Hepatitis A


Hepatitis A

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Key Facts

  • Hepatitis A is a condition that results in liver inflammation due to the ingestion of contaminated water or food, or direct contact with an infected person.
  • Due to the transmission method, hepatitis is most frequently found in populations that lack access to clean drinking water and proper sanitation.
  • While almost all patients who contract the virus recover fully and have lifelong immunity, a very small minority die from fulminant hepatitis since vaccines are available.

What is Hepatitis A?

Hepatitis liver, sick liverHepatitis A, a very contagious liver infection, is caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses, each resulting in liver inflammation and negatively affecting its function. Because hepatitis A is a short-term, relatively minor infection, most people do not require treatment and recover on their own within about 2 months. Keep in mind that hepatitis can be easily prevented with a vaccine. 

Learn More About: Hepatitis | Hepatitis B | Hepatitis C

Causes of Hepatitis A 

Because hepatitis A is a viral infection, it causes liver inflammation that impacts the organ’s ability to function properly. The virus often spreads when infected stool, even extremely small quantities, enters the mouth. This may occur if you eat or drink something contaminated. Be aware that the virus can live on a surface for a few months. While the virus is not spread by coughing, sneezing, or other casual interaction, close contact with an infected person is another mode of transmission.

Here are some examples of how hepatitis A spreads:

  • Consuming food handled by an infected person who didn’t wash their hands after using the bathroom
  • Drinking contaminated water
  • Eating food that was washed in contaminated water
  • Eating raw shellfish that came from polluted water 
  • Being in close contact with an infected person (even if they are not exhibiting symptoms)
  • Having sexual contact with an infected person

Risk Factors 

The following people face a higher risk of contracting the hepatitis A virus:

  • International travelers
  • Men who engage in sexual activities with men
  • People who use injectable drugs
  • Those exposed to the virus on the job
  • People who have close contact with an international adoptee
  • Those experiencing homelessness

Symptoms

Because many patients are asymptomatic, they may not be aware that they are infected and carrying the hepatitis A virus. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of chronic viral hepatitis, however, can take decades to develop. Symptoms include the following: 

  • Abdominal pain or distention
  • Dark urine or pale/clay-colored stools
  • Flu-like symptoms (unexplained fatigue, low-grade fever, nausea/vomiting, etc.)
  • General itchiness
  • Jaundice (yellowing of skin or eyes)
  • Appetite or weight loss

Diagnostic Test 

A physical examination may be performed, with these signs leading to a diagnosis:

  • Enlarged and tender liver
  • Fluid in the abdomen (ascites) that can become infected
  • Jaundice (yellowing of skin or eyes)

Your GI specialist may also use laboratory tests to reach a diagnosis and monitor your condition moving forward. Lab tests may include:

  • Abdominal ultrasound
  • Autoimmune blood markers
  • Hepatitis virus serologies
  • Liver function tests
  • Liver biopsy to check for liver damage
  • Paracentesis (if fluid is in your abdomen)

Treatment

Depending on the cause of your hepatitis, there are several treatment options available. Your gastroenterologist will suggest a treatment plan after learning more about your symptoms and viewing the results of any lab tests. Most commonly, your Charleston GI specialist will recommend rest, fluids, and a healthy diet. Patients with severe symptoms may need to be hospitalized until their condition improves.

Prevention

According to the Centers for Disease Control and Prevention, the following people should receive a hepatitis A vaccine:

  • All children at age one year
  • Older kids who have not yet received the vaccine
  • Anyone homeless (aged one year and older)
  • Infants aged 6 to 11 months who are traveling internationally to areas where hepatitis A is common
  • Family/caregivers of adoptees from countries with high infection rates
  • People in direct, regular contact with infected patients
  • Laboratory workers who may encounter hepatitis A
  • Men who have sex with men
  • People who work or travel internationally to places where hepatitis A is common
  • Recreational drug users (including but not limited to injected drugs)
  • People with chronic liver disease, including hepatitis B or hepatitis C
  • Anyone wishing to obtain immunity

Safety Tips 

When Traveling

If you're traveling to parts of the world where hepatitis A is common, be sure to take these steps:

  • Wash all fresh fruits and vegetables in bottled water and peel them yourself (with clean hands). Avoid consuming pre-cut produce.
  • Never eat raw or undercooked meat and fish.
  • Drink bottled water only and use it when brushing your teeth.
  • Avoid all beverages (and ice) of unknown or questionable purity. 
  • If bottled water isn't accessible, boil tap water before drinking it.

General Hygiene

Be sure to thoroughly wash your hands often, especially:

  • Before handling food.
  • Before eating.
  • After using the bathroom.
  • After changing a diaper.
  • After coming in close contact with a potentially infected person.

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Hepatitis A Frequently Asked Questions

How is hepatitis A transmitted?
Hepatitis A often spreads when infected stool, even in tiny amounts, is consumed. This may occur if you eat or drink something contaminated. Close contact with an infected person is another mode of transmission.

Here are a few real-world examples to consider:

  • Drinking contaminated water
  • Eating food that was washed in contaminated water
  • Eating raw shellfish that came from polluted water 
  • Being in close contact with an infected person
  • Having sexual contact with an infected person
  • Consuming food handled by an infected person who didn’t wash their hands after using the bathroom

Is hepatitis A sexually transmitted? 
The virus can be transmitted through any sexual contact with an infected person, often when bodily fluids mix with infected fecal matter.

Is hepatitis contagious? 
Yes, hepatitis A, B, and C are caused by viruses and are highly contagious. 

How serious is hepatitis A?
Those who contract hepatitis A may experience symptoms for a few weeks, but often do not require treatment to recover fully. In these cases, no lasting liver damage results. The most severe cases, however, may cause liver failure and even death – mostly in elderly people or those with pre-existing chronic liver conditions.

Does hepatitis A go away? 
Yes, hepatitis typically goes away on its own without treatment. Chronic hepatitis, however, may linger long-term and cause liver damage.

How common is hepatitis A in the United States?
Over 12,000 hepatitis A cases were reported in the U.S. in 2018. Because some patients are never diagnosed, the actual number may, in fact, be closer to 24,900. Since 2016, person-to-person outbreaks have been increasingly common, mainly among injectable drug users and those experiencing homelessness.

Is there a vaccine for hepatitis A?
Yes. A single shot of the vaccine can help prevent hepatitis A if administered within two weeks of exposure. 

How long does hepatitis A virus survive outside the body?
The hepatitis A virus can survive outside the body for months. Heating food and liquids to temperatures of 185°F (85°C) for at least 1 minute can kill the virus. Exposure to freezing temperatures does not affect the virus.

How can I protect myself against hepatitis A?
The best way to prevent hepatitis A is to get vaccinated. To get the full benefit, more than one shot is needed. The number and timing of these shots depends on the type of vaccine, so be sure to consult your physician to optimize immunity.

Is the hepatitis A vaccine safe?
Yes, the hepatitis A vaccine is safe. No serious side effects have been reported. Soreness at the injection site is common, but no serious side effects have been reported. Keep in mind that the potential health risks of infection are much greater than any risk associated with the vaccine. Millions of hepatitis A vaccines have been given worldwide since it was first licensed in 1995.

Who should not receive the hepatitis A vaccine?
Anyone who ever had a life-threatening allergic reaction to the hepatitis A vaccine or who is known to be allergic to any part of the hepatitis A vaccine should not receive it. If you have any severe allergies, speak to your doctor before getting vaccinated. Also, the vaccine is not licensed for use in infants under one year of age.

Who should get the hepatitis A vaccine before traveling internationally?
All unvaccinated people should be vaccinated before traveling to countries where hepatitis A is common – even if they plan to stay in urban or developed areas. While proper hygiene can help reduce your risk of transmission, getting vaccinated is the best way to stay safe while traveling. 

How soon before travel should I get the hepatitis A vaccine?
Doctors advise receiving the first dose of the hepatitis A vaccine as soon as you plan international travel – but it will still provide some protection even if you get vaccinated close to departure. For older adults over age 40, people who are immunocompromised, and people with chronic liver disease or other chronic conditions, getting an injection of immune globulin at the same time may be recommended.

What should I do if I am traveling internationally but cannot receive hepatitis A vaccine?
If you are allergic or the hepatitis A vaccine is not available to you, you should get a single dose of immune globulin. This injection helps provide protection against hepatitis A virus infection for up to two months, depending on the dosage. If your trip will last longer than two months, you can get another dose of immune globulin during your visit.


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