Hepatitis A

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What is it?

Hepatitis A is a virus that infects your liver cells. The disease begins slowly, and many times you don't even realize that you have it. In fact, you find out at some future date that you have antibodies to the virus, which indicates a prior infection. Hepatitis A is rarely fatal, but hospitalization may be required to control its symptoms. Unlike other types of hepatitis, type A does not become chronic. The illness generally runs its course in six to eight weeks and your liver fully recovers. You're usually contagious before you know you are ill. Rapid destruction of your liver (fulminate hepatitis) occurs in less than one percent of cases. Usually fulminate hepatitis only happens to someone whose liver has previously been damaged (e.g. chronic alcoholism or infection with Hepatitis C).

Diagnosis

Doctors diagnose hepatitis A with a blood test that measures your liver function. Inflammation of the liver can destroy its cells, and liver enzymes spill into your blood. If your blood test reveals these enzymes at an elevated level, you probably have hepatitis, and your doctors will then search for the cause. Hepatitis A is specifically diagnosed by checking your blood for antibodies to the virus. When any of these are present, you have or have had the infection.

Symptoms

Feeling tired is the most common symptom (you may feel like you can't get out of bed), followed by loss of appetite, nausea and vomiting (that worsens as the day progresses) and for smokers, loss of your desire for cigarettes. Jaundice (when your skin and eyes turn yellow) is also a very common symptom, as is darkening of your urine. You might also have a dull pain in your upper abdomen. In severe cases, you may have problems with bleeding and poor blood clotting (your liver manufactures substances crucial to blood clotting; liver damage hurts the process).

Hepatitis A passes between people via a "fecal/oral" route. The virus lives in the liver and is passed in the stool. The virus enters another person when hands, food, or objects contaminated with stool are put in the mouth. The amount of contamination needed to spread the infection is very small and is not visible to the eye.We sometimes hear of Hepatitis A outbreaks when a restaurant worker is infected and does not thoroughly wash his/her hands after going to the bathroom and then contaminates food.Countries that don’thave good sewage treatment systems often have endemic Hepatitis A because it can be spread through drinking water or eating shellfish contaminated with the virus.

Hepatitis A can also be spread through sexual activity. And no, you don't have to eat shit: if hands or mouth come in contact with stool or parts of the body contaminated with stool, hepatitis A infection can be transmitted. Rimming an infected partner can give you the virus. You also risk infection when you take off a condom after anal sex and forget to wash your fingers before they end up in your mouth.A person is most contagious during the 2 weeks before the illness symptoms begin.

Hepatitis A is not spread by kissing, sneezing, or by saliva.
Eating raw shellfish from contaminated waters or food prepared by infected workers can also give you hepatitis A.

How to treat it?

There's no medication to treat hepatitis A once you have it. Often, treatment is commonly called "supportive": your nutrition level and liver function are carefully monitored by your doctor. You mustn't drink alcohol, no matter what type of hepatitis you have, until your liver completely heals. If you get nauseous, try to eat more in the morning, when nausea is usually less severe. You must get lots of rest. The more tender love and care (TLC) you receive from loved ones, the better you'll feel. Hospitalization is rare, and you may be given medication to decrease nausea. Anyone with hepatitis A should be vaccinated against hepatitis B.

Myths dispelled

Here are some facts to clear up some common misconceptions.

  • Hepatitis A is not the same as hepatitis B or C.
  • Nor is hepatitis A is the only form of infectious hepatitis.
  • Once you have had hepatitis B, you cannot catch it again.

Prevention

Hepatitis A is a completely preventable disease, and vaccination will prevent infection. The vaccines for Hepatitis A and B are different, and one won't protect you from the other! If you've previously had hepatitis A, you can't catch it again. The hepatitis A vaccine is given in two doses spaced 6 to 12 months apart. Most people become immune within one month of the first injection. The vaccine is extremely safe, and the most common side effect is a sore arm.

If you're exposed to hepatitis A and are not immune to it, you can get an immune globulin shot within two weeks of exposure to help keep you from becoming infected. Immune globulin (IG) is a blood plasma product that can prevent hepatitis A if given within 14 days of exposure to an infected individual. IG is effective 80-90% of the time. IG is necessary if the exposed person has not been vaccinated against hepatitis A and has never had a hepatitis A infection. Immune globulin provides protection against hepatitis A for about 3 months, vaccine is needed for long-term protection.

Immune globulin may be recommended for you if you:

  • Live with someone who has hepatitis A.
  • Have eaten food or put objects in your mouth handled by a person infected with hepatitis A.
  • Have had sexual or other intimate contact with a person who has hepatitis A.
  • Are traveling to an area where hepatitis A is common (see above list).
  • Are a child attending, or an employee of a child care program in which another child or employee has hepatitis A.

There's no need to barricade yourself from someone with hepatitis A. If you get vaccinated against hepatitis to begin with, then you won't have to worry!Hepatitis A is a common STD for men who have sex with men.Of particular concern to ethnic
Cultures known to eat raw seafood have higher incidence of hepatitis A.

Incubation period

The incubation period is extremely variable, but it averages two to six weeks.Sex
Refrain from sex with a partner who has hepatitis A until the infection is completely gone. Rimming is a common way for hepatitis A to pass between partners. Not washing your hands after touching a used condom can lead to a hepatitis A infection.

Prevalence

There are 125,000 to 200,000 hepatitis A infections and about 100 subsequent deaths each year in the United States. Thirty-three percent of Americans have evidence of a prior hepatitis A infection. Areas with high rates of hepatitis A include: South America, Africa, Greenland and Asia. The Soviet Union also has an increased prevalence of hepatitis A.