HEPATITIS

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Hepatitis is an inflammation of the liver that may be caused by a viral infection, medication, alcohol, and other things. Today I would like to concentrate on hepatitis A. Hepatitis A is caused by the hepatitis A virus (HAV) and can be transmitted by contact with the feces of an infected person. Transmission may occur by directly touching the feces of an infected person or consuming food or water that has been contaminated by fecal matter. Hepatitis B and C are not transmitted by food or feces but rather by contact with the bodily fluids of an infected person. Hepatitis A may be spread by sexual activity (mostly men who have sex with men) and intravenous drug use, however these types of cases are uncommon. Foods most commonly associated with hepatitis A are fruits, vegetables, salads, raw shellfish, and contaminated rice. Fruits, vegetables, and salads may become contaminated if prepared by someone with hepatitis A who did not properly wash their hands following a bowel movement. Shellfish can be contaminated if harvested from polluted waters and rice by contaminated rice paddies. Hepatitis A may be spread up to two weeks before symptoms appear and up to a week after symptoms appear. The time from exposure to symptoms is usually two to six weeks.

Symptoms include fever, fatigue, abdominal pain, nausea, vomiting, and jaundice (yellowing of the skin and eyes). Jaundice is caused by the liver releasing bilirubin, or bile, into the blood stream rather than into the biliary ducts, which normally conduct bile into the small intestine. Because bile is released into the blood stream and not the intestine, not only do the skin and eyes turn yellow, but the urine darkens to a tea-like color and the stools, without bile, are a pale color. Because it is caused by contaminated food, hepatitis A usually occurs in localized outbreaks. There have been several recent outbreaks in the U.S. among homeless people. The HAV can survive on food surfaces and is only killed when the food is heated to at least 185 degrees for a minimum of one to two minutes. There is no specific treatment for hepatitis A and symptoms usually subside within two months, although the Centers for Disease Control (CDC) does report that 10 to 15 percent of those infected by the HAV may have symptoms that can last up to nine months.

Someone who knows they have been exposed to hepatitis A may be given immune globulin (basically, antibodies to HAV) within two weeks of exposure. Otherwise vaccination is the only prevention. Vaccination is recommended for all children at age one year and to those at risk for infection. Those at risk for HAV infection include men who have sex with men, those who travel often to areas where HAV is common (i.e. Southeast Asia), intravenous drug users, those with liver disease or clotting problems, and teachers and children in childcare facilities. At any rate, regardless of vaccination status, everyone should wash their hands often to prevent spread of hepatitis A.

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