LIVER DISEASES-(HEPATITIS )CONTINUES

HEPATITIS A

Hepatitis A is caused by the viral hepatitis A or (HAV). It is an acute illness (acute viral hepatitis) that never becomes chronic. It was once referred to as "infectious hepatitis" because it could be spread from person to person like other viral infections. Infection with hepatitis A virus can be spread through the ingestion of food or water, especially where unsanitary conditions allow water or food to become contaminated by human waste containing hepatitis A (the fecal-oral mode of transmission). Hepatitis A typically is spread among household members and close contacts through the passage of oral secretions (intimate kissing) or stool (poor hand hygiene). It also is common to have infection spread to customers in restaurants and among children and large groupings if hand washing and sanitary precautions are not observed.

DESCRIPTION-SIGNS AND SYMPTOMS:

Hepatitis A is a liver disease caused by the hepatitis A virus. Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis A virus infection in persons 12 months of age and older. Immune globulin(IG) is available for short-term prevention of hepatitis A virus infection in individuals of all ages.

Adults will have signs and symptoms more often than children.
• jaundice
• fatigue
• abdominal pain
• loss of appetite
• nausea
• diarrhea
• fever

LONG-TERM EFFECTS:

There is no chronic (long-term) infection. Once you have had hepatitis A, you cannot get it again.
About 15% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period.

TRANSMISSION:

HAV is found in the stool (feces) of persons with hepatitis A. HAV is usually spread from person to person by the fecal-oral route. Food borne transmission occurs when an HAV-infected food handler contaminates food during preparation or when food is contaminated during harvesting or processing before reaching the food service establishment or home( putting something in the mouth-even though it might look clean) that has been contaminated with the stool of a person with hepatitis A.

PERSONS AT RISK OF INFECTION:

Household contacts of infected persons, Sex contacts of infected individuals, persons especially children- living in areas with increased rates of hepatitis A, Men who have sex with men and Users of injection and non-injection drug.

PREVENTION:

Hepatitis A vaccine is the best protection. Short-term protection against hepatitis A is available from immune globulin(IG). It can be given before and within 2 weeks of coming in contact with HAV. Always wash your hands with soap and water after using the bathroom, changing undergarments, and before preparing and eating food.

VACCINATION:

Among the vaccines available are Havrix and Vaqta. Both contain inactive (killed) hepatitis A virus. For adults, two doses of the vaccine are recommended. After the first dose, protective antibodies develop in 70% of vaccine recipients in 2 weeks and more than 95% of recipients in 4 weeks. After two doses of the hepatitis A vaccine, immunity against hepatitis A infection is believed to last for many years.

Individuals at increased risk for acquiring hepatitis A and individuals with chronic liver disease (e.g., cirrhosis or chronic hepatitis C) should be vaccinated. Although individuals with chronic liver disease are not at increased risk for acquiring hepatitis A, they can develop serious (sometimes fatal) liver failure if infected with hepatitis A and, thus, they should be vaccinated.
Individuals at increased risk of acquiring hepatitis A are:
• Travelers to areas where hepatitis A is common
• Men who have sex with men who are infected
• Illegal drug users (either injection or non-injection drug use)
• Researchers working with hepatitis A or primates that are susceptible to infection with hepatitis A
• Patients with clotting factor disorders who are receiving clotting factor concentrates that can transmit hepatitis A
Some local health authorities or private companies may require hepatitis A vaccination for food handlers.

Because protective antibodies take weeks to develop, travelers to endemic areas should be vaccinated at least 4 weeks before departure. Immune globulin is recommended to be given in addition to vaccination if departure is prior to 4 weeks. Immune globulin provides quicker protection than the vaccines, but the protection is short-lived.