Hepatitis is an inflammatory and infectious condition of the liver. Acute infectious hepatitis, or hepatitis A, is the most common type. It is caused by the hepatitis A virus (HAV), which is not easily killed by heat, cold or chemicals. The virus is carried in the gastrointestinal tract and is transmitted primarily by fecal-oral contamination. Poor personal hygiene by food handlers and shellfish harvested from polluted waters are possible sources of infection. Hepatitis A can be a mild illness, particularly for children, but adults may miss weeks of work and elderly people are at increased risk of serious complications.
Symptoms
Poor appetite, sweating, fatigue, body aches, fever, nausea, vomiting, green-tinted foamy urine, clay-colored stools and jaundice are typical signs of hepatitis A. Jaundice is a yellow color of skin and deeper tissues which indicates faulty liver function. The pigment comes from the destruction of red blood cells and the elimination of resulting wastes through the skin. Hepatitis A is contagious two to three weeks before and one week after jaundice appears. A single infection confers lifetime immunity.
Prognosis
The more serious blood-borne pathogens hepatitis B and C viruses cause chronic liver diseases which may lead to cirrhosis or liver cancer. Acute infectious hepatitis, or type A, is self-limiting and does not remain in the body. Children have milder symptoms and usually recover within a few days. Illness in adults may last a few weeks. Severity of the disease and the risk of rare complications increase with age and other health factors, such as alcoholism or diabetes. In a Texas study, 42 percent of people over the age of 70 with HAV infections required hospitalization. Treatment is supportive and includes bed rest, fluids and small frequent meals low in fat and high in antioxidants (fruit and vegetables). Isolation practices can limit the spread of infection.
Prevalence
Hepatitis A primarily affects children and young adults in developing countries. Those with known exposure may be given a vaccine or immune globulin to boost immunity and lessen the severity of infection. When caring for an infected person, wash your hands often. Clothing and bed linens should be laundered in hot water with chlorine bleach. Because feces are infectious, bathroom fixtures and floors should be disinfected frequently.
Development of a vaccine in 1996 has helped reduce the incidence of infection in the United States by 76 percent. Prior to 1997, 17 U.S. states had a high incidence of hepatitis A outbreaks among children. Partly because of routine vaccination, hepatitis A is no longer primarily a children's disease; the virus now strikes mostly adults.
Vaccination is recommended for high-risk groups including those who have a history of liver disease, people who have anal sex with multiple partners, and those traveling to Africa, the Middle East, the Carribean and South and Central America. Ask a healthcare provider about possible risks associated with the vaccine.
