Hepatitis
A
DEFINITION:
A
viral infection infecting the liver.
SYMPTOMS:
Fever, malaise, nausea, vomiting, decreased appetite, yellow
skin and eyes (jaundice) and abdominal pain.
CAUSES:
A virus.
CONTAGION:
Hepatitis A is contracted by eating contaminated food or drinking
contaminated water. It can be in uncooked shellfish, uncooked
fruits or vegetables and drinks with contaminated water or
ice cubes. The illness is passed fecal/orally meaning that
if a person who has the illness does not wash properly after
stooling, the virus can be transmitted from the hands to food
or objects that another person can then put in their mouth.
The incubation period is four to six weeks.
DIAGNOSIS:
Jaundice,
along with fever, abdominal pain, nausea and vomiting are
suspicious for Hepatitis A. A blood test can then confirm
the diagnosis.
TREATMENT:
There is no treatment for Hepatitis A since this is a virus.
Supportive measures include fluids and rest.
OUTCOME:
Usually good. There are about 100,000 cases of Hepatitis A
in the USA each year. There are no long-term complications
of this illness, however, there are about 100 deaths per year
during the acute stage of this illness. If you survive the
acute stage, then the illness will resolve.
DISCUSSION:
Hepatitis
A is prevalent throughout the world. The illness is generally
harmless but can affect some people severely. A vaccine for
this virus became available in 1995. The recommendations are
to give this vaccine only to people in high-risk categories.
This includes people traveling to all countries except Australia,
Canada, Japan, New Zealand, Scandinavia or countries in Western
Europe. All other countries including Mexico and the Caribbean
are considered high risk. The vaccine takes about four weeks
to become effective after injection so if there is not enough
time before traveling, a shot of immunoglobulin can confer
temporary immunity until the vaccine becomes effective. For
susceptible people exposed to Hepatitis A, a shot of immunoglobulin
will prevent contracting the illness. The vaccine is a two-dose
series given six months apart to anyone over two years of
age. The year 2000 vaccine schedule recommends the vaccine
for high-risk states and communities as well as travel. More
and more communities are falling under this high-risk recommendation
and eventually Hepatitis A will be part of the routine vaccine
schedule for everyone.
ONE DOCTOR'S OPINION:
I don't understand why everyone isn’t required to get this
vaccine. The vaccine is harmless and it can prevent at least
feeling lousy for weeks. I think the reason is that some people
don't like children to get any extra shot unless it is absolutely
necessary and Hepatitis A is generally harmless. However,
there are 100 deaths per year and many people suffer greatly.
If this vaccine were combined with another vaccine so that
there was no extra shot, it would now be part of the routine
vaccine schedule for everyone. I think that an extra shot
is a small price to pay for immunity to this illness. I would
recommend this vaccine for everyone, as my prediction is that
it will soon become required for all children.
