Juvenile Health Education And Release Planning
counseled, along with their parent or guardian, regarding preventing transmission to household, sexual, and drug-use contacts provided referral for hepatitis B vaccination of contacts counseled regarding ways to reduce further liver damage, including limiting alcohol and drug use, and afforded substance-abuse treatment when appropriate and provided aftercare that includes medical follow-up .
How Can I Protect Myself Against Viral Hepatitis
There are many ways you can reduce your chances of getting hepatitis:
- Get the vaccines for hepatitis A and hepatitis B.
- Use a condom during sex.
- Don’t share needles to take drugs.
- Practice good personal hygiene such as thorough hand-washing with soap and water.
- Don’t use an infected person’s personal items.
- Take precautions when getting any tattoos or body piercings.
- Take precaution when traveling to areas of the world with poor sanitation.
- Drink bottled water when traveling.
It is very important that you take these preventive measures if you participate in risky behaviors. Take preventive steps, too, if you work in places like a nursing homes, dormitories, daycare centers, or restaurants where there you have extended contact with other people and a risk of coming into contact with the disease.
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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The Earliest Universal Hbv Mass Immunization Program
The first universal hepatitis B mass vaccination program in the world was launched in Taiwan in July 1984. Pregnant women were screened for HBsAg and then HBeAg. Infants of mothers negative for HBeAg or HBsAg received the plasma-derived hepatitis B vaccine only at 0, 1, 2, and 12 mo. The vaccine was shifted to a recombinant hepatitis B vaccine at 0, 1, and 6 mo after October 1992. The immunization program in the initial 2 years covered only infants of HBsAg carrier mothers. From the third year on, all of the infants were covered. Infants of highly infectious mothers with positive HBeAg received HBIG within 24 h after birth in addition to the hepatitis B vaccine. The coverage rate of hepatitis B vaccine for neonates was 94% in initial years, and was 99% recently. Catch-up vaccination was also given to preschool and then school children .
Pregnancy And Hepatitis A Immunisation
Hepatitis A immunisation is not usually recommended for women who are pregnant although vaccination might be recommended in some situations.
Speak with your doctor if you are not immune to hepatitis A and you are at increased risk of infection or if you have a pre-existing medical condition such as liver disease.
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Who Is At Risk Of Getting Hepatitis A
Hepatitis A is usually spread from person to person, making it highly contagious. However, certain factors can increase your risk of contracting it, including:
- living in an area where hepatitis A is common, including most countries with low sanitation standards or a lack of safe water
- injecting or using illegal drugs
- living in the same household as someone who is hepatitis A-positive
- having sexual activity with someone who is hepatitis A-positive
- being HIV-positive
Tests For Liver Problems
To check how well your liver is working, you may have:
- Liver function tests. These are blood tests that can help your doctor find out if you have liver damage.
- A liver biopsy. The doctor puts a needle in the liver to find out whether the virus has caused scarring or damage to your liver.
- Imaging tests such as a CT scan, an MRI, or an ultrasound to make sure that you don’t have liver cancer.
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What Are Treatment Options For Hepatitis A
Hepatitis A has no particular treatment however, infected people are treated based on their symptoms. The body will get rid of the virus eventually, although it may take a few months for complete recovery.
A person must maintain a proper diet, drink plenty of fluids, and get plenty of rest to recover. Their surroundings should be well ventilated, and the patient should wear loose clothing and avoid hot showers to reduce the intensity of itching if any. The doctor may prescribe antihistamine drugs to control itching.
The doctor will advise you to avoid alcohol, certain medications, such as acetaminophen, and vitamins that require the liver for metabolism. These may increase liver inflammation and damage. It is highly recommended to consult the doctor before taking any over-the-counter medications.
Hospital admission may be required in patients with severe diseases, such as those with acute liver failure or symptoms, such as severe pain, excessive vomiting, confusion, tremors, severe dehydration, and jaundice.
How Can You Avoid Hepatitis B
Getting the vaccine for hepatitis B is the best way to prevent hepatitis B. The hepatitis B vaccine is safe and effective. It is usually given as 3-4 shots over a 6-month period. You will not get hepatitis B from the vaccine. Ask your health care provider if you should get this vaccine. It is recommended for:
- All infants, starting with the first dose of hepatitis B vaccine at birth
- Everyone under the age of 19 who has not been vaccinated
- People whose sex partners have hepatitis B
- Sexually active people who are not in a long-term, faithful relationship
- People with a sexually transmitted disease
- People who share needles, syringes, or other drug-injection equipment
- People who have close household contact with someone infected with the hepatitis B virus
- Health care and public safety workers at risk for exposure to blood or body fluids on the job
- People with kidney disease. This includes all those on dialysis and those being considered for dialysis.
- Adults with diabetes
- Before anal sex
- Before oral sex
- Have sex with only one partner who does not have sex with others and does not have hepatitis B.
- Sterile tools
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How Is It Treated
Experts recommend that nearly everyone who has hepatitis C receive treatment. Talk with your doctor about whether you should get treatment. Current treatments for hepatitis C almost always work.
Taking care of yourself is an important part of the treatment for hepatitis C. Some people with hepatitis C don’t notice a change in the way they feel. Others feel tired, sick, or depressed. You may feel better if you exercise and eat healthy foods. To help prevent further liver damage, avoid alcohol and illegal drugs and certain medicines that can be hard on your liver.
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.
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Who Is At Risk For Infection
Anyone who is not immune to hepatitis A can get hepatitis A infection. Food-borne outbreaks occur sporadically throughout the USA. Certain groups of people do have a higher risk of developing HAV infection and should be vaccinated:
- Persons experiencing homelessness
- People who eat raw or under-cooked shellfish
How Common Is Hepatitis A
In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked.1 However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness.1 Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.2
Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.
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How Do I Avoid Getting Sick
These tips will help protect you and your family from Hepatitis A:
- Wash your hands after using the washroom and changing diapers, and before preparing or eating food.
- When travelling, especially to developing countries:
- drink water from a safe supply
- avoid ice cubes in drinks
- eat only freshly cooked food
- avoid non-peelable raw fruit or vegetables
Also, these safe food practices will reduce your risk of contracting Hepatitis A and other foodborne illnesses.
How Do People Get Hepatitis A
Hepatitis A virus is found in the stool of people with HAV infection. It enters the body through the mouth after someone handles something contaminated with HAV, or eats or drinks something contaminated with HAV.
People usually get hepatitis A by having close contact with a person who is infected, from food or drinks prepared by someone who is infected, or by eating shellfish harvested from sewage-contaminated water. After the virus enters the body, there is an incubation period lasting 2 to 7 weeks until illness begins.
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What Is The Outlook For Hepatitis
Hepatitis A and E usually only cause short-term infections that your body can overcome. The others can also cause acute infections, but might also cause chronic infections. The chronic forms are more dangerous. Hepatitis non-E is usually acute, but can become chronic.
Most people recover fully from hepatitis even though it might take several months for the liver to heal. To help improve your health and to help speed up your recovery:
- Avoid alcohol.
- Practice good nutrition.
- If you feel sick, rest.
- Talk to your healthcare provider about your medicines, even over-the-counter drugs or vitamins and supplements, to know which ones you should take and which to avoid until you are recovered.
With hepatitis, your healthcare provider will also be looking for long-term damage to the liver in the forms of cirrhosis or liver failure. You may be asked to take other types of tests, such as liver function tests, imaging tests or possibly a liver biopsy.
If you have questions, new symptoms, or worsening of any existing symptoms, you should call the office of your healthcare provider.
In the U.S., A, B and C are the most common viral forms of hepatitis. It doesnt matter how you were infectedwhat matters is taking care of yourself once you have been diagnosed and taking care not to spread the infection to anyone else.
Last reviewed by a Cleveland Clinic medical professional on 01/06/2020.
References
How Is Hepatitis A Diagnosed And Managed
A blood test will confirm whether someone is infected with hepatitis A.
There is no medicine to treat hepatitis A. Your doctor may suggest rest, plenty of fluids and relief for any nausea or pain.
To protect your liver, you should not drink any alcohol while you have hepatitis. Your doctor will advise you what medicines you can take.
If you are diagnosed with hepatitis A, your doctor will need to enter details on the Notifiable Diseases database.
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What Causes Hepatitis C Infection
Hepatitis C is caused by the hepatitis C virus. It is spread by contact with an infected person’s blood.
You can get hepatitis C if:
- You share needles and other equipment used to inject illegal drugs.
- You had a blood transfusion or organ transplant before 1992. Since the early 1990s, all donated blood and organs are screened for hepatitis C in Canada.
- You get a shot with a needle that has infected blood on it. This happens in some developing countries where they use needles more than once when giving shots.
- You get a tattoo or a piercing with a needle that has infected blood on it. This can happen if equipment isn’t cleaned properly after it is used.
In rare cases, a mother with hepatitis C may spread the virus to her baby during pregnancy or childbirth, or a health care worker may be accidentally exposed to blood that is infected with hepatitis C.
The risk of getting hepatitis C through sexual contact is very small.footnote 1 The risk is higher if you have many sex partners or you engage in unprotected sexual activity that may involve contact with blood or an exchange of blood with an infected person . The presence of HIV or other sexually transmitted infections also increases the chances of getting hepatitis C sexually.
You cannot get hepatitis C from casual contact such as hugging, kissing, sneezing, coughing, or sharing food or drink.
Duration Of Protection After Hbv Immunization In Infancy
Anti-HBs titers gradually decline with age in children immunized in infancy with hepatitis B vaccine, which is also seen in those who received a booster dose during childhood . In a prospective long-term follow-up study of 1200 HBV vaccinees in the general population , the annual new anti-HBc seropositive rate was low , and no new chronic HBV infection was detected. The decay rate of anti-HBs titer during age 716 yr was 20% of the titer of the previous year. Among the uninfected children who had anti-HBs < 10 mIU/mL, the boosted and nonboosted children developed new anti-HBc positivity at a similar rate, indicating that a vaccine booster at this age is not necessary .
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How Do You Get Hepatitis A And How Common Is It
Hepatitis A can affect anyone. The virus is passed out in the stools of infected people. In areas of poor sanitation, or where disposal of sewage is poor, hepatitis A can become common due to dirty water and food. This means you may become infected with hepatitis A by eating uncooked food prepared or washed in contaminated water, or by drinking contaminated water. Shellfish caught in contaminated water can also carry the hepatitis A virus. Someone who has hepatitis A infection may pass on the infection to others. This can occur through preparing food, or through close contact with another person, if they have not washed their hands properly after going to the toilet.
The highest-risk areas of the world for hepatitis A infection include: the Indian subcontinent , Africa, parts of the Far East , South and Central America and the Middle East.
Hepatitis A has become uncommon in parts of the world where sanitation is generally good, such as the UK and Western Europe. Most cases of hepatitis A infection in the UK are diagnosed in people returning home after travelling to a country where sanitation is poor and risk of hepatitis A infection is higher. Outbreaks in schools and families can sometimes occur in the UK, as the virus is quite easily passed on from person to person if personal hygiene is not good. For example, the virus may be passed on if infected people do not wash their hands after going to the toilet.
What Occupations Have Increased Risk Of Hepatitis B
In general, occupational groups with increased risk include:
- Health-care workers repeatedly exposed to blood or blood products or those who are at risk of needlestick injury.
- Pathologists, laboratory personnel, or embalmers.
- Dentists, dental assistants, and dental hygienists.
- Certain staff members of institutions for the developmentally handicapped.
- Staff of institutions where workers may be exposed to aggressive, biting residents.
Travellers to regions with intermediate or high rates of endemic HBV infection may also consider being vaccinated.
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Take Care When Eating And Drinking
You should avoid eating and drinking the following when travelling to high-risk countries:
- Raw or inadequately cooked shellfish.
- Raw salads and vegetables that may have been washed in dirty water.
- Other foods that may have been grown close to the ground such as strawberries.
- Untreated drinking water, including ice cubes made from untreated water.
- Unpasteurised milk, cheese, ice cream and other dairy products.
Also be careful when buying food from street traders. Make sure that food has been recently prepared and that it is served hot and on clean serving plates. Food that has been left out at room temperature or food that may have been exposed to flies could also pose a risk.
Note: if you have had hepatitis A infection, you will be immune to further infection. This means that you can’t catch the infection again.