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Hepatitis A.

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WHAT IS IT?

Abstract

VOL: 100, ISSUE: 18, PAGE NO: 30

 

WHAT IS IT?
- Hepatitis A is a virus that causes inflammation of the liver.

 

 

- It is transmitted by the faecal-oral route and through the consumption of contaminated food or water.

 

 

- It is common in countries with poor standards of drinking water and sewage disposal, and where personal and food hygiene standards are poor.

 

 

- The illness can spread easily within families and where people live closely together.

 

 

EPIDEMIOLOGY
- In most cases of hepatitis A reported in the UK, infection has occurred abroad.

 

 

- In 2002, a total of 1,318 hepatitis A infections were reported in England and Wales (Health Protection Agency, 2003).

 

 

- True incidence is unknown, as people with mild symptoms may not see a doctor.

 

 

- Southern and eastern Europe, Africa and parts of the middle and far East are high-risk areas.

 

 

- Incubation is 28 days on average but can be anywhere between 15-50 days (Crowcroft et al, 2001).

 

 

SYMPTOMS
- Flu-like symptoms (fatigue, aches and pains, fever, loss of appetite).

 

 

- Nausea and vomiting.

 

 

- Stomach pain and/or diarrhoea.

 

 

- Jaundice.

 

 

- Some people, particularly young children, may be asymptomatic.

 

 

- The illness tends to be more serious in older people. On rare occasions, it can cause fatal liver damage.

 

 

DIAGNOSIS
- Hepatitis A is diagnosed by a blood test for the antibody to the virus.

 

 

- Liver function tests usually show elevated results.

 

 

VACCINATION
Vaccination offers 10 years’ protection against the virus and is recommended for:

 

 

- People visiting countries where hepatitis A is common;

 

 

- Injecting drug users;

 

 

- People whose sexual behaviour puts them at risk (for example those having unprotected anal sex);

 

 

- People whose work puts them at risk (for example those who come into contact with sewage);

 

 

- People who already have long-term liver disease.

 

 

- People who have been in close contact with an infected person or who are travelling at short notice. Immunoglobulin injections can offer short-term protection (three to six months).

 

 

PREVENTION
When in countries where hepatitis A is common, infection can be prevented by avoiding:

 

 

- Ice in drinks;

 

 

- Tap water;

 

 

- Ice cream;

 

 

- Poorly cooked shellfish;

 

 

- Uncooked vegetables;

 

 

- Unpeeled fruit;

 

 

- Unpasteurised milk.

 

 

TREATMENT
- As is the case with most viral illnesses, there is no specific treatment for hepatitis A.

 

 

- Jaundice can cause severe itching that may require treatment.

 

 

- Many people require more rest than usual.

 

 

- Generally, people are encouraged to eat and drink as well as possible.

 

 

- Alcohol and excessive exercise should be avoided.

 

 

WEBSITES
British Liver Trust:

 

 

www.britishlivertrust.org.uk

 

 

Health Protection Agency:

 

 

www.hpa.org.uk/infections/topics_az/hepatitis_a/menu.htm

 

 

NHS Direct:

 

 

www.nhsdirect.nhs.uk

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