Modern Homoeopathy

Monthly E-Newsletter February 2008

Hepatitis A – General Medical Consideration

Presented by

Dr. Pawan S. Chandak

Introduction: Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the liver caused by the hepatovirus hepatitis A virus. Most commonly transmitted by the fecal-oral route. The patient's immune system makes antibodies against the hepatitis A virus that confer immunity against future infection. Some vaccines remain effective for a lifetime, while others have to be updated after a few months or years.

Virus:

Hepatitis virus (HAV) is a non-enveloped ssRNA virus with a single serovar.

Signs & Symptoms

Symptoms of hepatitis A may be mistaken for flu. Some sufferers, especially children, may exhibit no symptoms at all.

Symptoms typically appear 2 to 6 weeks after start of infection.

Symptoms may return over the following 6-9 months and may include:

    * Fatigue

    * Fever

    * Abdominal pain

    * Nausea

    * Diarrhea

    * Appetite loss

    * Depression

    * Jaundice, a yellowing of the skin or whites of the eyes

    * Sharp pains in the right-upper quadrant of the abdomen

    * Weight loss

Treatment

There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated. Approximately 15% of people diagnosed with hepatitis A may experience one or more symptomatic relapse(s) for up to 24 months after contracting this disease.

Prognosis:

Young children who are infected with hepatitis A typically have a milder form of the disease, usually lasting from 1-3 weeks, whereas adults tend to experience a much more severe form of the disease. They are often confined to bed and minimal activity for about 4 weeks and have to stop their work for one to three months or longer.

Many adults take up to 36 months and occasionally longer to recover entirely. Symptoms that may be experienced after the first month or two are low immunity: It is much easier to catch minor infections and for these infections to linger longer than they normally would. Many people experience a slow but sure improvement, over this later period. They are generally able to function fairly normally, still needing more sleep and reduced athletic activity. It is common for recovering patients to experience occasional "off" days, during which they need to rest more. Hepatitis A can be sexually transmitted, especially during oral-anal contact, but not after the patient has recovered.

Prevention

Hepatitis A can be prevented by good hygiene and sanitation. Vaccination is also available, and is recommended in areas where the prevalence of hepatitis A is high. To prevent it, use your own towels and toothbrushes, eating utensils, and other personal products. Always wash your hands after and before eating and more importantly after using the toilet.

Hepatitis A vaccine:

This Hepatitis A vaccine, Avaxim, protects against the virus in more than 95% of cases and provides protection from the virus for ten years. The vaccine contains inactivated Hepatitis A virus providing active immunity against a future infection.

Epidemiology:

HAV is found in the feces of infected persons and those who are at higher risk include travelers to developing countries with high prevalence rates, and those having sexual contact or drug use with infected persons. HAV outbreaks still occur in developed countries and are usually traced to poor hand hygiene among infected, sometimes symptomatic restaurant employees failing to wash their hands after toilet breaks.

References

   1. ^ a b Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology, 4th ed., McGraw Hill, 541–4. ISBN 0838585299.

   2. ^ Hepatitis A Symptoms. eMedicineHealth (2007-05-17). Retrieved on 2007-05-18.

   3. ^ Hepatitis A : Fact Sheet. Center for Disease Control (2007-08-09). Retrieved on 2007-12-07.

   4. ^ Avaxim. NetDoctor.co.uk. Retrieved on 2007-03-12.

   5. ^ http://wwwn.cdc.gov/travel/yellowBookCh4-HepA.aspx#362

   6. ^ http://www.cdc.gov/Ncidod/diseases/hepatitis/a/fact.htm

   7. ^ http://www.cdc.gov/Ncidod/diseases/hepatitis/a/global_hepA_epi.pdf

   8. ^ Nick Swedberg for the Kane County Chronicle "Houlihan’s worker diagnosed with hepatitis A; clinic started" [1] Jan. 20, 2007