Hepatitis A (infectious liver inflammation type A)
Reviewed by Dr Janice Main, senior lecturer and honorary consultant physician in infectious diseases and general medicine
What is type A hepatitis ?
Hepatitis is the Latin word for liver inflammation. Type A hepatitis is caused by a virus called hepatitis A virus. Other types of infectious liver inflammation include hepatitis B and hepatitis C.
What causes type A hepatitis ?
Hepatitis A virus is present in stools passed by infected persons. It can be transmitted via contaminated food, eg shellfish and ice-cream, as well as contaminated water and beverages.
The virus can also be spread through contact with an infected person's stools through poor hygiene.
The infectiousness of the disease is greatest just before the patient develops jaundice. After that it quickly becomes less infectious.
Type A hepatitis is very common in countries with poor sanitary conditions. Most people get infected during trips to less-developed countries or by direct contact with others infected with hepatitis A virus.
What are the symptoms of type A hepatitis ?
Hepatitis A has an incubation period of 10 to 40 days. This is the time from the exposure to the hepatitis A virus until the onset of the disease.
The first symptoms include loss of appetite, distaste for cigarettes, nausea, aching muscles and joints and a mild fever.
Later symptoms include yellowing of the skin, mucous membranes, and white portions of the eyes (jaundice, icterus); light-coloured stools; and dark urine.
When the latter symptoms develop, the infected person usually begins to get better.
The duration of the disease is typically two to three weeks, but it can last up to one to two months.
Small children are, in most cases, only mildly affected by the disease, and usually do not develop jaundice.
How can type A hepatitis be prevented?
Good hygiene reduces the risk of infection:
wash or peel fruits and vegetables during trips to countries with poor sanitary conditions.
remember that insanitary conditions allow shellfish to be contaminated by human sewage.
If a household member is infected with the type A virus, the following is recommended:
always wash your hands with soap and water after using the toilet.
good hygiene in connection with food preparation is essential.
have a separate towel for each family member.
wear disposable gloves when helping the sick family member with personal hygiene.
clothes which have been contaminated by stools should be washed immediately, or kept in a tightly closed bag until they can be washed.
household members who are not ill should be given gammaglobulin (see below).
Is there a vaccine for type A hepatitis?
A vaccine for type A hepatitis is available. People receive two injections, 6 to 12 months apart. The protection provided by the vaccine exceeds 95 per cent and it lasts for at least 10 years. The vaccine is recommended in connection with trips to countries where the general standard of hygiene is very poor, eg Asian, South American, and African countries.
For short trips, normal immunoglobulin (eg Kabiglobulin) is a cheap alternative to the vaccine. Travellers only receive one shot, which will last one to three months, depending on the size of the amount injected.
What can be done at home?
Rest while blood tests show that the disease is active.
Abstain from all alcohol intake while ill.
Eat a healthy, well-balanced diet.
How is type A hepatitis diagnosed?
The diagnosis is made on the basis of an antibody test, which will demonstrate the presence of antibodies against hepatitis A virus in the patient's blood.
Blood tests for liver function will reveal the severity of the disease, ie to what extent the liver is affected by the virus.
Future prospects
Very few patients (approximately 1 in 1000) develop liver failure and consequently risk dying of the disease.
Most patients have fully recovered after four to eight weeks.
Type A hepatitis never becomes a long-term, debilitating (chronic) condition.
Once a person has recovered, they will be immune to infection by the hepatitis A virus for the rest of their life.
How is type A hepatitis treated?
There is no specific medical treatment.
Normal immunoglobulin (eg Kabiglobulin) may reduce the severity of the disease when administered to people who have been exposed to hepatitis A virus but have not yet developed any symptoms.
Based on a text by Professor Court Pedersen, consultant and Professor Ove Schaffalitzky de Muckadell, consultant
Last updated 01.04.2005
Your uninformed blathering does not include a cost anylysis on how much money vaccines save by keeping people healthy. You can go on and on, but that doesn't make you right. The actual money saved is far more because less is spent on treating those that would otherwise be sick, costing companies and parents money by staying home sick or taking care of the sick. Not to mention the cost of burying dead people, and the people left behind with less resources because a spouse is no longer around to help with costs of living, etc.
