Hepatitis A

Hepatitis A is a viral infection that affects the liver. The hepatitis A virus (HAV) can cause the liver to become inflamed, tender, and swollen. Usually symptoms of HAV are mild but can be worse the older a person is. Death rarely occurs from a HAV infection. There is no cure, but the body’s natural defenses will usually fight it off.

Reporting

According to the Center for Disease and Control (CDC) in the United States there were 3,578 acute (newly acquired or short-term) clinical cases of hepatitis A reported in 2006. However, it is estimated there were actually 15,000 acute clinical cases of hepatitis A and 32,000 new infections of the virus. (source)
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Transmission

The hepatitis A virus (HAV) can be transmitted from the blood or feces of an infected person. It can also be transmitted by touch.

Blood transfusions, blood products, or sharing needles can cause transmission of HAV. However, transmission these ways is often rare, because the virus does not remain in a person’s blood that long after he or she has been infected.

The primary way HAV is transmitted is through infected feces. This includes eating food prepared by people with HAV who did not wash their hands after using the bathroom, not washing your hands after changing a diaper, or by touching infected people or objects that have the virus on them (HAV can survive on objects for some time).

The virus can also be transmitted through eating contaminated food (such as strawberries and lettuce) or drinking contaminated water (especially in developing countries). Shellfish is another food that can be infected.

HAV can be spread through sexual contact. Oral to anal sexual contact (rimming) can easily transmit the virus. Oral sex can as well, even with a condom, because a used condom can have the virus on it. Handling the condom could then transmit the virus.

Young children in day care or in a setting that has them around other young children who are in diapers can have HAV spread easily among them because they can not wash their own hands.
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Symptoms

Most people will have symptoms from hepatitis A. For most of them the symptoms will be mild and last one to two weeks. However, the severity and length of symptoms a person experiences usually increase with age. Children on the other hand usually do not have any symptoms. People who are infected with hepatitis B or C are more likely to have more severe and longer lasting symptoms than those not infected with hepatitis B or C.

One of the more obvious symptoms of hepatitis A is jaundice (yellowing of the skin and eyes, darker urine and pale feces). Other symptoms that can be experienced are itchy skin, nausea, vomiting, diarrhea, loss of appetite, weight loss, abdominal discomfort, malaise (feeling of ill-health), or fatigue (feeling tired all the time).
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Testing / Diagnosis

Laboratory tests are used to diagnose the hepatitis A virus (HAV). Testing is done on a blood sample. A health care provider can order the blood drawn and tested.

Testing for HAV can show that immunity has been built up to the virus, which is a sign of past infection, or show that a person is currently infected with the virus.
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Treatment

Hepatitis A does not have a cure, but goes go away after the body fights off the hepatitis A virus (HAV) infection. This can take one to four weeks. Taking an immunoglobulin (a protein that fights infection) can help reduce or prevent symptoms from occurring. Some health care providers may recommend a low fat and high protein diet, plenty of rest, drinking plenty of fluids and avoidance of alcohol, sedatives, or strong painkillers during recovery. Sexual contact should also be avoided till the infection has been fought off.

Once the infection has been fought off, a person is immune and can not get hepatitis A again.
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Complications

Complications from the hepatitis A virus are rare. Some people may need to be hospitalized, but not usually. Death is also rare, but can occur in older people or those who already have pre-existing liver damage.
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Prevention

Hepatitis A can be prevented with a vaccine. Most people will have no side effects from the vaccine besides soreness at the site of injection. However, a few people may feel tired and nauseous. The vaccine is recommended for people who have pre-existing liver damage, people traveling to a developing country that has a high rate of hepatitis A virus (HAV) infections, people who live in an area that has a high rate or a prolonged outbreak of HAV infections, people who receive blood transfusions or products, men who have sex with other men, and drug users who share needles.

Abstaining from sexual contact can also prevent the transmission of Hepatitis A. A mutual monogamous relationship with a trusted partner known to be tested and uninfected is another way.

Correctly using latex condoms during anal or oral sex can reduce the risk of transmission. During oral to anal sexual contact (rimming) using a dental dam, plastic wrap, or a latex condom cut up and opened flat can also reduce the risk. However, it is important to remember the barrier method used (condom, dental dam, or plastic wrap) can have HAV upon it. So hands should be washed immediately after handling and disposing of it. Any part of the body that may have come into contact with a sexual partner’s anal area should also be immediately washed.

People who share sex toys for anal use should place condoms on them, switching to a new condom when the toy goes from one person to another. People should also wash their hands after handling the sex toys.

Practicing good hygiene by washing hands after going to the bathroom or changing diapers can also prevent transmission of HAV. Avoiding contaminated water or food sources is another way. If contamination can not be avoided, boil water for at least 1 minute and heat foods to above 185 degrees Fahrenheit for at least 1 minute. Surfaces that could have been contaminated with HAV can be disinfected with a solution of household bleach and tap water (1:100 dilution, 1 part bleach, 100 parts water).

Drug users should avoid sharing needles to prevent themselves from being infected.
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