Hepatitis A is a highly contagious infection of the liver caused by the HAV virus. The hepatitis A virus causes inflammation of the liver. Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease and rarely leads to death. But it can cause disabling symptoms and fulminant hepatitis.
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Causes of hepatitis A
The hepatitis A virus can be detected in the stool and blood of an infected person about 15-45 days before symptoms manifest and also during the first week of the disease.
You can get hepatitis A if you:
- eats and drinks food contaminated with the virus;
- comes into contact with the stool or blood of an infected person;
- participates in sexual practices that involve oral-contact.
Possible risk factors include:
- Trips abroad
- Drug abuse
- living in a nursing home or rehabilitation centre,
- Work in healthcare, gastronomy or the wastewater industry.
Other viral infections of the liver can be hepatitis B and hepatitis C. Hepatitis A is the less serious disease because it is the only one that is not chronic.
Risk for travellers
Hepatitis A can easily affect travelers. The risk is higher for those who travel to areas where hepatitis A is endemic (occurs frequently).
The risk of contracting hepatitis A is higher in travelers who:
- visit rural areas,
- eating and drinking in places with poor hygiene,
- Drink untreated water and eat raw foods (for example, crustaceans) or unhygienically prepared foods.
Travellers staying in areas where hepatitis A is native are at risk of infection, even if they only stay there for a short time.
Symptoms of hepatitis A
This infection can be asymptomatic (the patient has no symptoms) or cause health problems.
According to Shelton’s health hygiene theory, it is not the virus that causes the disease; but if the immune system works incorrectly, the body cannot eliminate the viruses that thus accumulate. According to natural medicine, the symptoms are caused by poor diet and unhealthy lifestyles, not microorganisms or viruses that are lifeless compounds.
According to conventional medicine, 2-6 weeks of incubation pass from the moment of contact with the virus before the first symptoms appear (the mean incubation period is 4 weeks).
The first symptoms of hepatitis A are similar to the symptoms of the flu and include:
- Loss of appetite
- Fatigue
- Fever
- Nausea and vomiting
- Abdominal pain, especially at the level of the liver (right side)
- Joint pain
- General malaise
About 10 days after the onset of the first symptoms, the symptoms directly related to the liver should appear (icteric phase).
The symptoms of the icteric phase are:
- yellowing of the skin and eyes (jaundice)
- Dark urine
- Light stool color
- Itch
Symptoms should pass after a few months, but some people develop a recurrence with symptoms lasting up to 6 months.
Once recovered from the virus, there is immunity.
Infection of hepatitis A
The possibilities of transmission of hepatitis A are:
- drinking untreated water,
- eating raw, contaminated food (for example, crustaceans),
- consumption of unhygienically prepared food, for example, imported blueberries and wild berries,
- from person to person, if there is insufficient stool hygiene (for example, among children or in certain sexual practices). It is not possible for a person to be a healthy carrier of hepatitis A because it is an acute disease and there is no chronification as with hepatitis B.
Hepatitis A exists all over the world, but especially in regions with inadequate hygiene.
Regions where the risk of coming into contact with the virus is high:
- Indian subcontinent (mainly India, Pakistan, Bangladesh and Nepal)
- Africa
- Middle East
- Some areas in the Far East (except Japan)
- Central and South America
- Mexico
Vaccination against hepatitis A
This therapy is recommended for all those who want to travel to places where poor hygiene standards prevail.
Vaccination is also recommended for some specific groups of people, including:
- people working with children;
- men with homosexual relationships;
- people with liver problems (for example, cirrhosis);
- chefs and restaurateurs;
- People who handle or work with needles.
Number of vaccine doses:
- Inactivated vaccine: two, the most common form.
- Attenuated vaccine: one.
Attenuated vaccine: one dose
of vaccination program with inactivated vaccine: two doses, booster occurs approximately 6 months after the first injection.
In healthy people, a single dose appears equally effective.
Immunity begins 2-4 weeks after the first dose of vaccine.
The vaccination can be administered until the day of departure when travelling abroad and provides travellers with sufficient protection.
The minimum age for vaccination against the hepatitis A virus is 1 year.
It is not possible to vaccinate pregnant women or nursing mothers against hepatitis A.
Undesirable side effects of hepatitis A vaccination include:
- high fever
- Weakness
- Pain at the injection site
- Headache
- Fatigue
- Nausea
- Anorexia
Diagnosis and examinations for hepatitis A
Blood tests are done to determine the presence of the HAV virus in the body.
The doctor checks the existing signs and symptoms to make a preliminary diagnosis.
If the patient suffers from hepatitis A, the levels of GOT and GTP (transaminases) in the blood are increased.
Treatment of hepatitis A
There is no specific therapy for hepatitis A. This virus usually regresses solely through the action of the immune system. Most people affected by hepatitis A do not need hospitalization. However, hospitalization may be required for severe vomiting and dehydration.
A possible therapy may be aimed at treating the symptoms.
During the condition, it is normal to feel tired. Then the doctor can prescribe a medication for fatigue / weakness.
To relieve itching, it is recommended to wear loose clothing and avoid hot baths or showers. A diet low in fat and without alcohol helps to keep the symptoms low.
During the recovery of hepatitis A, repeated blood tests are recommended at regular intervals to monitor liver function.
It is also important to maintain thorough personal hygiene to reduce the risk of infection to other people. It is advisable to wash your hands thoroughly every time you use the toilet and avoid handling food and unprotected sex. You should ask your family doctor when you can resume daily activities.
Prognosis for patients with hepatitis A, can you die from it?
The hepatitis A virus does not remain in the body after one has been cured of the disease. Over 85% of people with hepatitis A recover within 3 months and almost all patients experience an improvement in symptoms within 6 months. The risk of death is very low and is usually present in people with chronic liver disease.
Prevention of hepatitis A
The spread of hepatitis A can be reduced by:
- an adequate supply of drinking water,
- proper sanitation within communities.
- Hygiene practices such as regular hand washing with clean water.
Various vaccinations are available internationally. All vaccines are similar in terms of protection and side effects. No vaccine is given to children under one year of age.
Almost 100% of people develop protective antibodies within a month of a single vaccination. Even after contact with a virus, a single vaccination within two weeks of exposure to the virus has a protective effect. Manufacturers recommend at least two doses of the vaccine to ensure long-term protection (5-8 years).
The vaccines have been administered worldwide without serious side effects.
The vaccine can be given as part of regular childhood vaccinations and in combination with other traveler vaccines.
