Hepatitis A

What is Hepatitis A?

Hepatitis A is a highly contagious viral liver infection that can cause mild to severe infection or illness. Hepatitis A is preventable by vaccine.

Hepatitis A disease is caused by the hepatitis A virus (HAV). This infection spreads from consuming contaminated food or water or through direct contact with an infectious person.

Check out here viral hepatitis and non-viral hepatitis.

Hepatitis A virus is found in human poop (faeces). The virus is primarily transmitted when an unvaccinated or uninfected person ingests food or water that is contaminated with the faeces of an infected person. 

Note – Hepatitis A liver infection is vaccine-preventable.

Hepatitis B liver infection is vaccine-preventable. 

Hepatitis C – No vaccine is available for Hepatitis C.

Symptoms of hepatitis A include nausea, fatigue, stomach pain, and jaundice. The best way to prevent and spread hepatitis A infection is to get vaccinated.

Summary – Hepatitis A is a liver infection that causes inflammation of the liver caused by the hepatitis A virus (HAV). The virus spread when an uninfected and unvaccinated person ingests food or water with contaminated faeces of an infected person.  HAV is found in the stool that people infected with the hepatitis A virus.

Hepatitis A Epidemiological Triad 

Hepatitis A Epidemiological Triad

Agent– The causative agent is hepatitis A virus (RNA virus), hepatitis A virus, present mostly in the stool (feces)  and blood of an infected person.

Host – The reservoir of the hepatitis A virus is only human being infected with the virus. Hepatitis A virus infection is frequent in children.

Environmental factors– Overcrowding, poor sanitation, Rainy, seasonPoor standard of hygiene, contaminated water, and food.

Causes of Hepatitis A

Hepatitis A is caused by an HAV virus that infects liver cells and causes inflammation. The inflammation can affect liver work and cause signs and symptoms of hepatitis A.

The virus most commonly spreads when people eat or drink contaminated with fecal matter of an infected person, even just tiny amounts. Hepatitis A infection does not spread through sneezing or coughing.

How contracted is Hepatitis A?

People get develop hepatitis A infection after contracting HAV. This virus is typically transmitted by ingesting food or liquid that is contaminated with fecal matter of the infected person that contains the virus. Once transmitted HAV, the virus spreads through the bloodstream to the liver, where it causes inflammation and swelling of liver.

Individuals contracted hepatitis A virus through-

1. Ingesting contaminated food

2. Drinking contaminated water

3. Eating food that is handled by someone with the virus who doesn’t thoroughly wash his or her hands after using the toilet

4. Being in close contact with a person who’s infected even if that person has no signs or symptoms

5. Having oral-anal sex with someone who has the virus

Risk factors for Hepatitis A

The risk factor of hepatitis A disease is associated with –

1. Unsafe water or food

2. Poor sanitation/ inadequate sanitation 

3. Poor personal hygiene such as contaminated hands

4.  Oral-anal sex

Mode of Transmission Hepatitis A

1. Faeco-oral route

a. Direct contact (person to person contact) – Direct contact with the hepatitis A virus.

b. Indirect contact- Ingestion of contaminated food, water with the faeces of an infected person.

2. Rarely by Parenteral route

3. Sexual transmission – such as oral-anal sex

The hepatitis A virus infection is primarily transmitted by the faecal-oral route. When an uninfected person/ unvaccinated person ingests food or water that has been contaminated with the faeces of an infected person.

Hepatitis A virus spread through dirty hands when an infected person prepares food or handles it.

Waterborne outbreaks of Hepatitis A virus are usually associated with sewage-contaminated or inadequately treated water.

The Hepatitis A virus can also be transmitted through close physical contact with an infectious person such as oral-anal sex. Casual contact with people does not spread the virus.

Check out here source of infection of hepatitis B and hepatitis C.

Incubation Period of Hepatitis A

The incubation period of hepatitis A is usually 14 – 28 days (range 15 to 50 days).

Pathophysiology of Hepatitis A

1. Due to etiological factors; Ingestion of contaminated food or water (through fecal-oral transmission)

2. Exposure to hepatitis A virus, Virus enters and replicates in the liver

3. Cause Infection, inflammation, swelling of the liver

4. Hepatocyte (liver cells) damage and necrosis of the part of the liver lead to alteration of live function

5. After 10 to 12 days, the virus is present in blood and is excreted via the biliary system into the feces

6. Peak titers (antibody level) occur during the 2 weeks before the onset of illness

Clinical Manifestation of Hepatitis A

Symptoms of hepatitis A infection range from mild to severe-

1. Fever

2. Chills

3. Headache

4. Fatigue/weakness

5. Anorexia/ malaiseNausea/ Vomiting

6 Diarrhoea

7. Itching

8. Abdominal pain or discomfort, especially on the upper right side beneath the lower ribs

9. Dark-colored urine

10. Clay-colored bowel movements

11. Joint pain

12. Jaundice (yellowing of the skin and/or whites of the eyes)

Lab Investigation for Hepatitis A

1. Fecal examination – for Hepatitis A Virus

2. IgM antibody test – Blood examination for IgM antibody to Hepatitis A virus in patient’s serum to detection of HAV-specific Immunoglobulin G (IgM) antibodies in the blood.

3Reverse transcriptase-polymerase chain reaction (RT-PCR) – to detect the hepatitis A virus RNA

4. IgG anti-HAV test – to detect past HAV infection

Treatment of Hepatitis A

No specific treatment exists for hepatitis A infection. Treatment is typically focused on reducing symptoms of diseases. Therapy is given to treat the symptoms and reduce illness called supportive care.

Therapy is aimed at providing comfort and maintaining adequate nutritional balance, replacement of fluids and electrolytes that are lost from vomiting and diarrhea.

Recovery from hepatitis A infection, symptoms may be slow and may take several weeks or months. In most cases of hepatitis A infection Liver heals within six months.

Prevention and Control of Hepatitis A infection

1. Avoid alcohol

2. Maintain a healthy diet

3. Drink plenty of water

4.  Practice good hygiene

5. Control of reservoir

6. Disinfectant of faeces and fomites

7. Adequate supplies of safe drinking water

8. Controlling the transmission of disease

9. Habit of personal hygiene practices such as regular hand-washing before meals and after going to the toilet.

10. Disinfectant and sterilization of syringes, needles and other equipments.

 11. Immunization  – Active immunization

Two types of vaccine- Live attenuated vaccine and killed or inactivated vaccine

A combination vaccine which contains hepatitis A inactivated and recombinant hepatitis B, are used for children under 1 year of age and older people.

Vaccine                            Doses given at age                Route

Combination vaccine         0 months                            I/M

                                          1months

                                           6months

Note – A single shot of the hepatitis A vaccine, can provide protection against hepatitis A if given within 2 weeks of exposure.

Once recover from hepatitis A, in body develop antibodies that protecting for a lifetime.

Complications of Hepatitis A

Hepatitis A infection does not cause long-term liver damage, and not become chronic, Unlike other types of viral hepatitis.

In rare cases, in older adults or people associated with chronic liver diseases, hepatitis A can cause a sudden loss of liver function.

Acute liver failure case requires a stay in the hospital for monitoring and treatment.

Hepatitis A FAQ

 

1. How spread hepatitis A infection?

The hepatitis A virus route of entry is faecal-oral route,  transmitted; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person.  hepatitis A virus primarily by the faecal-oral route.

The hepatitis A virus present in stool of infected person and is carried in the stool (poop) of infected people. 

2. Is hepatitis A is curable?

Currently No specific medicines are used to treat or cure  hepatitis A means there is no cure for hepatitis A virus.

Symptoms of hepatitis A recover or reduced with supportive treatments and care.

3. What happens if get hepatitis A?

Hepatitis A is a viral infection, it causes liver inflammation and damage. Inflammation is swelling can damage Liver organs. 

4. Is hepatitis A STD?

Hepatitis A is a virus sheds in human faeces (poop). Uninfected individual get infected when eats or drinks contaminated food and water infected with  Hepatitis A virus. It can also  transmitted through unprotected sexual activities, particularly oral-  anal sex.

 

5. How can prevent infection after an exposure to the hepatitis A virus?

Hepatitis A infection can be prevented by getting vaccine or immune globulin soon after coming into contact with the Hepatitis A virus.

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