In all the countries of the World Health Organization’s (WHO) Eastern Mediterranean Region (EMR), hepatitis B infection is endemic [1]. In low-risk countries, hepatitis B infection occurs in teenagers and young adults as a result of risky behaviours. Effective vaccination, better blood screening and proper sterilization/disinfection has contributed considerably in its control [2]. In endemic countries, including EMR countries, however, the infection tends to occur in infants and children from maternal–fetal transmission, close contacts from persons nursing the infected patient’s wounds and the percutaneous route (unsafe injections, improperly sterilized invasive medical devices and improperly screened blood transfusions) [3,4]. Unfortunately in endemic countries, the disease in children is generally unrecognized because the signs and symptoms are negligible. These cases are unlikely therefore to be recorded in the surveillance data. As a result, endemic countries bear the brunt of hepatitis B infection as adult chronic disease, cirrhosis and its complications and hepatocellular carcinoma [5].