How Do Doctors Treat Hepatitis A
Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.
Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicinesany of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.
See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.
What Are The Signs & Symptoms Of Hav Infection
Hepatitis A can be a mild infection, particularly in kids younger than 6, so many people might not ever know that they had an infection.
When symptoms do happen, they typically start 2 to 6 weeks after exposure to the virus and are more likely in adults and kids older than 6. HAV can cause vomiting and diarrhea, as well as fever, loss of appetite, darker than usual urine , jaundice , and abdominal pain.
HAV infections that cause serious symptoms can last for weeks or even months. Some people with HAV can feel ill for up to 6 months.
Who Gets Hepatitis A
Anyone can get hepatitis A, but certain persons are at increased risk of infection, including:
- Children and adults living in areas with increased rates of hepatitis
- Persons traveling to countries where hepatitis A is common
- Men who have sex with men
- Injecting and non-injecting drug users
- Sexual contacts of infected persons
- Household contacts of infected persons
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How Do People Get Sick
Hepatitis viruses are spread from person to person through contact with infected feces , either directly or indirectly . People can carry the virus without showing symptoms, then spread it to other people, foods or surfaces.
People can get Hepatitis A after eating contaminated food and beverages. Food and drinks can become contaminated through:
- a contaminated food handler
- hands that were not washed properly after using the washroom
- contamination during harvest, manufacturing and processing
Common food sources of Hepatitis A include:
- contaminated water
Keep Personal Items Personal
Any tools or implements that may have a bit of blood on them from infected people are potential sources of hepatitis B or C transmission. Toothbrushes, nail clippers, razors, needles, and washcloths may all contain trace amounts of blood that can transmit infection. Keep personal items such as these to yourself and never use personal items that belong to others.
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What Is Viral Hepatitis
Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.
What If I Am Exposed To Hepatitis B What Should I Do
You should see your GP or local health centre as soon as possible to discuss your options. You will need to have a blood test and in some cases you may start treatment immediately to stop your body becoming infected with Hepatitis B. Management may include hepatitis B immunoglobulin, an injection of plasma which contains high levels of antibodies to help prevent hepatitis B infection from developing in a person who has been exposed.
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How You Can Get Hepatitis A
Hepatitis A is most widespread in parts of the world where standards of sanitation and food hygiene are generally poor, such as parts of Africa, the Indian subcontinent, the Far East, the Middle East, and Central and South America.
You can get the infection from:
- eating food prepared by someone with the infection who has not washed their hands properly or washed them in water contaminated with sewage
- drinking contaminated water, including ice cubes
- eating raw or undercooked shellfish from contaminated water
- close contact with someone who has hepatitis A
- less commonly, having sex with someone with hepatitis A or injecting drugs using contaminated equipment
Someone with hepatitis A is most infectious from around 2 weeks before symptoms appear until about a week after symptoms first develop.
How Is Hepatitis A Diagnosed
Your healthcare provider will listen to your symptoms and will take a blood test to confirm the diagnosis of hepatitis A. If the test finds immunoglobulin M antibodies, you have an acute hepatitis A. If there are antibodies, but not IgM antibodies, you are immune to the virus either because you had a case of it and recovered, or you got the hepatitis A vaccine.
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Common Symptoms Of Hepatitis
If you are living with a chronic form of hepatitis, like hepatitis B and C, you may not show symptoms until the damage affects liver function. By contrast, people with acute hepatitis may present with symptoms shortly after contracting a hepatitis virus.
Common symptoms of infectious hepatitis include:
It is crucial to understand what is causing hepatitis in order to treat it correctly. Doctors will progress through a series of tests to accurately diagnose your condition.
Immunization Against Hav In Patients With Chronic Illnesses
Persons with chronic liver disease are at an increased risk of HAV-related morbidity and mortality if they acquire HAV infection. Therefore, pre-exposure prophylaxis with the HAV vaccine has been recommended for patients with chronic liver disease who are susceptible to HAV.73 This recommendation should be extended to patients awaiting LT as well as those who have already undergone LT, although the immunogenicity of the HAV vaccine is reduced in such persons.74
An episode of acute hepatitis in a patient with underlying chronic liver disease poses the risk of considerable morbidity and mortality. Although current guidelines recommend immunization against HAV for all patients with chronic liver disease,32 the results of several cost-effectiveness analyses have been conflicting. A report published in 2000 found that saving the life of one patient with HCV infection through HAV vaccination would cost 23 million Canadian dollars,75 although some of the assumptions in this report have been challenged.76 Two other studies of patients with chronic hepatitis C showed a decided benefit to immunization against HAV.77,78 The methods used in these studies were dissimilar, and some analyses may have been insensitive to the incidence of HAV or may have underestimated the economic and societal costs of a case of ALF. Universal immunization against HAV during childhood, before the possible occurrence of chronic liver disease, offers the greatest promise of preventing HAV infection.79
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Comparison Of Hepatitis Viruses
- In hepatitis: Hepatitis A
Hepatitis A, caused by the hepatitis A virus , is the most common worldwide. The onset of hepatitis A usually occurs 15 to 45 days after exposure to the virus, and some infected individuals, especially children, exhibit no clinical manifestations. In the majority of cases, no special treatment other than
- In digestive system disease: Acute hepatocellular hepatitis
The hepatitis A virus is transmitted almost exclusively via the fecaloral route, and it thrives in areas where sanitation and food handling are poor and hand washing is infrequent. HAV proliferates in the intestinal tract during the two weeks following the onset of symptoms, but it
When Should I See A Doctor
Make an appointment if you have any of the symptoms and you recently:
- Traveled out of the country, especially if you went to Mexico, South America, Central America, or anywhere without good sanitation
- Ate at a restaurant that reported a hepatitis A outbreak
- Found out someone close to you, like a roommate or caregiver, was diagnosed with hepatitis A
- Had sex with someone who has hepatitis A
- Ate raw shellfish
- Used illegal drugs
When you see your doctor, they may spot some more signs that you’ve got the disease. For instance, they might find that you have:
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How Do You Prevent Hepatitis
Both hepatitis A and hepatitis B can be prevented with a vaccine. There is currently no vaccine available to prevent hepatitis C.
To prevent spreading or getting hepatitis A:
- Wash hands with soap and warm water for at least 20 seconds after using the bathroom, changing diapers, touching garbage or dirty clothes, and before preparing food and eating
- Follow guidelines for food safety
- Avoid unpasteurized milk or foods made with it
- Thoroughly wash fruits and vegetables before eating
- Keep the refrigerator colder than 40°F and the freezer below 0°F
- Cook meat and seafood until well done
- Cook egg yolks until firm
- Wash hands, knives, and cutting boards after contact with raw food
To prevent spreading or getting hepatitis B or hepatitis C:
- Practice safe sex and use a latex condom each time you have sex
- Dont share razors, toothbrushes, or any personal objects that might have blood on them
- Dont share needles or syringes
- Cover cuts and open sores with bandages
- Clean blood off of things with a mixture of bleach and water: use 9 parts bleach to one-part water
How Can I Avoid Getting Hepatitis A
There is a safe and effective vaccine that can protect you from getting hepatitis A. The vaccine is usually given in two doses six months apart. The vaccine will give you protection for up to 20 years. A combined vaccine for hepatitis A and hepatitis B is also available. Since up to 40% of the reported cases of hepatitis A occur in travellers, it is advisable to protect yourself with a hepatitis A vaccination six weeks before you leave.
Consider these additional safety precautions:
- Wash your hands frequently and thoroughly especially after using the washroom, before preparing food and before eating.
- Avoid raw or undercooked food.
- If you are travelling to countries with high rates of hepatitis A:
- Drink bottled or boiled water and use it for brushing your teeth.
- Drink bottled beverages without ice.
- Avoid uncooked food including salads.
- Avoid food from street vendors.
- Peel and wash fresh fruits and vegetables yourself.
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Causes Of Hepatitis A
Hepatitis A is caused by a virus. The virus can survive for several hours outside the body but persists on the hands and in food for even longer. It is resistant to heating and freezing.
The virus is spread when it enters the mouth, which can happen when hands, foods or other items are contaminated with the faeces of a person with hepatitis A. The disease can also be spread sexually by oral or anal contact.
A person with hepatitis A is infectious from 2 weeks before they show symptoms to one week after they become jaundiced .
If an infected person has no jaundice, they may pass on the virus until 2 weeks after they first have symptoms . Caution is advised beyond this period as the virus can be shed in stools for longer periods.
Good Hygienic Practices Are ‘critical’
Several factors contribute to berries being at risk of carrying the virus, including the uneven and rough surface of the fruit and that they’re picked by hand, Banerjee said.
Though “we are seeing more and more outbreaks associated with hepatitis A, we should not consider them as, perhaps, the only type of fruits that could have this virus,” Banerjee said. “There are other fruits that could also get the virus.”
The berries linked to the current outbreak were fresh and organic, according to the Food and Drug Administration. But whether the berries are organic or conventional, fresh or frozen, doesn’t make a difference in terms of its risk of carrying a harmful pathogen, experts said.
“Organic practices do not allow the use of sewage as fertilizer,” Diez said. “That goes against good agricultural practices if something like that happened, so it doesn’t matter whether they’re organic or conventional.”
The strawberries branded FreshKampo and HEB potentially linked to the outbreak are currently past shelf life and were purchased between March 5 and April 25, the FDA said. The agency encouraged consumers who bought and froze the berries to dispose of them.
The virus could survive freezing, and strawberries typically aren’t cooked, which kills the virus. Rinsing fresh fruits and vegetables before consumption helps reduce contamination, but won’t eliminate all microorganisms, Diez said.
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Side Effects Of Immunisation Against Hepatitis A
Immunisations against hepatitis A are effective and safe. All medications can have side effects.
For most people, the chance of a serious side effect from a vaccine is much lower than the chance of serious harm if you catch the disease.
Common side effects from the hepatitis A vaccine include:
- localised pain, redness and swelling at the injection site
- low-grade temperature
- headache.
How Long Does Hav Survive Outside The Body How Can The Virus Be Killed
HAV can live outside the body for months, depending on the environmental conditions. The virus is killed by heating to 185 degrees F for one minute. However, the virus can still be spread from cooked food if it is contaminated after cooking. Adequate chlorination of water, as recommended in the United States, kills HAV that enters the water supply.
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What Is Hepatitis E
Hepatitis E, also called enteric hepatitis , is similar to hepatitis A, and more prevalent in Asia and Africa. It is also transmitted through the fecal-oral route. It is generally not fatal, though it is more serious in women during pregnancy and can cause fetal complications. Most patients with hepatitis E recover completely.
Populations At Higher Risk
Given the way it is spread, almost anyone can become infected with hepatitis A. However, certain people are at higher risk of contracting the disease than others. These include people who:
- Travel to countries where hepatitis A is common
- Are male and have sexual contact with other males
- Are illegal drug users
- Have blood clotting issues such as hemophilia
- Live with another person who is infected with hepatitis A
- Have oral-anal sexual contact with someone infected with hepatitis A
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How Serious Is It
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 1020 years
Prevention Of Hav Infection
HAV infection can be prevented by hand washing, heating foods appropriately and avoiding the consumption of contaminated water and food in HAV-endemic areas. Chlorination and certain disinfecting solutions are also effective in inactivating the virus.
Pre-exposure prophylaxis with intramuscular human normal immunoglobulin has been available since the 1950s and can decrease the incidence of HAV infection by more than 90%. Passive immunity lasts for 46 months, depending upon the dose of immunoglobulin used, but is only effective if administered within 2 weeks of exposure. There are, however, a number of disadvantages of HNIG prophylaxis including pain at the injection site, the need for repeated administration, interference with development of immunity to live vaccines and the potential risk of transmission of infectious agents such as bloodborne viruses or prions. As a result, HNIG pre-exposure prophylaxis is generally reserved for non-immune individuals exposed to HAV who have contraindications to HAV vaccination.9
Post-exposure prophylaxis should be considered in non-immune individuals who have been exposed to HAV.18 Either passive or active immunization, or a combination of the two, may be used.
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Has This Happened Before
Pomegranates have been linked to outbreaks internationally but not in Australia.
Past food-related outbreaks in Australia have occurred in oysters, lettuce, semi-dried tomatoes and frozen berries.
Imported frozen berries from the same producer implicated in the pomegranate associated outbreak were recalled due to linked cases of hepatitis A in 2015 and again in 2017.
These outbreaks led to some questions regarding the screening and regulations of imported food coming into Australia and prompted new regulations by the Department of Agriculture, requiring the producer of imported berries to be declared. The Department of Agriculture and Food Standards Australia New Zealand also issued guidance and recommendations to ensure industry producers are compliant with Australias food standards.
Microbiological screening tests for imported berries currently only involves testing for the intestinal bacterium E.Coli.
Whos Most At Risk Of Hepatitis B
People at highest risk of hepatitis B include:
- people born or brought up in a country where the infection is common
- babies born to mothers infected with hepatitis B
- people who have ever injected drugs
- anyone who has had unprotected sex, including anal or oral sex particularly people who have had multiple sexual partners, people who have had sex with someone in or from a high-risk area, men who have sex with men, and commercial sex workers
- close contacts, such as family members, of someone with a long-term hepatitis B infection
The risk of getting hepatitis B for travellers going to places where the infection is common is generally considered to be low if these activities are avoided.
Your GP can arrange for you to have a blood test to check for hepatitis B and have the hepatitis B vaccination if youre at a high risk.
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