Hepatitis A on the attack. Are we in danger of an epidemic?

Proven content

Seventeen carriers of the HAV virus that causes hepatitis A are hospitalized, and several hundred people are under epidemiological control. More than half of the patients are employees of shops, restaurants and bars – informed the director of the Poviat Sanitary and Epidemiological Station in Ostrów Wlkp. Are we at risk of an epidemic of food jaundice? How to recognize the disease and what should provoke a visit to the doctor?

What is hepatitis A?

Hepatitis A is quite widespread in the world. It is said that hepatitis A accounts for over half of all viral hepatitis. The virus develops fastest in countries with very poor sanitation, especially in schools, orphanages and kindergartens. Hepatitis A is transmitted through dirty hands or contaminated food. The highest number of cases of viral hepatitis is recorded in the countries of South America, Southeast Asia and Africa. The easy spread of the virus in a given environment is related to its resistance to many factors, such as alcohol or phenol compounds. Hepatitis A is otherwise known as dirty cancer or food jaundice.

How does HAV become infected?

Hepatitis A infection most often occurs through the oral route (fecal-oral). This is most often related to the consumption of:

1. contaminated water – it may be water in the form of ice cubes that have previously been contaminated by people who excrete HAV along with their stools (the water has not been properly disinfected);
2. Contaminated food – such as meat, vegetables or fruit that has been washed in contaminated water before eating.

Other factors of infection (even more rare) include:

1. direct contact with an infected person;
2. hepatitis A infection through sexual intercourse (most often affects homosexual men);
3. bathing in contaminated water;
4. plasma transfusion;
5. making a tattoo;
6. undergoing acupuncture (needles).

The breeding period of hepatitis A is usually 15-50 days. A sick person can infect others about 14-21 before to about day 7 after the onset of clinical symptoms. The most at risk of hepatitis A infection are:

1. sewage treatment plant workers,
2. sewage workers,
3. all those who come into contact with impurities on a daily basis.
4. healthcare workers, schools and nurseries.

Symptoms of hepatitis A

What the symptoms of hepatitis A look like depends on the age of the patient. In toddlers under the age of 6, the infection is usually asymptomatic or very mild. However, in older kids and adults in about 80 percent. Hepatitis A is symptomatic. The incubation period of the disease is characterized by dyspetic symptoms, less often flu symptoms.

Clinical Signs of Hepatitis A:

1. arthralgia,
2. sore throat,
3. abdominal pain,
4. nausea,
5. vomiting,
6. fever,
7. weakness,
8. diarrhea,
9. lack of appetite
10. jaundice,
11. itchy skin
12. dark urine,
13. discolored feces.

Loss of appetite and nausea appear during the incubation period of hepatitis A. At the same time, there may be a feeling of general fatigue of the patient, pain in muscles and joints or low-grade fever. After another 7 days, symptoms typical of hepatitis appear.

Very many patients also experience nausea, vomiting, and sometimes – especially in children – diarrhea or catarrh of the upper respiratory tract with enlarged lymph nodes.

As hepatitis A develops, the urine, which becomes a dark beer, darkens, and the stools lighten as a result of damage to the liver cell. Jaundice develops, first on the sclera and then on the skin (the yellowness may be slight, barely visible to very intense).

With the onset of jaundice, the fever subsides and you feel better. After a few days, the patient’s appetite returns and yellowness disappears. The patient is infectious for two weeks before and ten days after onset of symptoms. In the case of infants and young children – the excretion of the virus may take up to several months (no cases of chronic carriage have been reported so far). Hepatitis A is a self-limiting disease that does not cause chronic liver disease.

Hepatitis A and the vaccine

The hepatitis A vaccine is the most effective way to prevent infection (immunization). After a patient has taken the entire vaccination course, antibodies remain in the body to protect against hepatitis A for life. In Poland, there are three vaccines that are formaldehyde-inactivated and adsorbed on aluminum hydroxide HAV viruses: Havrix, Vaqta and Avaxim. Vaccination is divided into 2 doses administered 6-12 months apart. Who should get vaccinated against hepatitis A?

1. food production and distribution workers;
2. municipal waste and liquid waste workers;
3. waste maintenance workers;
4. military and policemen (barracks);
5. people suffering from hemophilia;
6. patients with chronic liver diseases, especially hepatitis B and C;
7. all those who go to countries covered by the greatest epidemiology of hepatitis A;
8. children (preschoolers, school children, adolescents) – who have never suffered from hepatitis A before.

Hepatitis A diagnosis

In the diagnosis of hepatitis A, it is of course very important to conduct a medical interview with the patient. If hepatitis A is suspected, the doctor recommends doing it Blood tests – an infected patient will have high levels of liver enzymes (aspartate and alanine aminotransferases) and high levels of bilirubin in the blood.

However, the primary method of diagnosis is testing of anti-HAV antibodies in the IgM class in the patient’s serum. This type of antibodies can be detected already during the hatching period, while their highest concentration can be noticed between 2-3 weeks of acute hepatitis A period. Anti-HAV antibodies are characterized by immunity and remain in the human body until the end of life.

Treatment of hepatitis A

In the case of hepatitis A, there is no need for special treatment with pharmacological agents (there is no preparation that accelerates the removal of the virus from our body) – usually a large amount of rest and a slightly digestible diet are enough. The patient’s diet should include a large amount of carbohydrates, a normal amount of protein and reduced fats. Hepatitis A usually goes away on its own after about 6 months. In addition, convalescent patients should avoid preparations that induce cholestasis and are metabolized in the liver. If the patient is accompanied by severe itching, cholestyramine can be used.

Support hepatitis treatment with natural preparations, such as bee’s feather, which has antiviral and anti-inflammatory properties. We also recommend Baicalin – Baikal Shield – Doctor Life dietary supplement available on Medonet Market.

Prophylaxis of hepatitis A

Non-specific prophylaxis is characterized by:

1. avoiding pathways of infection;
2. controlling food and water (preferably when we eat foods that have previously been thermally processed, e.g. fried or baked, and drink bottled water – especially abroad);
3. taking care of personal hygiene;
4. not allowing insects to come into contact with food.

In the seventies and eighties preparations of human gamma globulin were used in post-exposure prophylaxis. With the invention of the hepatitis A vaccine, this type of prevention has been limited. The best method to avoid complications of hepatitis A and compensatory epidemics, in addition to non-specific prophylaxis, are preventive vaccinations, recommended especially to people from high-risk groups (this has already been mentioned above). All vaccines are equally valuable, effective and safe.

Complications of hepatitis A

Complications that can occur with hepatitis A include:

1. marrow aplasia,
2. cholestatic jaundice,
3. hyperacute hepatitis,
4. acute hemolytic anemia.

It should be remembered that complications of hepatitis A can be very serious and in some cases even lead to death, in addition, the disease may relapse. HAV infection is characterized by the fact that it does not cause chronic hepatitis, followed by cancer and cirrhosis of this organ.

Prognosis of hepatitis A

The prognosis for hepatitis A is good, although the course of the disease may extend up to several months. The risk of death is related to liver failure in patients, most often those over 40 years of age. Hepatitis A mortality is approximately 0,14%.

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