrium; sometimes these pains can be more severe, even paroxysmal.

Jaundice usually does not grow particularly quickly, but after 1-2 weeks it reaches significant intensity. In some patients, jaundice is not accompanied by any other painful disorders; the patient simply begins to notice after some time that the urine has become too dark in color, the stool gradually began to discolor, and the sclera turned yellow. Sometimes those around him are the first to point out to the patient that he has turned yellow. The color of the skin varies from lemon yellow to saffron or orange. The icteric color is most pronounced on the sclera and mucous membrane of the soft palate; it can only be noticed in daylight and during a period of significant increase in jaundice. It is very difficult to judge the dynamics of the pathological process by the color of the external integument. This can be done by examining the amount of bilirubin in the blood. Data on fluctuations in bilirubinemia provide an idea of ​​the entire cycle of development and subsidence of jaundice more accurately than examination of the external integument.

At the height of the disease, the stool becomes a whitish-clay color (acholic stool), but not in all cases. In addition, it should be borne in mind that the color of the stool also depends on the admixture of fat, the amount of which increases with jaundice, since its absorption is difficult due to the limited supply of bile acids to the intestines. As soon as the skin begins to lighten, the stool becomes darker and darker, and sometimes even turns out to be intensely dark in color due, apparently, to the liver, which has restored its function, expelling excess bilirubin accumulated in the tissues.

During the period of jaundice, urine becomes rich in color, like dark beer; a large amount of bilirubin, as well as urobilin, can be easily detected in it. True, at the height of jaundice, during acholic stool, urobilinuria may weaken or disappear, since urobilin ultimately enters the urine from the intestines.

Jaundice in acute hepatitis is accompanied by other phenomena of functional liver failure in the sense of disruption of its participation in metabolic processes. So, the test with galactose turns out to be positive; the content of amino acids in the urine increases; A variety of sediment samples may be positive. At the height of the disease, the activity of a number of enzymes increases, such as aldolase, aspartic and glutamine alanine transaminases; the activity of some other enzymes, such as cholinesterase, decreases.

Usually, from the first days of illness, a moderate increase in liver size is observed. The organ is slightly painful on palpation, and sometimes slightly thickened. The spleen is less often enlarged, mainly in protracted forms.

Permanent deviations are detected in the cardiovascular system in the form of a slower pulse rate, lowered blood pressure, slight deviations in electrocardiographic examination, and sometimes the appearance of extrasystole. These deviations are most associated with the enhanced function of the vagus nerve, resulting from the accumulation of bile acids in the blood, but in severe forms, deviations from the myocardium may also depend on the toxic effects of cholemia.

On the red blood side, there is sometimes a tendency towards macrocytosis, and on the white side, initially towards leukocytosis, and in the later period towards leukopenia and monocytosis. Sometimes increased eosinopathy is observed, which is associated with the influence of an allergic factor; it is possible that a diseased liver allows foreign or poorly processed protein products from the intestines to pass through the bloodstream. Hemorrhagic phenomena in Botkin's disease of a normal, benign course are rarely observed.

The nervous system in these forms does not suffer significantly - patients experience a depressed mental state, increased irritability, they have poor sleep and are bothered by itchy skin, which is more often observed with intense or prolonged jaundice; it is usually associated with the accumulation of bile acids or bilirubin derivatives in the skin.

Botkin's disease in most cases is benign and ends in recovery. The duration of the pre-icteric period is on average 1 week, and the icteric period is from 2 to 5 weeks, sometimes more. After the illness, sometimes significant yellowness of the sclera, to a lesser extent the knives, persists for a number of months, and a slight increase in bilirubin content in the blood may be observed against the norm. During the period of reverse development of jaundice, low-grade fever may appear and patients begin to feel pain in the liver area. During this period, duodenal intubation can detect an excess content of leukocytes in portion C. These phenomena depend on an outbreak of cholangitis associated with hepatitis, caused by microorganisms entering through the weakened protective barrier of the liver with bile (from the intestines, tonsils). Finally, there are so-called anicteric forms of Botkin's disease, occurring only with slight icterus of the skin and mucous membranes or only with slightly increased bilirubinemia.

Diagnosis of Botkin's disease

Diagnosis of icteric forms of Botkin's disease is usually not difficult. Only in those patients who experience more severe pain in the right precostal area (caused by acute enlargement of the liver), it may be difficult to differentiate from acute hepatic (biliary) colic due to blockage of the common bile duct by a stone. Cases of erroneous surgical intervention in such cases have been described. In this case, a functional study of the liver is of great importance: in Botkin’s disease, functional tests give pronounced deviations from the norm, while in calculous jaundice they remain normal.

To differentiate the icteric form of the disease from forms of obstructive jaundice, laparoscopic examination is of great importance in unclear cases: with Botkin’s disease, a picture of the so-called red and then white liver is revealed, while with obstructive jaundice the liver is usually yellow-green in color. A puncture or biopsy of the liver performed in such cases is also very useful for differential diagnosis (dystrophic phenomena in Botkin's disease and a picture of bile stasis in the hepatic ducts in obstructive jaundice).

The diagnosis of anicteric forms of the disease is difficult; it is usually placed in cases where there is a massive spread of the disease occurring with jaundice.

Forecast. Botkin's disease should not be considered a mild, innocent disease, as was done in the past (“runny nose of the bile ducts”). In 2-3% of cases, the disease can relatively quickly take a severe form and even be fatal with a picture of acute or subacute liver dystrophy at autopsy. This transition from a normal form to a malignant one is observed in various epidemic outbreaks with different frequencies; it is more often observed in pregnant women, as well as in persons who previously suffered from syphilis, malaria and were treated with salvarsan, quinine, etc. In addition, relapses of the disease are rarely observed. Finally, it should be noted that acute hepatitis (Botkin's disease) is the most common cause of the development of chronic hepatitis and cirrhosis of the liver.

Treatment of Botkin's disease

1. General treatment measures consist primarily of mandatory early hospitalization of patients. There is reason to believe that the development of a malignant form of Botkin's disease is observed more often in those patients who are not hospitalized. The importance of rest and bed rest is based on the fact that physical work, including walking, leads to excessive consumption of glycogen in the liver and increases the breakdown of protein substances, i.e. increases the load on the liver. Bed rest is prescribed for the entire period of the height of the disease, on average for 2-3 weeks. Expansion of the regimen is allowed only with positive dynamics of functional tests and a significant decrease in bilirubinemia.

2. Patients are prescribed a diet with a sharp restriction of animal fat, a slight decrease in proteins (up to 100 g per day) due to an increase in carbohydrate content (up to 300-500 g per day).

3. Certain vitamins are administered both in food and specifically in powders or parenterally - ascorbic acid in large doses (up to 1 g per day), vitamin B12 (0.1 mg intramuscularly daily), vitamin B6 - pyridoxine (intramuscularly 40- 50 mg 2-5 times a day).

4. Give a large amount of fruit juices containing fruit sugar, sweet tea, and in more severe cases, 500 ml of a 5-10% glucose solution is injected into a vein by drop method, 1-2 times a day.

5. It is recommended to try the administration of steroid hormones, such as prednisolone or triamsinolone, in relatively small dosages (daily dose of prednisolone 15-20 mg, triamsinolone 4-6 mg); These drugs are especially advisable to prescribe in protracted cases. Steroid therapy is carried out until positive changes in liver function tests appear, a decrease in bilirubin content, and in the presence of edema and ascites - until a diuretic effect is achieved. The average duration of treatment with hormones is about 2-3 weeks (for prolonged cases - longer). The dosage is reduced gradually. Treatment is combined with the administration of potassium salts and chloride restriction.

Prevention of Botkin's disease consists of general sanitary and hygienic measures - cleaning drinking sources, using only boiled water for drinking, frequent hand washing, etc.

Content

This disease belongs to the category of acute infectious and affects the liver. The causative agent of hepatitis A is resistant to the external environment, has a durable shell, thanks to which it is not afraid of the protective barrier of the stomach, while Botkin's disease is transmitted both by household contact and by airborne droplets. Every year, about 10 million cases of infection are recorded in the world; scientists associate the incidence rate with compliance with personal hygiene rules.

What is Botkin's disease

Viral type A hepatitis is a disease accompanied by intoxication of the body, an increase in the volume of the liver and spleen, and jaundice (the latter symptom is observed in 70% of patients). Children are more susceptible to the disease, although adults with weakened immune systems can also become infected. Since after suffering Botkin's disease a person develops immunity, it is no longer possible to encounter hepatitis A a second time.

The hepatitis A virus infects the liver and causes characteristic symptoms that disappear only after 1-2 months. Botkin's disease can heal on its own, but doctors strongly recommend that patients take certain medications to avoid possible complications. Today, it is proposed to treat Botkin’s disease with drugs that reduce the concentration of the pathogen and help quickly remove toxins accumulated in the body. Epidemics of hepatitis A are more often recorded in the summer and autumn.

Causes

The hepatitis A virus is transmitted through food, dirty hands, and drinking water. After the infection enters the intestines, it is absorbed and delivered to the liver through the circulatory system. In the cells of the organ, the bacteria of Botkin's disease develop, as a result of which symptoms of the pathology appear. The inflammatory process that accompanies the disease has an immune mechanism, so the body destroys infected liver cells. The main causes of infection with Botkin's disease:

• drug use;
• kissing, sexual intercourse;
• alcohol abuse (this can also lead to liver cirrhosis);
• close contacts with infected people;
• failure to comply with hygiene rules;
• visiting countries with a high incidence of the disease.

Botkin's symptoms

The disease is characterized by stages, and the incubation period can last from 15 to 50 days. After its completion, the period of manifestation of symptoms of general intoxication of the body begins, which include:

• pain in the right hypochondrium;
• fever;
• sleep disturbance;
• stomach discomfort;
• vomiting, nausea;
• loss of appetite;
• diarrhea (not always);
• weakness.

Afterwards comes the acute phase of Botkin's disease. How does hepatitis A manifest at this time:

• the patient’s urine becomes dark and foams;
• stool becomes discolored;
• icteric staining of the skin, mucous membranes, and sclera of the eyes occurs (the sign of Botkin’s disease lasts about a month, while its intensity gradually decreases);
• The general well-being of a person greatly deteriorates.

In adults

The primary symptoms of hepatitis A often appear a month after infection, and the reason to visit a doctor should be a sharp and unreasonable deterioration in health, accompanied by an increase in body temperature. Women and men may exhibit typical signs of Botkin's disease, for example:

• fever accompanied by vomiting or nausea;
• abdominal pain;
• jaundice.

Unlike a child, an adult's Botkin's disease has more pronounced symptoms. An elevated temperature can last up to 10 days, while a person’s stool often becomes liquid and muscle weakness is observed. After liver damage, the stool changes color to a lighter color, the skin, eyes and mucous membranes acquire a yellow tint, which disappears within 2 weeks.

The need for therapy for Botkin's disease is due to the fact that if it lasts for a long time, liver failure can develop, which in extreme cases leads to death. Sometimes, instead of fever, adult patients experience other symptoms - decreased performance, severe weakness, loss of appetite, constipation, and other digestive disorders. About a third of people infected with hepatitis A have no symptoms of jaundice.

In children

Of the total share of people infected with hepatitis A, 60% are children, with the age group 3-7 years more susceptible to the disease. This is due to the fact that children often put unwashed hands in their mouths and eat dirty fruits and vegetables. The first signs of Botkin's pathology in children appear approximately 2 weeks after infection (contact with another patient). The virus in the baby's body leads to an increase in bilirubin in the blood. The appearance of jaundice is often preceded by a deterioration in the child’s well-being, which in symptoms resembles intestinal flu or cholecystitis. Other signs of Botkin's disease in children:

• temperature rise to 39 degrees;
• loss of interest in food;
• weakness;
• vomit;
• pain under the right rib, in the stomach area;
• stool lightening;
• increase in liver size (feeling of fullness in the right hypochondrium).

How is it transmitted?

The viral disease is called the disease of dirty hands because it usually occurs due to poor hygiene. Common routes of infection with hepatitis A are the consumption of unwashed berries, fruits, vegetables, contaminated water, and river products. Thus, the infection predominantly enters the human body through the fecal-oral route. However, you can become infected with hepatitis A through the hematogenous route, that is, through the blood. Botkin's disease is transmitted through contact with infected people.

Botkin's pathology is especially contagious during the incubation period, starting from the 20th day after infection and ending approximately a month later. The disease can be transmitted through common hygiene items, utensils, etc. The Botkin virus remains viable for a long time in ordinary living conditions; it is not affected by fresh air, sunlight or strong antiseptics. In food, the infection continues to live for about 1-1.5 years, and it can withstand half an hour of heat treatment.

Having entered the human body through food or other means, the virus quickly passes through the stomach (acid does not affect it) and penetrates the intestines. Absorbed into the blood, the bacterium is transported to the liver and begins to actively multiply in hepatocytes. At the same time, an inflammatory process begins in the organ, in response to which the immune system produces antibodies (protective cells - T-lymphocytes). Recognizing damaged hepatocytes, antibodies destroy them, thereby restoring liver function.

Diagnostics

If Botkin's disease is suspected, an examination is carried out by an infectious disease specialist. The specialist collects an anamnesis, which contains data on the patient’s last visited countries. In addition, the doctor conducts an examination, which involves determining the size of the spleen and liver, and prescribes a number of tests. To identify hepatitis type A, you must take:

• general urine/blood test;
• blood for biochemical composition;
• blood for clotting;
• blood for bilirubin;
• liver tests;
• for antibodies to hepatitis.

Treatment of hepatitis A

Since Botkin's disease causes the active functioning of the immune system, the patient's recovery occurs even without special therapeutic measures. However, treatment of hepatitis A in adults and children helps alleviate the condition of patients and relieve symptoms of intoxication. The fight against severe forms of the disease includes the following procedures, suitable even for women during pregnancy:

• compliance with a therapeutic diet;
• bed rest of the patient;
• administration of sodium chloride and glucose solutions;
• the use of drugs that provide liver protection;
• taking vitamins to strengthen the immune system and improve liver function;

Diet No. 5

A balanced diet helps the body cope with Botkin's infection faster. The main goal of diet No. 5 is to improve liver function, so it involves limiting the consumption of fatty foods. To quickly restore the health of a patient with hepatitis A, the following must be excluded from the menu:

• pickles;
• offal;
• marinades;
• smoked meats;
• sweets, especially baked goods;
• hot spices;
• alcohol;
• carbonated drinks;
• strong coffee.

What can you eat and drink during Botkin's disease:

• vegetables;
• yesterday's bread;
• cereals;
• low-fat dairy products;
• natural juices;
• fruits;
• lean meat, broth from it;
• soups;
• dried flour products.

Complications

Botkin's disease is more severe in older people and children under one year old; in middle-aged men, hepatitis A is accompanied by severe intoxication. Anicteric disease often occurs, and a person becomes a dangerous carrier of infection, especially dangerous for children. If the immune system does not function correctly or at a very early age (up to 6 months), Botkin's disease is extremely severe and can be fatal.

Forecast

As a rule, Botkin's disease ends in recovery, but sometimes it transforms into chronic liver disease. Thus, pathology can cause cirrhosis of the organ. With sub- or acute liver dystrophy, the prognosis becomes disappointing, since damaged hepatocytes are not restored. In some people with hepatitis A, recovery occurs with the development of liver fibrosis - this is how the body compensates for the consequences of the inflammatory process.

Prevention

The main preventive measure against Botkin's disease is vaccination, which is not included in the compulsory vaccination calendar, but is recommended for children visiting kindergarten and adults traveling to hot countries where cases of hepatitis A infection are often recorded. The serum is administered 2 times, the interval between which is six months , while full immunity in a person is formed for 10 years. In addition to vaccination against Botkin's disease, the following preventive measures will help avoid infection:

• timely hygiene procedures (hands should be washed with soap);
• careful processing of food;
• to avoid hepatitis A, fruits should be washed exclusively under running water;
• It is better to boil tap water, then the Botkin bacteria will die.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

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Classmates

Botkin's disease (viral hepatitis A) is an infectious liver lesion, which is one of the most favorable forms of hepatitis, as it is not prone to becoming chronic. Botkin's disease is one of the most common intestinal infections. All categories of the population are susceptible to the disease; hepatitis A is most often diagnosed in children, but in recent years there has been an increase in incidence in adults.

With timely and properly selected treatment, the prognosis is favorable. Complete restoration of liver function occurs in approximately 90% of cases.

The hepatitis A virus belongs to the RNA viruses of the Hepatovirus genus. It is quite stable in the environment: at a temperature of 4 °C it persists for several months, at -20 °C it persists for years, at room temperature for several weeks. Withstands boiling for up to 5 minutes; when exposed to ultraviolet radiation, inactivation occurs within a minute; is able to remain viable for some time in chlorinated tap water. It has an acid-resistant shell, which allows it to pass through the acidic gastric environment without damage. The hepatitis A virus is characterized by high immunogenicity; after suffering from the disease, a person develops stable lifelong immunity.

The source of infection is a sick person. Infection occurs mainly through household contact (through dishes and other household items) and through nutrition (by eating contaminated foods). When the hepatitis A virus gets into public water reservoirs, outbreaks occur. The parenteral route of transmission is less common - through blood when the rules for intravenous injections, blood transfusions, and dental procedures are violated.

The spread of Botkin's disease most often occurs in children's groups. At risk are employees of the catering sector, medical and sanatorium-resort institutions, and people leading an antisocial lifestyle.

Most often, Botkin's disease affects children 3–12 years old and young adults. The incidence is seasonal, with an increase observed in the summer-autumn period.

Forms of the disease

Botkin's disease can have a typical (with the presence of symptoms characteristic of hepatitis) and atypical (no specific symptoms) course.

Depending on the clinical picture, the following forms of the disease are distinguished:

Depending on the duration of its course, Botkin's disease can be acute or protracted. Depending on the severity: mild, moderate and severe.

The prodromal period of Botkin's disease can occur in febrile, dyspeptic, asthenovegetative and mixed forms.

Stages of the disease

In the clinical course of a typical variant of Botkin’s disease, three stages are distinguished:

1. Prodromal (pre-icteric) period.
2. Jaundice period.
3. Convalescence.

After the end of the icteric period, convalescence begins, i.e. recovery. There is a regression of intoxication and jaundice, the size of the liver is normalized. This stage can last 3–6 months.

Symptoms of Botkin's disease

In some cases (usually in children under 6 years of age), the disease is asymptomatic.

The incubation period for Botkin's disease is 3–4 weeks. The onset is usually acute.

The febrile variant of the prodromal period of Botkin's disease is characterized by an increase in temperature to high numbers, accompanied by pronounced signs of intoxication of the body (weakness, headache, pain in the joints and muscles, decreased appetite), nausea, belching, discomfort in the stomach and liver, as well as symptoms of catarrhal inflammation of the upper respiratory tract - sore throat, rhinitis, dry cough.

In the dyspeptic variant of the prodromal period of the disease, catarrhal symptoms are usually absent. Patients complain of nausea, vomiting, belching, bitterness in the mouth, dull pain in the right hypochondrium and epigastric region, as well as stool disorder (diarrhea or constipation, or their alternation).

The asthenovegetative variant of the pre-icteric period is not very specific. There is general weakness, lethargy, increased fatigue, decreased performance, sleep disturbances, and loss of appetite. In some cases, the disease may begin with the development of jaundice in the absence of any signs of a prodromal period.

The mixed version of the prodromal period is characterized by a combination of several clinical syndromes.

The prodromal period usually lasts from two to ten days, gradually turning into the icteric stage. Signs of general intoxication disappear, body temperature normalizes, and the patient’s general condition improves. However, dyspeptic symptoms, as a rule, not only persist, but also become more pronounced. Other symptoms of Botkin's disease in the icteric period include darkening of the urine, icterus of the sclera, the mucous membranes of the soft palate and frenulum of the tongue, and then the skin, turn yellow. A yellowish coating is found on the tongue and teeth. The feces lighten up to complete discoloration.

In severe cases of Botkin's disease, hemorrhagic syndrome develops (hemorrhages, petechiae on the skin and mucous membranes, nosebleeds, etc.). The liver is enlarged, painful on palpation, and in 10–20% of cases the spleen is enlarged. Bradycardia and hypotension are observed, astheno-vegetative symptoms and disorders of the central nervous system may develop.

The duration of the icteric period ranges from several weeks to a month, after which convalescence begins, i.e. recovery. There is a regression of intoxication and jaundice, the size of the liver is normalized. This stage can last 3–6 months.

Botkin's disease usually occurs in a mild or moderate form. The disease does not transform into a chronic form or viral carriage (latent form).

In rare cases, cholangitis, biliary dyskinesia and gall bladder, and cholecystitis may develop against the background of Botkin's disease.

Diagnostics

To make a diagnosis, a collection of complaints and anamnesis, a physical examination, and laboratory tests of blood and urine are carried out. In order to determine the morphological and functional state of the liver, instrumental diagnostic methods are used.

A general blood test reveals a decrease in the number of leukocytes, lymphocytosis, and an increase in ESR. A biochemical blood test reveals a sharp (8-10 times) increase in the activity of liver transaminases, an increase in the concentration of bilirubin (mainly due to direct bilirubin), and a decrease in albumin levels. The prothrombin index is usually below normal.

Specific diagnosis of Botkin's disease, i.e. identification of the pathogen, is carried out using enzyme immunoassays and radioimmunoassays. In the icteric period, there is an increase in the IgM titer, and at the stage of convalescence - IgG. In addition, the detection of hepatitis A virus RNA is carried out using the polymerase chain reaction method.

Treatment of Botkin's disease in most cases is carried out on an outpatient basis. Hospitalization is required only in severe forms of the disease, according to epidemiological indications. If there are severe signs of general intoxication, bed rest is indicated. An important component of therapy is adherence to the diet (table No. 5 according to Pevzner) and drinking regimen (drinking plenty of fluids).

Causal therapy for hepatitis A has not been developed; treatment is aimed at reducing symptoms and pathogenetic correction. To reduce signs of severe intoxication, intravenous infusion of crystalloid solutions is performed. In order to normalize digestive processes, lactulose preparations are used. To prevent the development of cholestasis, antispasmodics are prescribed. In some cases, there is a need to use corticosteroid drugs. With the development of hemorrhagic syndrome, the use of hemostatic drugs may be required, which are infused into the stomach using a tube. In case of bacterial infection, antibacterial drugs are used.

After the disappearance of the clinical manifestations of the disease, clinical observation by a gastroenterologist is indicated for 3–6 months.

Possible complications and consequences

In rare cases, cholangitis, biliary dyskinesia and gall bladder, and cholecystitis may develop against the background of Botkin's disease. Severe liver complications (acute hepatic encephalopathy), serious internal hemorrhage, cirrhosis, liver cancer, coma and death occur extremely rarely.

With timely and properly selected treatment, the prognosis is favorable. Complete restoration of liver function occurs in approximately 90% of cases; residual effects are observed in the remaining patients. The mortality rate for Botkin's disease is no more than 0.04%.

The prevalence of this form of hepatitis is directly related to poor sanitation and hot climates, so this rate is especially high in developing countries.

Prevention

General preventive measures aimed at preventing the development of Botkin's disease include control over the discharge of wastewater, ensuring high-quality purification of drinking water, providing food to the population in accordance with sanitary and hygienic requirements, ensuring the necessary quarantine measures in case of outbreaks of Botkin's disease in organized children's and adult institutions. teams. Contact persons are subject to observation for a month from the moment of contact with the patient. In areas of infection, disinfection measures must be carried out.

Vaccination against hepatitis A is recommended for children starting from the second year of life, as well as adults who do not have a history of Botkin’s disease and who have an increased risk of infection (medical workers in infectious diseases departments, workers in water supply and public catering enterprises, people traveling to areas , epidemically dangerous for viral hepatitis A, staff of preschool institutions, social workers in contact with injection drug addicts, etc.).

In order to reduce the risk of infection with the hepatitis A virus, it is recommended to observe the rules of personal hygiene, not to consume food products of questionable quality, to avoid drinking water from questionable sources and open water bodies, and to avoid contact with patients with Botkin's disease.

Video from YouTube on the topic of the article:



Hepatitis A in children and adults is often called Botkin's disease, named after the Russian physician who first described this disease. Botkin was the first to classify gastrointestinal catarrh (catarrhal jaundice) as an infectious disease, which was later confirmed by his colleagues during many years of research. Botkin's disease in children does not have a chronic stage, but every parent should know about the signs and prevention of the disease.

How is hepatitis A (Botkin's disease) transmitted to a child?

Epidemic hepatitis is also known as Botkin's disease. This is an acute infectious disease characterized by a severe course. Children suffer from epidemic hepatitis much more often than adults. The disease primarily affects the liver, but there is also general intoxication; Metabolic processes are disrupted, and jaundice often develops.

The causative agent of viral hepatitis A in children is a specific filterable virus. To date, the nature of the virus has not been established with certainty. There are two known varieties of this virus. Virus A is the causative agent of epidemic hepatitis, and virus B is the causative agent of serum hepatitis (infection occurs during injections).

The virus that causes hepatitis is very stable in the external environment; it easily tolerates drying and significant heating - more than 50ᵒ C.

The source of infection is usually a sick person. The virus is contained in his liver, bile, blood, intestinal contents and urine. The patient is most contagious in the pre-icteric period, as well as during the first two to three weeks of the icteric period. The source of infection can also be a patient suffering from a chronic form of the disease - during the period when the disease worsens.

How is hepatitis A transmitted to children and adults? Virus A is transmitted through the feces and urine of a sick person, through food or drinking water, and somewhat less commonly through the parenteral route. Winged insects, mainly flies, contribute to the transmission of infection. Virus B, which is contained exclusively in the blood of a patient or a person who has had serum hepatitis, is not excreted in the feces. Therefore, infection occurs only through blood transfusion, blood serum, plasma, or through the use of syringes and needles that are poorly sterilized (after performing an injection to the patient).

It should be noted that there is a greater susceptibility to epidemic hepatitis. Of all patients with Botkin's disease, children under 15 years of age account for 60-70%. However, children in the first months of life very rarely develop epidemic hepatitis. Immunity after an illness develops very stable.

For virus A, the entry gate is the gastrointestinal tract; for virus B, it is the place where the injection was made and where the pathogen ended up along with a particle of the patient’s blood or blood serum. Circulating throughout the body with the blood and multiplying, the virus finds the most comfortable conditions in the liver, concentrates there and thus selectively infects it. The very important functions of the liver begin to suffer quite quickly, which is why the metabolism in the body is disrupted. It is clear that the more severe the liver damage, the more metabolic processes are disrupted. All types of metabolism are affected by epidemic hepatitis. The patient's blood protein content decreases, but harmful metabolic products accumulate, and the amount of bilirubin in the blood increases. There is a lack of vitamin A and some B vitamins in the body; the absorption of vitamin K is impaired, resulting in prothrombin deficiency - and the resulting hemorrhagic phenomena are directly related to this. Such an important liver function as the antitoxic function suffers. Toxic liver dystrophy develops.

How does hepatitis A manifest in children: the first signs of Botkin’s disease in a child

The duration of the incubation period for epidemic hepatitis can vary from two weeks to one and a half months. The incubation period for serum hepatitis can be even more than one hundred and fifty days.

During Botkin's disease, three periods are distinguished: pre-icteric period, icteric period and convalescent period.

The manifestation of symptoms of Botkin's disease in children in the pre-icteric period is observed within 3-10 days. Some patients may not have it, but most patients experience this period. This period is characterized by such symptoms of hepatitis A in children as dyspeptic symptoms - anorexia, nausea and vomiting, abdominal pain, constipation or diarrhea. The first signs of hepatitis A in children may be general weakness and headache. The child tends to lie down and does not show interest in his surroundings. Body temperature may remain normal, but mild fever is more common. Sometimes a patient in the pre-icteric period develops a runny nose, cough, neuralgic pain, and rheumatic-type arthralgia. Upon examination, the doctor discovers a slight enlargement of the liver, and pain is noted on the part of the liver. In young children, symptoms of Botkin's disease in the pre-icteric period may include an enlarged spleen. Gradually, the content of bilirubin in the blood increases. The patient's urine becomes deep yellow due to the appearance of bile pigments in it. The stool, on the other hand, may be discolored.

How does hepatitis A manifest in children during the icteric period? Some patients may feel better at the beginning of the icteric period and their body temperature will return to normal. But in most patients, with the appearance of jaundice, the general condition begins to suffer more - since general toxic phenomena intensify. Jaundice is characterized by a gradual development: first, children develop a symptom of Botkin’s disease, such as yellowness in the whites of the eyes; if you examine the patient’s oral cavity, you can see the yellowness of the soft palate; after a while the skin turns yellow. The severity of jaundice varies, and its degree does not necessarily correspond to the severity of the disease. Some patients with mild hepatitis experience severe jaundice; in others, even with severe disease, the icteric coloration of the skin is insignificant. Often, with jaundice, there is skin itching - although slight. The patient may have hemorrhagic rashes on the skin. There are also cases of nosebleeds. Also signs of hepatitis A in a child are lethargy, irritability, and sleep disturbances. Appetite worsens, belching may occur, nausea and vomiting intensify, pain appears in the epigastric region, some patients are bothered by constipation, others have diarrhea, feces, the masses are discolored. An enlarged, dense liver can be felt; pain in the liver area is not severe. Sometimes a symptom of viral hepatitis A in children is a decrease in heart rate (bradycardia). Significant changes in blood and urine are detected. The period of jaundice lasts on average about two weeks. The process of disappearance of such a sign of Botkin's disease in children as icteric coloration of the skin is much slower than the process of increasing jaundice. As the level of bilirubin in the blood decreases, the patient's general condition improves.

The recovery period sometimes takes a very long time. During this period, liver function is gradually restored, the size of the liver decreases to normal. Dependency noticed: The younger the child is, the faster the period of restoration of impaired liver functions passes. Some patients may have exacerbations during this period. Residual effects of hepatitis can be detected in a child for several more months - this is mainly a slight enlargement of the liver and barely noticeable jaundice.

In practice, various clinical forms of Botkin's disease are observed. According to the course, there are acute hepatitis, prolonged hepatitis (the duration of the disease is more than three months), and chronic hepatitis (the duration of the disease is more than six months). According to the severity of the course, hepatitis can be mild, moderate, severe and very severe (toxic liver dystrophy develops). There is also an atypical form of epidemic hepatitis - anicteric.

For most patients with epidemic hepatitis, the prognosis is favorable - they recover. In rare cases, the disease becomes chronic, sometimes with the development of liver cirrhosis. With the development of toxic liver dystrophy, with the development of atrophic cirrhosis, the patient may have a fatal outcome, although it should be said that the mortality rate from epidemic hepatitis is low.

Treatment of hepatitis A in children and diet for Botkin's disease

A child with viral hepatitis must be hospitalized without fail. The patient's peace is very important - both physical and mental. Throughout the illness, the child observes strict bed rest. If the disease is mild, bed rest is canceled after the main symptoms disappear; if the severity of hepatitis is average, the duration of bed rest is at least a month; in case of a severe course of the disease, the child must remain in bed for more than a month, otherwise the recovery process may be delayed, and there may be exacerbations and relapses.

In the complex treatment of hepatitis A in children, diet plays an important role. Not only the patient’s appetite or lack thereof is taken into account, the degree of liver dysfunction and the severity of toxicosis are also taken into account. The patient is prescribed table No. 5. This diet provides the child with complete, easily digestible nutrition. Food is predominantly carbohydrate, but with a sufficient amount of protein. Proteins are limited or completely excluded from the diet only when severe intoxication develops. The child’s diet consists of fermented milk products such as kefir, yogurt, cottage cheese, as well as vegetables and fruits; You can eat sugar, jam, bee honey. The menu includes jelly and compotes, weak black long tea, fruit juices, alkaline mineral waters, a decoction of cinnamon rose hips (it is recommended that the child drink more in order to cleanse the body). The consumption of fats and table salt is limited. It is required to exclude canned food, spicy and fried foods, extractive substances, marinades, seasonings, chocolate, cocoa, and cakes from the menu. Food products must contain sufficient amounts of vitamins. In addition, vitamins are prescribed to the child additionally. It is especially important for the patient to receive vitamins A and group B (vitamin B1); if a child has hemorrhagic rashes, additional vitamin K is indicated. The patient may be prescribed vitamin complexes such as Aerovit, Vitrum, Vitalux, etc.

If hepatitis is severe, measures are taken against intoxication. A fasting diet is prescribed for one or two days: The child is given kefir, fruit, jam, sugar, and plenty of fluids. To cleanse the intestines of toxic products, cleansing enemas are done. Large amounts of fluids are administered intravenously (drip): solution (5%) glucose, Ringer's solution, hemodez, etc. The doctor may also resort to blood plasma transfusion. In case of severe and protracted course of hepatitis B, the patient is given antiviral therapy:α-interferon or its preparations are prescribed (human leukocyte interferon, reaferon, viferon, wellferon, etc.).

If necessary, for the treatment of hepatitis A in children, enterosorbents, enzyme preparations (mezim, pancreatin, Creon), immunosuppressants, and choleretic agents are prescribed. In the presence of secondary biliary tract infection, antibiotics are indicated; the patient is also given therapeutic drainage (using the Demyanov method). In severe forms of hepatitis, steroid hormones may be prescribed.

When the disease enters a period of reverse development, the treatment plan for the treatment of viral hepatitis A in children includes Karsil, LIV-52 or other hepatoprotectors. Good results during this period can be achieved using physiotherapeutic procedures; UHF therapy, ozokerite treatment, paraffin treatment are indicated. Physical therapy classes are regularly held for recovering children.

After a child who has suffered Botkin's disease is discharged from the hospital, he is under dispensary observation at his place of residence for at least six months. Preventive vaccinations cannot be carried out during this time; Also, antihelminthic treatment should not be carried out during this period. If residual effects of the disease are observed for a long time, treatment in a sanatorium is recommended for the child.

Caring for a child with hepatitis A

A mother allowed to care for a sick child should pay attention to the following recommendations:

• you need to carefully ensure that the child follows the bed rest prescribed by the doctor, so that he does not eat foods that require restrictions in the diet or complete exclusion from the diet;
• In order for the child’s body to quickly rid itself of toxins, he needs to be given drinks more often and without restrictions. Vitamin teas may be recommended - for example, those made from the fruits of rowan and cinnamon rose hips. Your child should drink 1 glass of these teas per day. In the form of fruit drink, gooseberries, black currants and other berries should be given. These fruits contain chemical compounds that have a diuretic effect on the body;
• Make sure that the child passes stool regularly - once a day. If stool is passed irregularly, toxic substances accumulate in the intestines of a sick child, which leads to an aggravation of the severity of the disease; the mother, seeing that the child’s stool is delayed, should inform the nurse about this, and she (as prescribed by the doctor) will give the child a cleansing enema;
• if a child suffers from a severe form of epidemic hepatitis, he should not be left alone for a minute (since hepatic coma may begin to develop at any moment);
• during the recovery period, in order to stimulate the secretion of bile and other digestive juices, more often give the child fresh vegetable juices to drink - carrot, cabbage, beetroot, potato, etc. Juices should be diluted with boiled water in a ratio of 1:4. Drink 1/3 glass a day, gradually increasing the dose.

After the child is discharged from the hospital, he should be given a gentle diet and protected from significant physical activity.

Prevention of hepatitis A (Botkin's disease) in children

To prevent hepatitis A in children, the following measures should be taken:

• to prevent hepatitis A and B, active immunization is carried out; Early diagnosis and timely isolation of sick people are very important;
• all patients are required to be hospitalized in special departments; discharge from the hospital is carried out only after complete recovery - however, not earlier than 3 weeks from the beginning of the icteric period or a month from the onset of the disease. A child who has had epidemic hepatitis is admitted to the children's group only a month after complete recovery;
• utensils used by a sick child must be soaked in a disinfectant solution;
• everyone who has been in contact with a sick child is observed by a doctor for 50 days (after the last contact); those children who have been in contact with the patient are injected intramuscularly with γ-globulin - this can reduce the incidence of hepatitis many times over;
• disinfection is carried out in the epidemic outbreak - current and final; current disinfection is carried out before the patient is hospitalized, final disinfection is carried out after his hospitalization; before disinfection, all flies in the fireplace must be exterminated;
• in the children's institution where a person with epidemic hepatitis was found, quarantine measures are carried out;
• syringes, needles and other piercing instruments are thoroughly sterilized.

Hepatitis A (Botkin's disease) is a viral infection of the liver that occurs as a result of violation of personal hygiene rules, consumption of food or water contaminated with viruses. This infection belongs to the category of “diseases of dirty hands”. Most common in hot countries.

Botkin's disease is widespread in Asian and African countries, including traditional tourist countries - Tunisia, Egypt, Turkey, India. Children under 5–6 years of age are most often affected; many suffer from a mild form of hepatitis.

Outbreaks are common in children's groups; after illness, lifelong immunity remains.

Botkin's disease is caused by a virus that is transmitted through water, food and dirty hands.

When viruses enter the intestines, they are absorbed and enter the liver through the blood. The development of infection occurs in liver cells, damaging them and causing the main symptoms of the disease. The inflammatory process has an immune mechanism; the body recognizes damaged cells and destroys them.

Who is at risk of getting sick?

There is a high risk of developing Botkin's disease if:

• close contacts with patients, violation of hygiene rules;
• during kissing, sexual intercourse;
• when traveling abroad to countries with high incidence rates;
• when using drugs.

How to find out about infection

If Botkin's disease is suspected or to determine the presence of immunity, blood is tested to detect antibodies to the anti-HAV IgG virus.

If they are present in the blood, this indicates that there has already been contact with the virus (as a result of vaccination or illness). In this case, re-infection is impossible; vaccination is not necessary.

If there are no antibodies, it means there is no immunity to Botkin’s disease and routine or emergency vaccination and the administration of immunoglobulin are necessary (it can prevent infection or stop the infection within two weeks).

All family members of the sick person and contact persons, if this is a child, are subject to examination.

Symptoms of Botkin's disease

Botkin's disease occurs in stages, the incubation period from the moment of infection lasts from 15 to 50 days.

After its completion, the stage of prodromal phenomena (i.e., general symptoms) begins - symptoms of general intoxication of the body arise:

• fever;
• nausea and vomiting;
• appetite disturbances;
• heaviness in the stomach;
• pain in the right side;
• weakness, sleep disturbances.

At the height of Botkin's disease, the following appear:

• foamy and dark urine;
• jaundice, manifested on the skin, mucous membranes and whites of the eyes;
• discoloration of stool.

Against the background of jaundice, the patient's general health improves. Jaundice lasts about a month, gradually decreasing in intensity.

Depending on the age and state of immunity, the disease lasts from 30 to 40 days; in weakened patients, it can become chronic, lasting up to six months.

Most cases of Botkin's disease lead to complete recovery, without any consequences.

Diagnostics

The diagnosis is made by an infectious disease doctor.

To make a diagnosis, it is important to indicate contact with a carrier of Botkin’s disease or stay in countries that are dangerous for infection. A detailed examination is required to determine the size of the liver and spleen, and a number of tests.

• general blood and urine analysis;
• blood test for bilirubin and liver enzymes (liver tests);
• blood chemistry;
• blood for antibodies to hepatitis;
• blood for clotting.

The criterion for the acute form of Botkin's disease is the detection of class M antibodies in the blood; with a chronic course or immunity, class G antibodies appear.

Treatment of Botkin's disease

Due to the active work of the immune system to fight viruses, recovery occurs even without treatment. The use of therapy methods is aimed at alleviating the condition and relieving the symptoms of intoxication.

• during the acute period, a “liver” diet (table No. 5);
• creating peace, isolating the patient;
• removal of intoxication by administering solutions of glucose and sodium chloride;
• administration of vitamins to maintain immunity and liver function;
• administration of drugs that protect liver cells from destruction.

The diet of table No. 5 includes boiled or stewed vegetarian dishes, dairy, cereal dishes, and lean meat. Fatty, fried, spicy foods, spices and excess salt are prohibited. It is important to eat often, at least five times, in small portions.

More information about nutrition for Botkin's disease is written in our separate article.

Antiviral therapy is not carried out as it is ineffective. When antibodies are detected in the blood of contact persons, they are administered anti-hepatitis immunoglobulin to prevent infection.

Complications

Botkin's disease is severe in children under one year of age and in the elderly. In adults, hepatitis A is accompanied by severe intoxication.

There may be cases of anicteric mild course of the disease; such a person is a source of infection, especially dangerous for children.

With defects in the immune system or at an early age of up to six months, a severe course of Botkin's disease occurs with the development of liver damage, including death.

Hepatitis A is similar in many manifestations to other hepatitis, so any cases of jaundice require examination.

Prevention

Prevention of Botkin's disease is vaccination. Today it is not included in the compulsory vaccination schedule, but is strongly recommended for children attending kindergartens, people traveling on vacation and people at high risk of contact.

The vaccine is administered twice, with an interval of 6 months, and full immunity is formed for up to 10 years. Vaccination is carried out for children from three years of age, adults who have not had hepatitis A, and people at risk.

Diagnosis by symptoms

Find out your likely illnesses and to which to the doctor should go.

Hepatitis A(second name - Botkin's disease) is an intestinal infection that is common in children. During its development, general intoxication of the body occurs, but the human liver is mainly affected. As a rule, hepatitis A develops not in one child, but in a whole group of children who are in close contact with each other. The disease most often affects children aged three to seven years. However, adults also suffer from hepatitis A. As a percentage, more than 60% of cases of the disease occur in children. The disease is very rare in infants, who are reliably protected antibodies mother.

Hepatitis A virus

Hepatitis A is an acute infectious disease that develops under the influence of a virus.

The hepatitis A virus is resistant to a number of substances - acids , broadcast , chlorine . At the same time, he shows sensitivity to formaldehyde , and when boiled it dies within 5 minutes.

The virus is excreted from the human body along with feces, and a person is contagious from the time of completion incubation period and during the pre-icteric period. The virus is not detected in the stool of a person with already developed jaundice. The virus enters the body through the mucous membranes of the gastrointestinal tract.

With viral hepatitis A, the duration of the incubation period can vary markedly and range from 7 to 50 days. But generally it ranges from 15 to 30 days.

Reproduction of viral particles occurs in the cytoplasm of liver cells. After they leave the liver cells, they immediately enter the bile ducts and then, together with bile, end up in the intestines.

Hepatocytes (liver cells) are damaged due to inflammation that develops in the liver. In turn, the inflammatory process is a consequence of an attack by the body’s immune system on liver cells affected by the virus. As a result, infected hepatocytes die, Botkin's disease manifests itself and the functioning of the liver is disrupted.

How does infection occur?

The source of infection is a person infected with the virus. Its feces release billions of viruses into the environment. If a person consumes water or products that have been contaminated with the hepatitis A virus, the virus enters the person’s intestines, and then, along with the bloodstream, it moves to the liver and invades hepatocytes.

Thus, the mode of transmission of the hepatitis A virus is fecal-oral . Very often, infection with the disease occurs in countries with hot climates on different continents.

Hepatitis is also called the “disease of dirty hands.” In civilized countries, due to the normal functioning of sanitary and communal services, as well as due to the observance of hygiene rules by the population, people rarely suffer from hepatitis. Consequently, very few people develop antibodies to this disease. When in contact with a carrier of the virus, people who do not have antibodies run the risk of becoming infected. Therefore, during trips to Asian and African countries, cases of infection among our fellow citizens are relatively common.

A healthy person can have contact with a sick person without risking infection. It is more important to strictly follow all hygiene rules. But it is best to isolate children from patients with hepatitis A.

To determine the degree of risk of contracting the disease in order to decide on the advisability of vaccination, a special blood test can be carried out, which determines whether there are antibodies to the hepatitis A virus in the human body. If they are detected, this means that the person has immunity to the virus, and no vaccination is needed. People practically never get sick with hepatitis A again. In the absence of antibodies, the risk of infection exists, which means vaccination is needed.

Before a possible infection or after it, a person can be given immunoglobulin , which during this period will protect against infection or the development of illness in the body.

Symptoms of hepatitis A

During the incubation period, Botkin's disease gradually begins to manifest itself with some characteristic signs. The person may be bothered fever , as well as dyspeptic manifestations (vomiting, nausea, heaviness in the stomach and right hypochondrium). The child's body temperature may increase slightly in the first few days. In addition, symptoms of Botkin's disease include weakness and darkening of the urine. Later, the patient develops jaundice - the sclera and skin acquire a characteristic yellow color, and at the same time the feces become discolored. Jaundice appears on the body very quickly, almost overnight. This condition lasts for three to six weeks. Moreover, after the onset of jaundice, the patient begins to feel a little better. On average, the illness lasts approximately 40 days. At this time, adequate treatment is carried out. But the duration of the illness can be influenced by various factors, for example, age, the correct approach to therapy, and the presence of other chronic diseases.

In approximately 15% of people affected by the hepatitis virus, the disease becomes chronic and can last up to 9 months. In most cases, hepatitis A exhibits typical symptoms, and the patient recovers completely if the doctor's recommendations are followed, as well as the appropriate diet .

Hepatitis A is most severely affected by children under one year of age, adult patients, and elderly people. In preschool children, viral hepatitis A occurs in a milder form, while in adult patients, the symptoms of hepatitis A are severe, with severe intoxication. The illness can last up to three months, despite treatment.

It should also be taken into account that all hepatitis, of any origin, manifests itself with similar symptoms. Therefore, it is very important to consult a doctor in a timely manner and undergo a comprehensive examination.

Hepatitis A and pregnancy

If a woman plans pregnancy , she needs to be vaccinated against hepatitis A, since the disease can cause pregnancy complications and even premature birth. If vaccination has not been carried out, then the pregnant woman should clearly know how Botkin’s disease is transmitted, since prevention in this case is a very important point.

Classification of hepatitis A

There is a division of hepatitis A into several types according to different criteria. Depending on the manifestations of the disease, it is distinguished typical option (the patient has jaundice) and atypical variant (no jaundice observed). If the latter option occurs, then sometimes the disease goes unnoticed, since the child in this case suffers only from a short-term bowel disorder.

When assessing the course of Botkin's disease in a child, doctors distinguish light form (most cases) medium-heavy form (approximately 30% of cases), severe form (rarely, approximately 1-3% of cases).

Diagnosis of hepatitis A

To diagnose hepatitis A in a patient, the doctor must carefully study the patient's epidemiological history. In this case, we are talking about which countries the person visited, what he ate, whether he had contact with patients, etc. In addition, tests are required - general and biochemical blood tests, analysis for markers of viral hepatitis, general urinalysis, coagulogram .

The main criterion for diagnosing the acute form of Botkin's disease is the isolation of antibodies to hepatitis A from a person's blood. They can be detected in the blood only during the acute period of the disease.

Treatment of hepatitis A

If a person is diagnosed with hepatitis A, then specific therapy is not practiced, since the patient recovers without treatment. In modern medicine, the efforts of specialists are concentrated on reducing the content of harmful substances in the human body and removing them. Such substances begin to appear in the human body at a time when the liver is damaged and its basic functions are disrupted. Consequently, patients are administered detoxification solutions, as well as glucose. They are advised to take vitamins and hepatoprotective drugs (these drugs protect liver cells). With Botkin's disease, there is no need for antiviral therapy. If doctors are dealing with a severe case of the disease, the principle of treatment does not change, but the volume of prescribed medications increases.

During the treatment process, it is important to adhere to a certain dietary diet. Food should be high in calories and balanced. It is necessary to include proteins in the daily diet in the form of lean meat and fish, eggs, and low-fat cheese. Carbohydrates should be consumed in the form of cereals, potatoes, bread, sugar. Fats should be chosen from vegetable sources, and butter should also be consumed periodically. In addition, it is important for the child to eat a lot of vegetables, fruits, and drink juices. At the same time, it is prohibited to introduce refractory fats, fatty meats, fish, sausage, spicy foods, legumes, chocolate, smoked meats, etc. into the diet.

Equally important is proper rest and a state of emotional and physical peace. Children who suffer from the disease easily need to limit physical activity. But if a child constantly feels unwell, then he should adhere to bed rest.

After recovery, children are required to remain under medical supervision. If, after two examinations, no health problems are found in the child, then he is removed from the register.

With hepatitis A, the prognosis is favorable; a person experiences complete restoration of liver function. In rare cases, the liver remains enlarged, but its function is not affected.

Prevention of hepatitis A

The main preventative measure is vaccination from Botkin's disease. Modern vaccines highly effective and highly immunogenic. The vaccine must be administered twice, with an interval of six months to one year. After administration of the vaccine, a person is protected from infection by the virus for up to 10 years.

Vaccinations are given to children over three years of age, as well as to adults who have never had hepatitis A. It is also important to vaccinate those people who are at increased risk of infection.

Several categories of people are identified who need to be vaccinated against hepatitis A. First of all, these are family members of a patient with hepatitis A and people in close contact with him. Persons who have had sexual contact with patients should receive vaccinations. Vaccination is also necessary for those who live in regions where many cases of the disease are recorded; people planning to visit countries where hepatitis A is common; homosexuals; those who use drugs.

Hepatitis vaccinations should also be given to workers in infectious diseases departments of hospitals, all staff of children's institutions, employees of the water supply and public catering sectors, and people suffering from chronic liver diseases.

If someone in the family has contracted Botkin's disease, it is recommended that all family members be examined for the presence of antibodies to hepatitis A. In addition, as a preventive measure for the disease, everyone should follow the simplest rules of hygiene: wash your hands as often as possible, and always use soap. It is very important to teach children to follow the rules of prevention from a very early age.

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