Hepatitis A is an enterovirus transmitted by the
orofecal route, such as contaminated food. It causes an acute form of hepatitis
(inflammation of the liver), does not have a chronic stage, and will not cause
any permanent damage to the liver. The patient's immune system makes antibodies
against Hepatitis A that confer immunity against future infection. A vaccine is
available that will prevent infection from hepatitis A for life.
Features
Hepatitis A is a disease affecting the liver, and caused by the Hepatitis A
virus (abbreviated HAV). Only 3 out of 4 people with hepatitis A have symptoms.
Those symptoms may include:
 Jaundice
which first shows up first as yellow eyes
- Dark urine
- Nausea
- Fever
- Fatigue
- Loss of appetite
- Stomach ache
- Vomiting
Diagnosis
The diagnosis is made by the detection of antibodies directed at the virus by
the person infected (Serum IgM anti-HAV). It is the gold standard for the
detection of infection with Hepatitis A.
Treatment
There is no specific treatment for Hepatitis A. Sufferers are advised to rest,
avoid fatty foods and alcohol (these may be poorly tolerated for some additional
months during the recovery phase and cause minor relapses), eat a well-balanced
diet, and stay hydrated. Approximately 15% of people diagnosed with Hepatitis A
may experience a symptomatic relapse(s) for nine months to a year after
contracting the disease.
Prognosis
The United States Centers for Disease Control and Prevention (CDC) in 1991
reported a low mortality rate of 4 deaths per 1000 cases for the general
population but a higher rate of 17.5 per 1000 in those aged 50 and over.
Young children who catch hepatitis A often have a milder form of the disease,
usually lasting from 1-3 weeks, whereas adults tend to experience a much more
severe form of the disease. They are often confined to bed and minimal activity
for about 4 weeks and have to stop their work for from one to three months or
longer. Many adults take up to 6-12 months and occasionally longer to recover
entirely. Symptoms that may be experienced after the first month or two are low
immunity: It is much easier to catch minor infections and for these infections
to linger longer than they normally would. Many people experience a slow but
sure improvement, over this later period. They are generally able to function
fairly normally, still needing more sleep and reduced athletic activity. It is
common for recovering patients to experience occasional "off" days, during which
they need to rest more. Hepatitis A can be sexually transmitted, especially
during oral-anal contact, but not after the patient has recovered.
Prevention
Hepatitis A can be prevented by good hygiene and sanitation as well as using
condoms during sex. Vaccination is also available, and is recommended in areas
where the prevalence of hepatitis A is high.
Ways to prevent hepatitis A include the following: Wash hands with soap and warm
water before preparing or eating food, and after sexual activity. Keep bathrooms
clean and disinfected after every use. Cook shellfish thoroughly before eating.
Drink water from approved sources only. Use a dental dam or sheet of plastic
wrap during anilingus.
Epidemiology
Hepatitis A outbreaks still occur in developed countries and are usually traced
to unsanitary conditions at restaurants, including but not limited to employees
failing to wash their hands after restroom breaks. The most widespread Hepatitis
A outbreak in American history afflicted at least 640 people (killing four) in
northeastern Ohio and southwestern Pennsylvania in late 2003. In November of
that year, the outbreak was blamed on tainted green onions at a restaurant in
Monaca, Pennsylvania.
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