Health care 13 Report

Hepatitis A
Presented by
Vanessa S. Ediza
 Introduction
 Hepatitis A is a general term meaning
inflammation of the liver
 One of the oldest diseases known to humankind
 A self-limited disease which results in fulminant
hepatitis and death in only a small proportion of
patients
 Formerly called Infectious Hepatitis, Epidemic
Hepatitis, Epidemic Jaundice, Catarrhal
Jaundice, Type A Hepatitis, HA
 History
The manifestations of
liver disease such as
Hepatitis B included
jaundice
characterized by
Hippocrates and
found to be infectious
as early as the 8th
century.

Hippocrates
By 1885, hepatitis was found to be transmittable
through blood transfusions and syringes when
epidemics of jaundice broke out during the wars
of the 17th – 19th centuries. During the World War
II, between 1939 – 1945, a series of outbreaks
occurred after vaccination for measles and
yellow fever, implying further that the virus is
blood-borne.
In 1947, MacCallum classified viral hepatitis into
two types: Viral Hepatitis A or infectious hepatitis
and Viral Hepatitis B or serum hepatitis. By
1963, research concerning hepatitis finally paid
off.
In 1965, Baruch Blumberg,
then working at the National
Health Institute (NIH),
discovered the Australian
antigen ( later known to be
Hepatitis B surface antigen,
HBsAg ) in the blood of
aborigines. He had been
studying samples of sera
from multiplying transfused
hemophiliacs for
polymorphic antibodies, and
showed that the antigen
HBsAg had high presence
in leukemia and Down’s Baruch Blumberg
syndrome patients.
Later in 1968, Prince and Okochi isolated the
Australian antigen in Hepatitis B patients, and
from this information, along with the discovery of
the Dane particle in 1970, the first vaccine for
hepatitis B was produced in 1981 and licensed
as “Heptayax.”
More than a decade later, the nationwide
vaccination program on newborns in Taiwan
originally launched in 1984 showed successful
results, with reported in annual decrease of
hepatocellular carcinoma in children
 Risk of Hepatitis A

Dark red: High, Red: Medium-High, Yellow: Low-Medium,

Grey: Low
Geographic Distribution of Hepatitis A Prevalence, 2005
Obtained from US Centers for Disease Control and Prevention Traveler's
Health Section
 What Causes the Disease?
 Caused by Hepatitis A Virus
(HAV), a nondeveloped, positive
stranded RNA virus, first
indentified by electron
microscopy in 1973, classified
within the genus hepatovirus of
the picornavirus family.
 The virus interferes with the
liver’s functions while replicating
in hepatocytes. The individual’s
immune system is then activated Hepatitis A Virus
to produce a specific reaction to
combat and possibly eradicate
the infectious agent. As a
consequence of pathological
damage, the liver becomes
inflamed.
 How is HAV spread?
 HAV is transmitted from person-to-person via
the fecal-oral route
 As HAV is abundantly excreted in feces and can
survive in the environment for prolonged periods
of time, it is typically acquired by ingestion of
feces-contaminated food or water. Direct
person-to-person spread is common under poor
hygienic conditions.
 Occasionally, HAV is also acquired through
sexual contact (anal-oral) and blood
transfussions.
Who is Susceptible to Infection?
 People who have never contracted HAV and
who are not vaccinated against hepatitis A, are
at risk of infection.
 The risk factors for HAV infection are related to
resistance of HAV to the environment, poor
sanitation in large areas of the world, and
abundant HAV shedding in feces.
 In areas where HAV is highly endemic, most
HAV infections occur during early childhood.
 Signs and Symptoms
 Many people with HAV infection have no
symptoms at all. Sometimes, symptoms are so
mild that they go unnoticed. Older people are
more likely to have symptoms than children.
People who do not have symptoms can still
spread the virus.
 Symptoms of hepatitis A usually develop 2 and 6
weeks after infection. The symptoms are usually
not too severe and go away on their own, over
time.
 The most common symptoms are as follows:
 Nausea
 Vomiting
 Diarrhea, especially in children
 Low-grade fever
 Loss of appetite
 Rash
 Tiredness, fatigue
 Jaundice
 Urine is dark brownish in color, like cola or strong tea
 Pain in the area of liver
 Symptoms usually last less than 2 months, although they
may last as long as 9 months.
 Hepatitis does not occur simply from being near
someone who has the disease at work or at school.
 Treatment
 No specific treatment exists for Hepatitis A
 The main focus is on making sure you get
adequate nutrition and avoid any permanent
liver damage.
 Those who acquire fulminant hepatitis require
hospitalization for monitoring and additional
treatment such as providing adequate fluids and
nutrition and managing complications such as
bleeding. In some cases, people with fulminant
hepatitis may even require a liver transplant.
 Why is there no treatment for the
acute disease?
 Hepatitis A is viral disease, and as such, antibiotics are
of no value in the treatment of the infection.
 Antiviral agents, as well as corticosteroids, have no
effect in the management of the acute disease
 The administration of immune globulins (IG) may help
preventing or improving the clinical manifestations of the
disease if given 2 weeks of infection, but it is of no help
in the acute phase of hepatitis A.
 Therapy can only be supportive and aimed at
maintaining comfort and adequate nutritional balance.
 Complete recovery without therapy is generally the rule.
 Prevention
Protecting yourself
 Receive immune globulin or a hepatitis vaccine.
 Immuno globulin – provides short-term protection for
up to 3 months
 Hepatitis vaccine – protect you for up to 20 years
2 hepatitis vaccines approved by FDA
Havrix and Vaqta – contain inactivated forms of
hepatitis A virus and are safe for children older
than 2 years as well as for most adults
Twinrix – protects people age 18 and older
against both hepatitis A virus (HAV) and the
Hepatitis B virus (HBV)
 If you’ve already had hepatitis A, you
won’t need to be immunized because
you’ve developed your own protective
antibodies. These antibodies won’t protect
you form other forms of hepatitis,
however.
 Follow safety precautions for international
travelers.
Peeling and washing all your fresh fruits and
vegetables yourself
Avoiding raw or undercooked meat and fish
 Practice good hygiene
Protecting others
 Avoid sexual activity.
 Wash your hands thoroughly after using
the toilet.
 Use clean utensils.
 Don’t prepare food for others while you’re
actively infected.
The End