Medical Question. Any Nurses or Dr's Out There? Need Advice

IF it was me, and IF my nephew had been received a clear diagnosis for either Mononucleosis or the Hepatitis B Virus, I would most probably attend the party with my young children. If he had something that was unknown, I would probably skip it.

Here's my reasoning:

- Mononucleosis ("Mono") is caused by the Epstein Barr Virus (EBV). 95% of the population has been exposed and infected by the EBV (*usually* without symptoms) and have created antibodies against it. However, they can remain a carrier and infect others, with or without symptoms.

According to the Center for Disease Control, "The incubation period, or the time from infection to appearance of symptoms, ranges from 4 to 6 weeks. Persons with infectious mononucleosis may be able to spread the infection to others for a period of weeks. However, no special precautions or isolation procedures are recommended, since the virus is also found frequently in the saliva of healthy people. In fact, many healthy people can carry and spread the virus intermittently for life. These people are usually the primary reservoir for person-to-person transmission. For this reason, transmission of the virus is almost impossible to prevent."

- Hepatitis is a general term, simply meaning "inflammation of the liver". While often the result of a Hepatitis Virus (A, B, C, D or E), it can also be caused by excess toxins (alcohol, plant or chemically derived medicine, etc.) or it can be a symptom of another illness (such as Mono). Obviously, if your nephew has Hepatitis from a toxic source, he is not contagious. I assume you're referring to your nephew possibly having a Hepatitis Virus.

Hepatitis A is contracted orally from fecal matter - either on hands, food or contaminated water. In the States, there are very FEW *recorded* (most cases are symptom free and thus go undetected) cases of Hepatitis A and carriers are only contagious while infected. The chance of contracting Hep A is slim, unless you are traveling internationally. My Mom, for example, contracted Hep A while in Indonesia some thirty years ago from "dirty" food.

The Hepatitis B Virus, is "transmitted through percutaneous (puncture through the skin) or mucosal contact with infectious blood or body fluids". My children have been vaccinated against Hep B, so I would feel comfortable if they were exposed to it either with family, or in a situation unknown to me. Also, IMHO, all caregivers, adults and children should be taught "risk reduction". Specifically, we should be aware that blood borne pathogens are often carried quietly, or by unknowing carriers. I act as though everyone has a blood borne pathogen and thus don't share toothbrushes, leave cuts uncovered, or deal with injuries without gloves (just as examples).

Hepatitis C is transmitted only through blood to blood contact (think: contaminated needles used for tattoos, shared Intramuscular or Intravenous needle use, blood transfusions, etc.), though the Virus itself has a much longer "life" span, outside of the body, than many blood borne pathogens. It would be very unusual that your nephew had contracted it and, as long as standard preventative measures were being followed, that your children would contract if he did have it.

What *would* worry me, is the unknown potential. So, unless his doctors have found a concrete diagnosis and I knew how to (or if it is possible) to prevent transmission, I would not expose myself or my children to any unknown illness.

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I just wouldn't go. Why risk kids' health? They can get mad, but you're watching out for your kids.

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I am not a nurse or a dr. but I would take my kids - as long as the child is not running a fever - he's not contagious.

You can't live your life in fear. Why miss out on a celebration because you are afraid?!

you need to research and learn about diseases before you run and hide in fear. Hepatitis - is NOT contagious unless done through bodily fluids. Mono - again - bodily fluids.

If they put him on antibiotics for 24 hours prior to the party - then you are even more "secure".....hand washing - good hand washing - is something that prevents spread of disease....

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Why wouldn't they know already if it's mono? A simple finger prick blood test can determine that.

My own son had a swollen liver when he had a staph infection from a scratch on his knee that set up infection. He ended up taking staph antibiotics. They kept a check on his liver after that for 6 months because I was the one that took him back, being the worry wart that I am. They knew he was fine. I was the one that was worried.

I will tell you that while waiting for bloodwork to come back, doctors sometimes give differential diagnoses, things that it "could" be, but may not be. That has not been helpful in this instance, I believe. Unless you think your nephew has taken illegal drugs with dirty needles, or had unprotected sex with drug addicts, or had blood transfusions that may have been tainted, it is VERY unlikely that he has hepatitis.

If your nephew is heavy set, this liver can be swollen by too much fat. My own son is a big kid, 200 pounds 6 ft tall, barrel-chested. Not fat but certainly not skinny. The doctor told me that he wanted to check his cholesterol in case he had some fat issues in the liver in addition to the staph infection. The blood work came back fine, and after the antibiotics were done, he never had a swollen liver again.

Staph infections are not contagious, and neither is high cholesterol.

D.

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I'd skip the party. They really don't know what's going on with this kid and it's pretty irresponsible of the parents to have this party not knowing what they are inviting everyone else into. If they knew for certain then you could make an informed decision and weigh the risks for your family. This isn't about hiding from everything or living in fear. This child could very well have a communicable disease that you do not want your family to get. That's pretty cut and dry. And you have very young children to consider in this equation.

I get that they probably want to carry on and keep things "normal" for their son but that doesn't mean putting everyone else at risk. Again, if they knew for sure what they were dealing with it would be much easier to make a decision about going. But dealing with the unknown-I'd stay home and send him a gift.

And no way would I count on good handwashing to prevent the spread of a disease at a kids party. Not everyone is very diligent about washing hands or sanitizing especially when "it's just family".

Mono is mono and there are several different types of hepatitis. The burden shouldn't be on you to try to guess and research what may be going on with this kid so you can decide weather or not to attend in order to appease a family member.

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Hep and mono aren't as easily spread by coughing and such, but if a cup is shared, or the child is young and still putting things in his mouth, is he handling the food... that can spread the sickness. There are many different types of Hepatitis, some are spread more easily that others, though mono is also contagious, and can be passed through saliva (sneezing/drinking/rubbing snot on surfaces). It just depends if the child is has started antibiotics at the time of the party and is out of the contagious stage.

And to correct another poster, hep can be spread by other ways than drug use and stds... and staph infections are EXTREMELY contagious. My father died from a staph infection complications, so I have done my research. It's scary seeing the misinformation out there.

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I would maybe have that very difficult conversation with her and explain that you do not feel comfortable having your children around them until they are all feeling better. Maybe she doesn't realize how serious it may be, especially with little ones constantly putting things in their mouthes. Maybe tell her you would be willing to help her reschedule, make phone calls, help make food, etc... I had a friend who had mono & I watched her children. My Dr suggested not coming in contact with them for at least 4-6 weeks. Good Luck!

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These are your children and you are the keeper and protector of their health. You make the decisions for your children's welfare not other family members. Your answer should be as mine was, these are my children and I will make decisions based on what I feel is best. Until you know more, why would you subject your children to something serious for merely a birthday party. It isn't always easy to deal with family members but you must stand strong for your children and believe me as a grandmother, this won't be the last time you have to do this. As a healthcare provider, I am surprised they would expect adults or children to join the party without knowing what they are dealing with. Why not postpone the party till the test results are in? A 9 year old can understand this so why are his parents not handling this? Seems like they are truly acting irresponsible. Be strong, Mom, your babies are counting on you. Dr. Carol Rossetti, journeytohealthinc.com

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I would skip the party. And if they are upset about it well, not your problem.

Personally I would cancel the party if my child was that sick and possible going to pass it on to others...

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I am no expert in medical but I wouldnt go either. I wouldnt care if it caused a fight, because when it comes down to it, your children's health is most important. And if there is a chance that something is contagious then I personally wouldnt take my son over there. Surprising that she wouldnt maybe reschedule because of all this.

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Not a nurse, but I am surprised your SIL knows this and is still having the party to put people on the spot.

I would suggest to her nicely changing the date until she knows for sure what your nephew has isn't contagious since you are worried about your young ones.

If as a mom she can't relate and understand your concern, then I would forfeit going and let your husband go OR if you do go, don't stay long and kind of stay away from your nephew playing with the babies and watch what your young one puts in the mouth.

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I would definitely be skipping that party. We have a party planned this weeken and believe me if my child were sick I'd be calling everyone to postpone it. Mono can be passed by sharing drinks/utensils your little one is too little to know any better

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I wouldnt bring my DS over there and I'm sure your poor little nephews not in the mood to have a Party ! poor kiddo. I wouldnt take any chances with my child ... not worth it. Fight for your childrens health mama !!!!!!!!!!!!

PS: I would call the pediatrician and ASK - then take it from there......

I don't think I'd risk it. Your kids are so small. If you want to go and support and love on your nephew do you have a friend that can look after your kids for a couple hrs? I am not one to lie or anything, but have you noticed them battling allergies, sleeping off a little, fussy, something??? I would probably get someone to look after my kids and just politely say I couldn't bring them bc they were a little bit under the weather themselves but I didn't want to miss the day with my nephew, and I would take a great gift! I mean you will certainly not contact anything from him and you are his aunt, so I think if you and your husband can find a way to get over there, that is what I would do. Who cares if anybody thinks you are overprotective, you gotta look out for little ones!

Well if it is hepatitis it is not "extremely contagious." Hep b will be more easily passed than Hep C but even w/B you would have to have contact with bodily fluids in order to contract it. The mono thing I am not as sure but I believe that has to be through saliva... if the child is old enough to know not to share items etc your kids should be fine...and I am very paranoid about these things. If there is ANY question that bodily fluids could be swapped at some point then just don't go so you have peace of mind.

ETA - Just did a little research and really you should just not go. Not because of the hep but because of the mono unless you can somehow KNOW that he does not have mono. Mono can also be passed from sneezing etc. and that is not something you want your little ones getting. Who cares if it causes a fight, if they can't understand that you don't want your kids getting exposed to mono then they are being ridiculous.

Hi,

Firstly, what kind of hepatitis must have striken your nephew? For hepatitis A and E, the mode of transmission will be fecal-oral route. meaning to say, anything that your nephew has passed out and any of your children has placed in their mouths, there is a big chance they will get infected. By hepatitis B, C, D, these could only be infectious via contact with blood, body fluids. For a sound mind, you can even research on your own. I don't feel there is any threat if your nephew gets to mingle with other kids.

Hi,

I would call your own pediatrician and let them know what you told us. They will tell you if you should or should not take your babies! I have done that before and followed their advice. It made me feel better. You could also make up an "illness" such as a bad headache to not go, unless your husband would go anyway and take the kids.

Something along the lines of 95% of Americans get Mono (Epstien Bar Virus) and majority get it before the age of 4 years old. Reason why I know this is because at 31 years old!!! - I was so sick that I went to the ER and found out I had Mono! For 31 years - of sharing drinks, kissing tons of men and boys, etc - I got Mono after being in a monogamous relationship for 3 years!

So Mono isn't a problem... but hepatitis is!! If you feel you and husband can take turns watching your children - making sure they don't share drinks or stick another person's stuff on their mouths (like maybe bring a play yard or pack n play for youngest with tons of her toys) - I'd go. Hep and Mono can only be passed thru bodily fluids - mainly saliva for Mono.

im not a nurse or a dr. BUT, if you take your kids over their, then u are crazy! Hopefully your SIC would have enough since to call off the party, but if not, then steer clear, and tell them to kiss it if they get mad. You have to protect YOUR kids...