Why Prevention Is Key
Hepatitis A spread can be significantly reduced by using correct hand washing techniques and prevented by using the hepatitis A vaccine.
Centers for Disease Control and Prevention. Hepatitis A.
- Dienstag, JL. Acute Viral Hepatitis. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo , Harrisons Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008.
- Pickering, LK , The Red Book: Report of the Committee on Infectious Diseases, 26th e. American Academy of Pediatrics, 2003. 311-313.
What Are The Symptoms And Signs Of Viral Hepatitis
The period of time between exposure to hepatitis and the onset of the illness is called the incubation period. The incubation period varies depending on the specific hepatitis virus. Hepatitis A virus has an incubation period of about 15 to 45 days Hepatitis B virus from 45 to 160 days, and Hepatitis C virus from about 2 weeks to 6 months.
Many patients infected with HAV, HBV, and HCV have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu-like symptoms including:
How Do I Get Hepatitis A
Hepatitis A is spread through close contact with an infected person, or by eating hepatitis A contaminated food or drinking water. Because the virus is found in the stool of infected people, eating food prepared by an infected person, who does not wash his/her hands properly after using the washroom, is one way of getting the virus.
Eating raw or undercooked seafood and shellfish from water polluted with sewage, or eating salad greens that are rinsed in contaminated water are other ways of becoming infected. Sharing drug-use equipment, or having sexual contact with an infected person can also give you hepatitis A.
While often considered to be a travellers disease, hepatitis A can be contracted in Canada. Hepatitis A outbreaks or scares in Canada are most often associated with infected food handlers in restaurants and grocery stores or with contaminated produce.
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A New Jersey Starbucks Employee May Have Exposed Thousands Of Customers To Hepatitis A
Customers who visited a New Jersey Starbucks between early- to mid-November 2021 are being urged to get a hepatitis A vaccine after an employee at the store tested positive for the highly contagious virus.
Officials from the Camden County Health Department said in a news release that the organization was notified that the worker had hepatitis A and worked through the infectious period. The store was closed in response and all employees were vaccinated against the virus.
The employee is not currently working, and health department officials urge anyone who think they may have been exposedwhich includes people who visited the Starbucks on Nov. 4,5,6, 11, 12, and 13to get vaccinated against hepatitis A.
If youve already been vaccinated against hepatitis A in the past, the health department says that you dont need to get another dose.
All of this raises a lot of questions about hepatitis A and why, exactly, people should be so concerned about being exposed. Heres what you need to know.
What is hepatitis A?
Hepatitis A is a short-term liver infection caused by the hepatitis A virus, according to the Centers for Disease Control and Prevention . People who get hepatitis Awhich is highly contagiousmay feel sick for few weeks or several months but usually recover without lasting hepatic damage, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York.
How common is hepatitis A?
What are the symptoms of hepatitis A?
What Is Postexposure Prophylaxis
Postexposure prophylaxis refers to trying to prevent or treat a disease after an exposure. For hepatitis A, postexposure prophylaxis is an injection of either immune globulin or hepatitis A vaccine. However, the vaccine or immune globulin are only effective in preventing hepatitis A if given within the first 2 weeks after exposure.
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Contaminated Food And Water
Hepatitis A is most commonly passed on by eating food prepared by someone with the virus whose hands have not been washed properly. You can also get it by drinking dirty water and by eating raw or undercooked shellfish from dirty water.
You can protect yourself by:
- Washing your hands each time you go to the toilet, before you prepare or eat food, after coughing or sneezing, or handling rubbish or other dirty items.
- Peeling and washing all your fresh fruit and vegetables avoiding raw or undercooked meat and fish avoiding all drinks if youre not sure if theyre safe with or without ice.
- If tap water isnt safe and bottled water isn’t available, boil tap water before drinking it.
- People living in places with poor sanitation and hygiene are at a greater risk of hepatitis A infection. You may also be exposed to hepatitis A through your work, for example, sewage workers, staff in institutions where levels of personal hygiene may be poor , people working with animals that may be infected with hepatitis A and daycare centres.
Disinfection Of Potentially Contaminated Foods
Development of disinfection procedures for produce or shellfish has been hampered by the technical difficulties involved with detection of infectious HAV in food. Cell culture assays can indicate the presence of infectious HAV, but they are expensive and require several days to perform. Wild-type virus is not easily detectable, because it usually is not cytopathic. RT-PCR protocols can detect viral particles more rapidly but cannot readily distinguish infectious virus from noninfectious HAV RNA, and the variety of PCR inhibitors present in foods requires the development of food-specific protocols. Specific methods to detect enteric viruses, such as HAV, are necessary, because water and shellfish with low coliform counts have been shown to contain viable HAV , and outbreaks of hepatitis A associated with shellfish harvested from waters where fecal coliform counts were within accepted limits have been reported . Despite these challenges, methods are being developed to detect HAV on some types of produce , in shellfish , and in water .
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New Us Guidelines Urge A Hepatitis C Check For Most Adults
A New Jersey Starbucks employee who handled food tested positive for hepatitis A, prompting fears that thousands may have been exposed to the highly contagious liver disease.
The incident occurred at the Starbucks outlet at 1490 Blackwood Clementon Road in Gloucester Township, where the food handler had reportedly worked multiple days this month while contagious. The department was notified of the infection on Nov. 17, whereupon it inspected and then subsequently shuttered the coffee shop despite finding no evidence of food safety violations.
The county health department has been working closely with the patient and the staff at the Starbucks to address the situation, Camden County Health Officer Paschal Nwako said in a statement.The patient is not currently working, and close contacts have been identified.
That particular Starbucks location, according to the company, is busy, as most are, county spokesman Dan Keashen told CNN.Theyre saying they have an average of 600 patrons a day and some are return patrons maybe going multiple times a day but the exposure is probably in the thousands.
As a result, anyone who visited the location on Nov. 4, 5, 6, 11, 12 or 13 is being urged to get the hepatitis A vaccine as soon as possible but no later than 14 days after contact, per the press release.
Theyre saying they have an average of 600 patrons a day and some are return patrons maybe going multiple times a day.
Vaccination Against Hepatitis A
Vaccination against hepatitis A is not routinely offered in the UK because the risk of infection is low for most people.
It’s only recommended for people at an increased risk, including:
- close contacts of someone with hepatitis A
- people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
- people with any type of long-term liver disease
- men who have sex with other men
- people who inject illegal drugs
- people who may be exposed to hepatitis A through their job this includes sewage workers, people who work for organisations where personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas
The hepatitis A vaccine is usually available for free on the NHS for anyone who needs it.
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What Causes Hepatitis A And How Is It Contracted
People develop hepatitis A infection after contracting HAV. This virus is typically transmitted by ingesting food or liquid contaminated with fecal matter that contains the virus. Once transmitted, the virus spreads through the bloodstream to the liver, where it causes inflammation and swelling.
In addition to transmission from eating food or drinking water containing HAV, the virus can also be spread by close personal contact with an infected person. HAV is contagious, and a person who has hepatitis A can easily pass the disease to others living in the same household.
You can contract hepatitis A by:
- eating food prepared by someone with the hepatitis A virus
- eating food handled by preparers who dont follow strict hand-washing routines before touching food that you eat
- eating sewage-contaminated raw shellfish
- not using condoms when having sex with someone who has the hepatitis A virus
- drinking polluted water
- coming in contact with hepatitis A-infected fecal matter
If you contract the virus, you will be contagious two weeks before symptoms even appear. The contagious period will end about one week after symptoms appear.
Can Bleach Or Cleaner Kill Hepatitis A
Disinfectant that contains bleach can kill the hepatitis A virus on hard non-porous surfaces like toilet seats. However, freezing does not kill HAV.
If you cook food that is contaminated for one minute at cooking temperatures higher than 185ºF , it will kill HAV. However, food can be contaminated after cooking, so it is very important to wash your hands well with soap and water.
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What Is The Treatment For Hepatitis
Each type of hepatitis is treated differently.
Hepatitis A often goes away on its own and home treatment is all that is needed to help the liver recover, such as:
- Avoiding alcohol
- Avoiding certain medicines that can be harmful to the liver
Hepatitis B often goes away on its own in about 6 months, and can also be treated at home with the above remedies. Other treatments for hepatitis B include:
- Antiviral medications
- Liver transplant in severe cases
Treatment for hepatitis C is effective on certain forms of the hepatitis C virus. The choice of medications depends on the type of hepatitis C you have, whether you have been treated for the illness before, how much liver damage has occurred, any other underlying medical issues, and other medicines you take. Treatment for hepatitis C usually involves 8 to 12 weeks of oral antiviral medications, such as:
What Causes Hepatitis A
Hepatitis A is caused by infection with the hepatitis A virus. You get the virus when you unknowingly eat a small amount of infected feces. This can happen through person-to-person contact, or through eating or drinking contaminated food or water.
A person can have and spread hepatitis A, even if that person does not have any symptoms. You are most likely to get hepatitis A from another person when:
- A person who has the virus does not wash their hands properly after going to the bathroom
- A parent does not wash their hands properly after changing the diaper of an infected child
- A caregiver does not wash their hands properly after cleaning up the stool of an infected person
- A person has sex with a person who has the virus
You can also get infected with hepatitis A by eating contaminated food or drinking contaminated water. Contaminated food and water are more common in developing countries. When traveling in areas where hepatitis A is common, avoid eating raw fruits and vegetables, shellfish, ice, and untreated water.
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Return To School Or Child Care
If your child is toilet-trained and does not have diarrhea, he or she may return to school or child care when he feels better. A child who is not toilet-trained should stay home for at least 7 days before returning to school or child care. However, your child’s doctor should okay the child’s return to school or child care.
If you have any questions, be sure to ask your doctor or nurse, or call ____________________.
HH-I-168 10/76, Revised 10/11 Copyright 1976-2011, Nationwide Children’s Hospital
More About Hepatitis A
Hepatitis A virus infection can cause a mild illness lasting a few weeks to a severe illness lasting several months. People with liver disease, including chronic hepatitis B or C infection, are at greater risk of developing severe disease as a result of hepatitis A infection. People over 50 years old are also at greater risk of developing severe disease. Unlike hepatitis B and C, hepatitis A does not cause a chronic infection.
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Hepatitis C: What Happens
About 25% of people who get hepatitis C defeat the virus after a short-term infection. The rest will carry the virus in their body for the long term. Chronic hepatitis C can cause very serious complications, including liver failure and liver cancer. There are effective treatments for the virus, though.
Enteric Routes: Transmission Of Hepatitis A And Hepatitis E
The Hepatitis A and hepatitis E viruses are both transmitted by enteric, that is digestive or by fecal, routes. This is also known as the fecal-oral route. To be exposed to these viruses, you must ingest fecal matter that is infected with the virus. While there are several ways in which this fecal-oral route can be established, poor hygiene and poor sanitary conditions in some countries lead to higher rates of infection of these viruses.
As a result, some areas of the world, like India, Bangladesh, and Central and South America, are particularly prone to the hepatitis E virus. About one-third of people in the United States have been exposed to the hepatitis A virus.
It is believed that the hepatitis F virus may also be spread by enteric routes.
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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
What You Need To Know
Hepatitis A is a liver disease caused by the hepatitis A virus. Hepatitis A virus is transmitted through the fecal-oral route. If a person with hepatitis A does not wash their hands well after going to the bathroom they can contaminate objects, food, or drinks. Someone else can be infected when they put these items into their mouth.
Vaccination is a safe and effective way to prevent hepatitis A.
In addition to vaccination, consistent, thorough hand washing after going to the bathroom and before preparing or eating food is the most effective way to prevent getting hepatitis A.
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Who Should Obtain The Hepatitis A Vaccine
Hepatitis A vaccine is recommended for the following persons:
- Travelers to areas with increased rates of hepatitis A
- Men who have sex with men
- Injecting and non-injecting drug users
- Persons with clotting-factor disorders
- Persons with chronic liver disease
- All children aged 12-23 months children not fully vaccinated by age two
The hepatitis A vaccine may also be used in certain outbreak situations where ongoing transmission is occurring. Although studies of certain occupational groups have not shown an increased risk, such people may consider vaccination if they wish to further reduce their risk or are in communities where ongoing outbreaks are occurring.
When To Get Medical Advice
See your GP for advice if:
- you have symptoms of hepatitis A a blood test can usually confirm whether you have the infection
- you might have been exposed to the hepatitis A virus recently but you do not have any symptoms treatment given early on may be able to stop the infection developing
- you think you might need the hepatitis A vaccine your GP can advise you about whether you should have the vaccine
Although hepatitis A is not usually serious, it’s important to see your GP so they can rule out more serious conditions with similar symptoms, such as hepatitis C or scarring of ther liver .
It may also be necessary to test your friends, family and any sexual partners in case you have spread the infection to them.
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How Hepatitis A Is Spread
Hepatitis A is most commonly spread when someone eats food or drinks water that contains the hepatitis A virus. This is more likely when travelling outside Canada in areas of the world where hepatitis A is more common. Contaminated sources may include:
- raw or frozen fruits and vegetables
Hepatitis A can also spread:
- from person to person through:
- sexual contact with an infected person
- contact with the feces of an infected person
- blood transfusions or sharing needles for drug use
- changing diapers or cleaning up stool from an infected person
Even if you do not have symptoms, you can still infect others. Infected infants and children are more likely to be without symptoms than infected adults.
You can spread the virus starting 2 weeks before you show any symptoms. You can continue to infect others until about a week after you get jaundice .