Hepatitis A
(Hep A)
Definition
| Hepatitis |
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Causes
- Drinking water contaminated by raw sewage
- Eating food contaminated by the hepatitis A virus, especially if it has not been properly cooked
- Eating raw or partially cooked shellfish contaminated by raw sewage
- Sexual contact with a partner infected with the hepatitis A virus, especially as oral-anal contact
Risk Factors
- Having close contact with an infected person—although the virus is generally not spread by casual contact
- Using household items that were used by an infected person and not properly cleaned
- Having oral-anal sexual contact with an infected person
- Traveling to or spending long periods of time in a country where hepatitis A is common or where sanitation is poor
- Working as a childcare worker, changing diapers or toilet training children
- Being in daycare centers
- Being institutionalized
- Injecting drugs—especially if you share needles
- Receiving plasma products, common in conditions like hemophilia
Symptoms
- Tiredness
- Loss of appetite
- Fever
- Nausea and vomiting
- Abdominal pain or discomfort
- Yellowing of the eyes and skin
- Darker colored urine
- Light or chalky colored stools
- Rash
Diagnosis
- Blood test—to look for signs of hepatitis A
- Liver function studies
Treatment
- Help you stay as comfortable as possible
- Prevent the infection from being passed to others
- Prevent stress on the liver while it's healing. Mainly done by avoiding certain substances like specific medications or alcohol
Prevention
- Wash your hands often with soap and water.
- Wash your hands before eating or preparing food.
- Avoid using household utensils that a person with hepatitis A may touch. Make sure all household utensils are carefully cleaned.
- Avoid sexual contact with a person with hepatitis A.
- Avoid injected drug use. If you do, do not share needles.
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If you travel to a high risk region, take the following precautions:
- Drink bottled water
- Avoid ice chips
- Wash fruits well
- Eat well-cooked food
- Immune (Gamma) Globulin—temporary protection from hepatitis A. It can last about 3-6 months. It must be given before exposure to the virus or within two weeks after exposure.
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Hepatitis A Vaccine—highly effective in preventing infection. It provides full protection four weeks after the first injection. A second injection provides long-term protection.
The vaccine should be considered for:
- All children aged 12-23 months
- Children aged 24 months or older who are at high risk and have not been previously vaccinated
- People traveling to areas where hepatitis A is prevalent (The Centers for Disease Control and Prevention's Traveler's Health website shows which areas have a high prevalence of hepatitis A.)
- Men who have sex with men
- Injection drug users
- People who are at risk because of their job, such as lab workers
- People with chronic liver disease
- People with blood-clotting disorders, such as hemophilia
- People who will have close contact with an adopted child from a medium- or high-risk area
- People who desire immunity to hepatitis A
RESOURCES
American Liver Foundation http://www.liverfoundation.org
Hepatitis Foundation International http://www.hepfi.org
CANADIAN RESOURCES
Canadian Institute for Health Information http://www.cihi.ca
Canadian Liver Foundation http://www.liver.ca
References
Baker CJ, Pickerling LK, Chilton L, et al; Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med. 2011;154(3):168-173.
Hepatitis A. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated December 19, 2012. Accessed February 20, 2013.
Hepatitis A FAQs for the Public. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/A/aFAQ.htm#overview. Updated September 17, 2009. Accessed February 20, 2013.
Hepatitis A vaccine. What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-a.pdf. Accessed February 20, 2012.
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What I need to know about hepatitis A. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hepa%5Fez/index.aspx. Updated December 19, 2012. Accessed February 20, 2013.
Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.
9/25/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR Morb Mortal Wkly Rep . 2009;58:1006.