HEPATITIS-A

HEPATITIS-A

What is hepatitis A (HAV)?
Hepatitis A is a liver disease caused by the hepatitis A virus.



How common is it?
According to Centers for Disease Control and Prevention, it is estimated there are between 125,000 and 200,000 total infections per year in the United States. It is estimated that 84,000 to 134,000 of the total infections will show symptoms of HAV. Each year, approximately 100 people will die because of hepatitis A.



How is it transmitted?
Hepatitis A (HAV) is transmitted primarily through oral contact with feces (oral-fecal contact). This includes contaminated food or water sources and sexual contact, especially oral-anal sex.
Hepatitis A can easily spread among young children in day care settings because many are in diapers and cannot wash their own hands, and no one may know they have the disease since children normally do not have symptoms.

HAV has on rare occasions been transmitted through blood transfusion, use of blood products or sharing needles or other injecting equipment contaminated with HAV-infected blood. Transmission by blood is rare because the presence of virus in the blood occurs with the onset of infection and is not thought to be present long.



Symptoms
Most adults infected with HAV usually develop some symptoms. Symptoms may develop about 15-50 days after exposure; the average is 28 days. These may include:
Low-grade fever
Malaise (feeling of ill-health)
Fatigue (feeling tired all the time)
Loss of appetite
Nausea
Abdominal discomfort
Dark-colored urine
Jaundice (yellowing of the skin and eyes)
Children under 6 years of age seldom develop symptoms, although some may experience diarrhea.



Testing/Diagnosis
There are currently three blood tests available to detect HAV antibodies; antibodies may be detected for up to six months following the onset of symptoms. HAV antibodies usually disappear after this time.
Talk to your health care provider for more information about HAV testing.


Treatment
There is no cure for hepatitis A. Most people with severe infection will experience short-term illness and then recover completely. They are often told to rest for one to four weeks and to avoid intimate contact with others. Some doctors recommend a high-protein, low-fat diet during recovery and avoidance of alcohol, sedatives, or strong painkillers, such as narcotics. Once recovered, an individual is immune and will not get hepatitis A again.



What does it mean for my health?
Fortunately, complications from HAV are rare, and few deaths result from it. It is not known to cause chronic infections. However, it can make some people very sick, and it is easily preventable.



Reduce your risk - get vaccinated!

Vaccination before exposure to HAV:
HAV is preventable by vaccination. The hepatitis A vaccine is made from inactive hepatitis A virus particles. The body reacts with the inactive virus to produce an antibody that protects against infection of the liver by the hepatitis A virus. Clinical trials have shown that the vaccine is effective in preventing infection in about 95% of people who were exposed. There are generally no side effects, except for soreness at the site of injection. Less than 10% of those vaccinated become tired and nauseous.
The two-dose vaccine series, given at least six months apart, provides pre-exposure protection from HAV infection in children aged 1 years or older and in adults. Vaccination against HAV is recommended for those who are at risk of infection, including:

People 1 year of age and older traveling or working in countries with high rates of HAV
People who live in communities that have prolonged HAV outbreaks or high rates of HAV
Men who have sex with men
People who use street drugs
People with chronic liver disease
People who receive clotting factor concentrates
As of October 2005, the CDC ACIP (Advisory Committee on Immunization Practices) recommends that the hepatitis A vaccine become a routine childhood vaccine for U.S. children between 1 and 2 years of age in all states. (Previously the vaccine was only recommended for children in 17 states with the highest rates of disease; however, about two-thirds of cases are now reported from states in which hepatitis A vaccination of children was not recommended.)

A combination vaccine called Twinrix has been approved for protection from both HAV and HBV in persons 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.

Immune Globulin (IG) after exposure to HAV:
People who have been exposed to hepatitis A may talk with their health care provider about a post-exposure immune globulin (IG) injection. Immune Globulins (IG) are sterile solutions of antibodies made from human plasma. They are important tools in preventing illness.

A dose of IG, if given within 14 days after contact with HAV, may prevent illness from occurring. In some cases, the hepatitis A IG may also be given before a possible exposure.
Sexual Prevention:

Abstinence (not having sex)
Mutual monogamy (having sex with only one uninfected partner)
Cut-up non-lubricated latex condoms or use of other moisture barriers, such as household plastic wrap or dams (square pieces of latex) can reduce the risk of transmitting HAV during oral-anal sex.
Non-Sexual Prevention:

Avoid sharing drug needles and other drug-injection equipment.
Avoid contaminated food or water sources
Practicing good personal hygiene, especially hand-washing after using the toilet or changing diapers
To inactivate HAV, heat foods at temperatures above 185 degrees Fahrenheit for 1 minute or disinfect surfaces with a 1:100 dilution of household bleach in tap water (1 part bleach for 100 parts of water)


Talk to your partner
If you have tested positive for hepatitis A, you may want to tell to your sex partner(s) that you have the virus. As part of good partner communication, deciding to use latex condoms and moisture barriers during sexual contact helps reduce the risk of transmitting a sexually transmitted disease. HAV can be transmitted through oral-anal sex so it is recommended to always use safer sex methods to reduce the risk of transmission.



Where can I get more information?

Centers for Disease Control (CDC):
Viral Hepatitis Division and National Immunziation Program

Hepatitis Foundation International

American Liver Foundation

Immunization Action Coalition (IAC)

Parents of Kids with Infectious Diseases (PKID)