Hepatitis A

Points to Remember

• Hepatitis A is inflammation of the liver caused by the Hepatitis A virus. This virus is probably the most widespread of the 5 known Hepatitis viruses - A, B, C, D & E.
• Hepatitis A is a serious, highly contagious disease, which affects more than 1.4 million people worldwide every year.
• It is an important health concern for children, adolescent and adults.
• It can keep one out of school/ work for several weeks or even months.
• Leads to loss of productive time of the subject and his/her family.
• Causes inconvenience and affect quality of life.
• You and your family can be at risk.
• A vaccine is available now, which protects against Hepatitis -A

What is hepatitis A?
Hepatitis A is one of the most widespread infectious diseases worldwide. It is caused by the hepatitis A virus and is common in places with poor standards of hygiene and sanitation. The virus attacks the liver and causes varying degrees of illness in patients.

How is hepatitis A transmitted?
The hepatitis A virus is excreted in the faeces, and spreads primarily by the faecal oral route. The virus has a relatively long and infectious incubation period. Hence, the infected individual can pass on the disease to others even before the symptoms develop. Hepatitis A in children under 2 years is often unrecognized: thus they can be a potential source of infection. Direct contact with an infected person’s faeces or indirect contamination of food, water, hands and cooking utensils may result in the virus being ingested, causing infection.

What are the sources of infection?
A common source of infection is contaminated water or food, especially raw or insufficiently cooked food (fruits, salads, vegetables, seafood etc.) Food, which is well cooked but handled by infected individuals, can also be a source of infection. The infection may also be acquired through close contact with infected individuals with in families, school, daycare centers and hostels.

How serious can hepatitis A infection be?
The severity of infection is age related with symptoms being more common in adolescents & adults than very young children. Acute symptoms last for 4 weeks to 3 months and may be debilitating, requiring total rest and occasionally hospitalization. This causes disruption of daily activities and often leads to absence from work/school. Complete recovery can take a long as 6-12 months, with serious and occasionally fatal complications occurring in minority of patients. Hepatitis A can relapse, and the symptoms may persist for upto 6 months. The negative influence on productivity and quality of life though unmeasured, can be quite high.

What are the symptoms of Hepatitis A?
Symptoms include nausea/ vomiting, yellowness of eyes, skin & urine (Jaundice), diarrhoea, pale stools, abdominal pain, malaise/ fatigue, fever/ chills, lack of appetite, sore throat, etc. The frequency/ severity with which these symptoms occur vary depending on the age of the person.

Does hepatitis A pose a serious threat to the health of young children?
Though hepatitis A is considered to be a relatively benign disease in young children, this may not always be the case. Children present with more atypical signs and severe gastrointestinal symptoms than adults. There is evidence to suggest that over 60% of 2-5 year olds develop jaundice with associated dark urine and pale stools. The significant health risk that severe diarrhoea, nausea and vomiting can present to the young should not be forgotten.

Does improvement in living conditions decrease the chances of infection with hepatitis A virus?
Yes, risk of acquiring hepatitis A virus is closely tied to poor standards of living. Poor standards of hygiene and sanitation favor the spread of the virus. Chances of early childhood exposure are high in this setting. In contrast, an improvement in standards of hygiene and sanitation leads to a decline in levels of circulating virus. As a result, risk of early exposure is lesser among those living in an improved socio-group, economic environment. In this group, contamination is more likely among young children, adolescents and adults.

Who is at risk?
Any non –immune person exposed to the virus can develop hepatitis A. This includes children attending daycare centres, schools, etc. and individuals from upper socio-economic group who are unlikely to have been exposed to the virus. Travelers to highly endemic areas, food handlers, healthcare workers, school or daycare employees and contacts of infected persons are also at risk.

Is hepatitis A different from hepatitis B?
Hepatitis A and B are two different forms of viral hepatitis caused by different viruses. While the hepatitis a virus is transmitted mainly through blood, sexual contact or from the infected mother to the newborn. Jaundice- i.e. yellowness of eyes, skin and urine can be an early symptom of both hepatitis A and hepatitis B.

Can hepatitis A be prevented?
Immunoglobulins can be administered to provide temporary protection for 3-5 months. Since regular injections are required to maintain protection, this option is expensive.

A vaccine is now available and is the most practical means of protection against hepatitis A. Primary vaccination protects the person for up to one year and a booster does administered after 6 months, provides predicted protection for at least 20 years.

If I've been vaccinated against hepatitis B, am I also protected against hepatitis A?
No. Each type of hepatitis is different. Vaccination against hepatitis B does not protect form hepatitis A, and vice versa.

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