Hepatitis A is a liver infection brought on by the hepatitis A virus (HAV). The virus is spread largely when an uninfected (and unvaccinated) person consumes food or water contaminated with an infected person's feces. The disease is linked to contaminated water or food, poor sanitation, personal hygiene, and oral-anal sex.
Hepatitis A, unlike hepatitis B and C, does not cause chronic liver disease, but it can induce debilitating symptoms and, in some cases, fulminant hepatitis (acute liver failure), which can be fatal. According to the World Health Organization, 7134 people died from hepatitis A in 2016. (accounting for 0.5 percent of the mortality due to viral hepatitis).
Hepatitis A occurs intermittently and in epidemics all throughout the world, with a cyclic recurrence pattern. Epidemics caused by tainted food or water, such as the one that killed 300,000 people in Shanghai in 1988, can be devastating. They can also be long-lasting, with person-to-person transmission affecting communities for months. Hepatitis A viruses survive in the environment and can withstand the inactivation or control of bacterial pathogens used in food production.
The hepatitis A virus is primarily spread through the fecal-oral route, which occurs when an uninfected person consumes food or water contaminated with an infected person's feces. This can happen in households when an infected person prepares food for family members with dirty hands. Though rare, waterborne outbreaks are mainly linked to sewage-contaminated or improperly cleaned water. Close physical contact (such as oral-anal sex) with an infectious individual can also transmit the virus, however, casual touch between persons does not spread the infection.
Hepatitis A normally takes 14–28 days to fully develop.
Fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine, and jaundice are some of the symptoms of hepatitis A, which can range from moderate to severe (yellowing of the eyes and skin). Not everyone afflicted will experience all of the symptoms.
Adults are more likely than children to show signs and symptoms of the disease. In senior age groups, disease severity and mortality consequences are increased. Infected children under the age of six do not normally show any symptoms, and only 10% of them develop jaundice. Hepatitis A can relapse, which means that a person who has recently recovered becomes ill with another virus.
The hepatitis A virus can infect anyone who has not been immunized or has never been infected. The majority of hepatitis A infections occur during childhood in locations where the virus is common (high endemicity). The following are some of the risk factors:
Poor sanitation, a lack of potable water, living in a household with an infected person, having a sexual partner of someone with acute hepatitis A infection, recreational drug use, intercourse between men, and traveling to places with high endemicity without getting inoculated are all risk factors.
Hepatitis A cases cannot be distinguished clinically from other kinds of acute viral hepatitis. The presence of HAV-specific immunoglobulin G (IgM) antibodies in the blood allow for a precise diagnosis. Additional tests, such as reverse transcriptase-polymerase chain reaction (RT-PCR) to detect hepatitis A virus RNA, may be required and may necessitate the use of specialized laboratory facilities.
Hepatitis A does not have a specific treatment. The recovery from infection symptoms might be lengthy, taking several weeks or months. It's critical to avoid using medications that aren't necessary. Acetaminophen, paracetamol, and anti-vomiting medications should all be avoided.
In the absence of abrupt liver failure, hospitalization is unnecessary. The goal of therapy is to maintain comfort and a healthy nutritional balance, which includes replacing fluids lost due to vomiting and diarrhea.
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Prevention
The most effective approaches to combat hepatitis A are improved sanitation, food safety, and vaccine.
The spread of hepatitis A can be slowed by doing the following:
- A sufficient supply of safe drinking water;
- effective sewage disposal within communities
- personal hygiene behaviors
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