Hepatitis A

Hepatitis A is a very common infection that affects an estimated 9,000 people per year, though far fewer cases are reported to the Centers for Disease Control and Prevention (CDC). And while the resulting illness can be bothersome, it is typically not life threatening and it can often go unnoticed by the person who is infected.

Definition

Hepatitis A is a viral infection that causes irritation and swelling of the liver. Hepatitis A is the most common strain amongst the several types of hepatitis infections. It is easily spread by close contact with someone who is infected.

The virus causes the body to create specific antibodies to fight the infection, which are called immunoglobulin M and immunoglobulin G, or IgM and IgG, respectively. These antibodies, along with elevated liver enzymes, are easily detectable in blood tests, which is the primary way that hepatitis A is diagnosed. A blood test will usually be positive for IgM before it is positive for IgG, and in this way doctors can monitor the progress of the disease.

Mild cases of hepatitis A often go unnoticed by the person infected. Because it is so easily spread, it is not uncommon to see wide spread outbreaks in facilities such as daycare centers or schools. After infection, there is a 2 to 6 week incubation period, which can make it difficult to pinpoint the source of the infection if it came from a public place.

Most people who are infected with hepatitis A recover completely and experience no lasting effects. Rarely, hepatitis A becomes fulminant, which is means that the condition becomes life threateningly severe very quickly.

Causes

Hepatitis A is caused by a viral infection. This viral infection is easily spread through contact with microscopic amounts of fecal matter in foods and drinks. This can occur in a number of ways. Often fruits and vegetables can be contaminated during the growing or harvesting process. Seafood can be contaminated in the water if the water is polluted, or food service workers can spread the disease by not properly washing their hands. Hepatitis A can also be spread by some sexual practices.

There are some people who have a higher risk for contracting hepatitis A than others:

  • International travelers, specifically those who recently traveled to Central America, South America or certain parts of Asia.
  • IV drug users.
  • Those who live in group facilities such as nursing homes, rehabilitation centers and prisons.
  • Those who work in the health care, sewage or food industries.

Symptoms

The symptoms associated with hepatitis A are usually quite mild and many people with hepatitis A don't notice any symptoms at all. Symptoms include:

  • Reduced appetite
  • Malaise
  • Fever
  • Nausea or vomiting
  • Abdominal pain
  • Jaundice (yellow skin)
  • Dark urine
  • Itching
  • Pale or clay colored stools

Treatment

Treatment for hepatitis A is supportive, meaning that any treatment is meant to ease the discomfort of the person, but there is no specific treatment that will cure the infection. The body will fight off the infection on its own in time.

Rest is recommended when the symptoms are the most severe. People with hepatitis A should also avoid substances that are toxic to the liver, such as alcohol and acetaminophen (Tylenol), and fatty foods since one of the functions of the liver is to process the fat that someone eats. Someone who eats fatty food while infected with hepatitis A may experience nausea or vomiting.

Prevention

There are a number of things a person can do to avoid being infected with hepatitis A:  

  • Wash hands thoroughly after using the restroom, before serving food, or after coming in contact with an infected person's blood, stool, or other bodily fluids.
  • Avoid unclean food and water.
  • Always wash produce thoroughly before preparing.
  • Get the hepatitis A vaccine.

People who travel should take further precautions:

  • Avoid dairy products, especially unpasteurized products.
  • Don't eat raw foods or undercooked foods.
  • Cooked foods should be served hot and should be eaten immediately.
  • Do NOT buy food from street vendors.
  • Don't eat fruits that have been pre-sliced. Travelers should peel all fruits themselves.
  • Avoid tap water for drinking and when brushing your teeth.
  • Avoid ice cubes as they come from tap water and can contaminate your beverages.
  • If no other option is available, tap water can be boiled to make it safe. Bring water to a rolling boil and boil for at least one full minute.

Hepatitis A Vaccine

A vaccine is available for hepatitis A. The vaccine is given in two doses, the second booster vaccine being given six months after the first dose. The hepatitis A vaccine is on the schedule of vaccines for infants and should be given at a year old. 

If you have been affected by Hepatitis A, but have recovered from the infection, you no longer need to be vaccinated. Once you have recovered from hepatitis A, you become immune to the virus for the rest of your life.

There are certain individuals who should not receive the hepatitis A vaccine, which include:

  • People who suffer an allergic reaction to the vaccine.
  • Women who are pregnant or nursing.
  • Children less than 1 year of age.
  • Those suffering from an illness or fever should not receive the vaccine until they have recovered.

Hepatitis A can be bothersome, but it is very rarely ever fatal, and often goes unnoticed or is mistaken for something else. With proper preventative measure people can significantly reduce their risk of contracting hepatitis A.

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