Hepatitis A: Definition Causes Symptoms and Prevention

Introduction

Hepatitis A is a highly contagious form of liver infection that is caused by the Hepatitis A virus, also referred to as the HAV virus. HAV is one of three forms of viruses that may cause hepatitis; it is one of the three most common forms of hepatitis viruses in America. Other forms of hepatitis include Hepatitis B and Hepatitis C.

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Contracting the hepatitis A virus is most common through either water or food, although it may also be contracted through fecal matter or close contact with someone who has already been infected, even if that person does not appear to be ill. Some persons who are infected do not develop symptoms or signs of illness; others may develop flu-like symptoms. Cases of hepatitis A that are mild do not require treatment; many people who become infected with the HAV virus completely recover without permanent liver damage. Unlike other forms of hepatitis, hepatitis A does not develop into either cirrhosis or chronic hepatitis, both of which are potentially fatal conditions. Practicing good hygiene to include washing your hands frequently is one of the primary ways to avoid contracting hepatitis A. There are also vaccines available for persons who are at risk for hepatitis. Once you have had hepatitis A, you develop lifelong immunity and cannot get the disease again.

Due to the way it is spread, the hepatitis A virus commonly occurs in epidemics and outbreaks. Approximately one out of three persons in America have antibody to HAV; they have been exposed to the virus and most of them do not become ill with it. In America, the number of cases of hepatitis A varies among different communities. The introduction of a vaccine has not significantly affected the number of cases since its introduction in the early 1990's.

Causes of Hepatitis A

The HAV virus is found in the feces of persons with hepatitis A, and is transmitted when an infected person puts something in their mouth which has been contaminated with the feces of an infected person. The process of transmission is referred to as, 'Fecal-Oral Transmission.' Water or food that has become contaminated with the HAV virus through the stool of an infected person can spread to others who consume the contaminated substances. The HAV virus may also be spread through consumption of undercooked or raw shellfish that has been collected from water which has been contaminated by sewage.

While the virus may be transmitted via blood transfusions, it is a highly rare event. More common means of transmission include engaging in either oral or anal sex with a person infected with the HAV virus, or consumption of foods prepared by a person who is infected that has not washed their hands after they have used the bathroom. It is important to wash your hands after changing a diaper, and not to drink contaminated water.

Risks and Hepatitis A

Persons who have become infected with the HAV virus have the potential to spread the virus within a week of exposure. Even though they may not present symptoms, they can still spread the virus. The HAV virus is present throughout the world, and the risk of infection is highest in developing nations where sanitation and hygiene standards are poorest. The rate of infection is also greater in areas where direct fecal-oral transmissions are most likely to happen. These areas include prisons, mental health institutions, and daycare centers.

Specific groups of people who are at risk for the HAV virus include those who travel internationally; particularly to developing countries, as well as military personnel who are stationed in developing nations. People who either live or work in close proximity with others; in residential facilities, dormitories, prisons - or who work in daycare facilities for example, are at greater risk if strict hygiene practices are not pursued. People who work in health care, sewage and waste water management, or food preparation are actually not at any greater risk than those in the general population.

Other people who are at risk for hepatitis A include people who engage in oral or anal sex, sexual partners of persons infected with the HAV virus, and persons who use illegal drugs. People who have the potential to come in contact with the HAV virus while at work have a greater risk of contracting the virus. Household contacts of people who are infected with the virus are also at an increased risk of contracting hepatitis A.

Symptoms of Hepatitis A

There are many people who have an HAV infection who do not experience any symptoms at all. Other people have symptoms that are so mild they do not notice them. Persons who are older are more likely than than children to experience symptoms of hepatitis A. People who do not experience symptoms still have the ability to spread the HAV virus. The symptoms involved with hepatitis A commonly may last anywhere from two to nine months. Approximately fifteen-percent of persons who are infected with hepatitis A experience symptoms that come and go over a period of six to nine months. The symptoms associated with hepatitis A usually begin to develop between two and six week after a person has become infected with the virus, although the symptoms are commonly not too severe and tend to go away on their own over a period of time.

There are a number of symptoms that people may experience in association with hepatitis A. These symptoms include:

• Rash
• Nausea
• Vomiting
• Irritability
• Headache
• Dehydration
• Loss of appetite
• Low-grade fever
• Rapid heartbeat
• Pain in area of liver
• Tiredness or fatigue
• Feeling weak or tired
• Diarrhea; particularly in children
• Urine that is dark brownish in color
• Urinating less frequently than usual
• Feeling confused or unable to concentrate
• A yellow discoloration of the skin and the whites of the eyes

Treatment of Hepatitis A

The majority of people who have been infected with the HAV virus do not require any form of treatment, other than treatment to relieve the symptoms they are experiencing. There are no specific medications to cure an HAV infection. For persons who have been exposed to the HAV virus, there is a treatment that can prevent them from becoming infected with the virus. The treatment is known as, 'Immune Globulin,' and is most likely to be effective when administered within two weeks of the time of exposure to the HAV virus.
Immune Globulin is a substance that is made from human blood plasma; it contains antibodies that protect against infection. Immune Globulin is administered as a shot, providing short-term protection over approximately three months against hepatitis A. An Immune Globulin shot can be administered either prior to exposure to the HAV virus, or in order to prevent infection after a person has been exposed to the virus.

Testing for Hepatitis A

Testing for hepatitis A involves detection of the antibodies a person's body uses to protect itself from antigens. Immunoglobulin M (IgM) is the first antibody produced by a person's body when it has been exposed to a virus; it is used to detect early signs of an infection. IgM antibodies to HAV infection are used in persons who exhibit evidence of acute hepatitis such as dark urine, pale colored stools, jaundice, loss of appetite, or fever. Immunoglobulin G (IgG) antibodies develop at a later time and remain in a person's body for a number of years, protecting them against another infection by the same virus. There is a test referred to as a, 'Total Antibody Test,' which detects both IgM and IgG antibodies. The Total Antibody Test detects both current and previous infections with HAV, returning positive results after a person has received the hepatitis A vaccine.

A doctor may order a test for the IgM antibodies if a person is exhibiting symptoms of hepatitis, or if they believe they have been exposed to a person with the virus. If the person is considering the HAV vaccine, a doctor may order a Total Antibody Test prior to administering the vaccine to determine if the vaccine is needed. Once a person has received the vaccination, a doctor may order a Total Antibody Test to determine how the person has responded to the vaccine. People who have received a positive test result and have not received the HAV vaccine have a hepatitis A infection. Approximately thirty-percent of adults over the age of forty have antibodies to HAV. People who have received the vaccine for HAV and receive a positive test result are immune to HAV and cannot be infected by the virus.

Prevention of Hepatitis A

The best way to prevent hepatitis A is to get vaccinated against it. Hepatitis A vaccination is recommended for children, people traveling to certain nations, as well as for people who are at high risk for infection with the HAV virus. Washing your hands frequently is another way to prevent hepatitis A, particularly after going to the bathroom, preparing food, or changing a diaper.

In general, the hepatitis A vaccination is recommended for the following groups of people:

• All children at age 1 year
• People who have oral or anal sex
• People with chronic liver diseases
• People who use injection and non-injection illegal drugs
• People receiving treatment with clotting-factor concentrates
• Persons traveling to countries that have high rates of hepatitis A
• People who work with hepatitis A infected animals, or in a hepatitis A research laboratories

The hepatitis A vaccine is administered through two shots, given approximately six months apart. The vaccine is also available in a combination form that contains both hepatitis A and B vaccines which can be given to persons who are over the age of eighteen. The combination vaccine is administered through three shots over six months. The hepatitis A vaccine is very effective in preventing infection caused by the HAV virus. Protection through the vaccine begins about two to four weeks after a person receives the first injection; the second injection ensures long-term results.

There are no serious side-effects resulting from the hepatitis A vaccine; it is very safe. People may experience soreness at the site of injection. The first hepatitis vaccine was licensed in 1995 and since then millions of doses of the vaccine have been administered in America and world-wide. There are some people who should not receive the hepatitis vaccine. These people include those who have had a serious reaction to the vaccine or are known to be allergic to any part of the hepatitis A vaccine. It is important to tell your doctor if you have any serious allergies. The hepatitis vaccine is not licensed for use in infants who are under the age of one year. It is not harmful to receive a repeat dose of the hepatitis A vaccine. Persons who are immunocompromised can still receive the hepatitis vaccine.

For people who are planning to travel, it is recommended that they receive the hepatitis vaccine two weeks or more before their departure date, although receiving the vaccine anytime before traveling will provide some level of protection for most people who are healthy.

Author Credentials:
Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a Nursing Assistant Thomas has assisted people from a variety of racial, religious, gender, class, and age groups by providing care for people with all forms of disabilities from Multiple Sclerosis to Parkinson's; para and quadriplegia to Spina Bifida. Explore Thomas' complete biography for comprehensive insights into his background, expertise, and accomplishments.