Pathology

HAV No chronic disease CFR=0.3%, higher in adults

HBV Pre-ecteric, ecteric, convalescence phases, similar to others S & S CFR=1%, higher >40yo WW with 3 types of areas 1- Highly endemic = Infants chronic infection 2- Low endemic = young adults 3- Intermediate = all groups Any All those dealing with blood or genital secretions & vertical transmission

HCV Same but milder acute & more chronic

HDV HBV/HDV co-infection HDV superinfection after HBV Makes HB more fulminant Same as HBV

HEV Same 50% anicteric

Place

Endemic in developing Declined in developed Incidence unknown

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Same as HAV

Time Person

Any 1- Age: all especially children, severity increases with age 2- Sex: equal 3- Travelers & military 4- CLD increases severity 30 days (15-50) One serotype, resistant, inactivated by boiling 5 min & superchlorination Man as cases clin or sub No carriers Food & drink, feco-oral, common vehicle, oro-anal contact Blood & serum only in viremic, parenteral

Any Same as HBV but vertical is less & associated with HIV

Any Same as HBV

Any Same as HAV

IP Agent

120 days (45-180) DNA, highly resistant, inactivated by chlorination & autoclave 30 min Man as cases & carriers Blood mainly & other fluids Parenteral, sexual Rarely perinatal

---------ssRNA

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15-64 days -------------

Reservoir Source of Infection & MOT

Same as HBV Same as HBV but perinatal is rare

Same as HBV -----------

Man & animals Same as HAV

Susceptibility & postinfection immunity

General Lifelong

General Only if anti HBs forms For life Plasma-derived old not used Recombinant HBsAg, 3 doses, 0-1-6 months Boosters only to hemodialysis patients

Like HBV

Only those with HBV

Unknown

Period of 2 weeks before & 1 week communicability after Vaccine Formalin inactivated, IM, 2 doses 6-12 months apart Given to endemic, travelers, CLD, outbreaks, food handlers Highly immunogenic, new & no data about persistance H.education, prevent fecooral transmission, sanitation, vaccine, dispose sharps Report. Isolate(1week), disinfect Enlist, educate, surveillance, passive immunization IG, active with vaccine, investigate for source

Same as HBV No vaccine

Same as HBV --------------

Unknown ---------------

Prevention

Control (Cases) Control (Contacts)

Vaccine, preventive measures of blood banks, sharp sterilization, discourage tattooing, HCP measures, screening mother Same Enlist, educate, vaccinate, Investigate for source Infants of HBsAg +ve mothers should receive vaccine 12 h from birth

Same as HBV except for vaccine

Prevent HBV

Same as HAV

Same Same as HBV except for vaccine

Same Control of HBV

Same Same as HAV