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hepatitis A

Hepatitis A is an acute necroinflammatory disease of the liver, known as common jaundice, resulting from infection by the hepatitis A virus (HAV). HAV is one of the most widespread viruses that cause hepatitis affecting millions of people worldwide every year. The virus is usually transmitted enterically and is therefore particularly associated with poor standards of hygiene and sanitation. The host organ for HAV is the liver.

Prevention

Hepatitis A is not as mild a disease as is often thought. It can last for weeks or months. It is a serious cause of lost work time and distress, and can have severe, sometimes fatal, complications. Also in children severe complications such as fulminant hepatitis occasionally occur. Currently, there is no effective specific treatment for hepatitis A. However, the disease can be prevented.

Hepatitis A can be prevented:

• with improvements in sanitation and hygiene
• through passive immunization
• by vaccination.

Hepatitis A is highly infectious. The most common routes of transmission are the fecal-oral and parenteral routes.

Fecal-oral route

The virus is shed in the feces of an infected subject in large quantities in the early stages of infection. Shedding occurs before symptoms appear, so the subject and his or her contacts are unaware that he or she is infectious. The virus is easily spread to others who ingest it through contact with fecally contaminated materials. The usual vehicles for transmission are:

Shellfish and fish - Shellfish are notorious as a means of transmitting hepatitis A. They can concentrate the virus from contaminated waters and retain it. As they are often eaten raw, or only gently steamed, the virus may not be destroyed before eating. Fish may also harbor HAV in their gills and thus pose a risk to those who eat fish heads that have not been thoroughly cooked.
Other foods - Food prepared by an infected subject may be contaminated with HAV. If it is uncooked, or inadequately cooked, or handled after cooking, there is a risk that the virus may spread to others. This is true even if the food is frozen and then thawed before being eaten.
Public water supplies - Fecal material containing hepatitis A virus can contaminate water supplies, especially where sewage disposal and water purification systems are inadequate. Hepatitis A outbreaks have been linked to contaminated drinking water and to the use of such water for washing salads, fruits and other foods prior to consumption.
Recreational waters - It is well known that the sea, lakes, rivers and swimming pools in crowded situations often contain fecal material. This can be demonstrated by the presence of high concentrations of enterobacteria. Hepatitis A can be contracted by those who accidentally ingest fecally contaminated recreational waters.

Parenteral Transmission

HAV is present in the blood of an infected subject for about 3–5 days, before any symptoms appear. A blood donor could therefore be infected without knowing it and pass HAV on to the recipient, even if the infected plasma has been frozen for several months. Blood products contaminated with HAV have been linked to outbreaks of hepatitis A in hemophiliacs, immunosuppressed and cancer patients.

Low concentrations of HAV viral particles have been found in saliva, and a few cases have been linked to transmission by oropharyngeal secretions.

• Hepatitis-A, commonly known as Jaundice, spreads through food & water contaminated with Hepatitis-A virus.
• The outbreaks of Hepatitis–A have been traced to contaminated salads, fruits and frozen foods.
• Cases of Hepatitis–A has also been seen during and immediately after the monsoon.
• Contaminated recreational waters/swimming pools can also spread infection.
• Hepatitis–A is prevalent throughout India, because of overcrowding, poverty, poor standards of hygiene and sanitation, inadequate access to clean and drinking water and inefficient sewage disposal.
• It is a highly infectious viral disease, which leads to inflammation of liver.
• In certain patients the infection may lead to fulminant hepatitis, relapsing hepatitis and cholestatic jaundice. These complications can be fatal.
• There is no effective treatment for Hepatitis–A infection. Prevention is the only solution