Viral Hepatitis and Hepatitis A: Outbreak, Causes, Symptoms, Treatments, Prevention
What is a Viral Hepatitis?
Viral Hepatitis is a contagious disease which causes the liver to inflame. Viruses that attack the liver are called hepatitis virus. The major concern of this disease is inflammation of the liver, which restricts the secretion of bile juices, which is responsible for digestion thus, can be fatal. Though the primary causative factor of hepatitis is a virus however, it can also occur due to secondary medication, drug or alcohol consumption or through other toxins.
There are five types of Hepatitis virus- A, B, C, D, E and G, which was recently discovered. Although during the 1990s, a number of cases of Hepatitis F were claimed1,2,3; however, none of them were proven. Hence, it was termed as a Hypothetical Disease. Most common types of Hepatitis are A, B, C. All three of them including Hepatitis E can be acute; which means can become severe, but B can C can become chronic; which means it can recur constantly and lasts long.
Although Hepatitis can be prevented by proper vaccination, in recent years, USA has seen a surge in the cases of Hepatitis A. Since 2016, the disease has increased its presence in eight states of the USA. About 1,390 cases of Hepatitis A were reported in 2015 and it only increased since then4,5. In 2016, a significant surge was noticed and the number of cases went over 20006.
Types of Viral Hepatitis
Hepatitis A or infectious jaundice is caused by Hepatitis A virus or HAV. They are transmitted by an oral-fecal route which can enter into the body by ingesting contaminated food. It is an acute disease rather than a chronic one. Antibodies are formed inside the patient’s body hence doesn’t attack repeatedly. They can be spread through personal contact, consumption of raw meat and drinking contaminated water. Vaccines are available for hepatitis A.
Hepatitis B is caused by the hepatitis B virus or HAB. It is one of the most dreaded diseases in the USA because they are both acute and chronic which means that the effect of this disease can impact deeply. Blood transfusion, unsafe sexual activities, unsanitary tattoos, and breastfeeding are some identified mode of transmission.
Although the patient’s immune forms antibodies but they are not capable of fully eliminating the virus as a result, lack of treatment often results in acute liver failure followed by a painful death. Vaccines are readily available for hepatitis A.
The virus of Hepatitis C is similar to Hepatitis B. They share the same method of transmission and consequences. According to virologists, a person suffering from Hepatitis C is susceptible to Hepatitis A and B. Hence it is advisable for them to get immunized against both the viruses.
Hepatitis D is caused by Hepatitis D virus (HVD). It is known as the progeny of Hepatitis B. It can only propagate in the presence of Hepatitis B virus.
Hepatitis E is similar to Hepatitis A but it is chronic and can last long.
Hepatitis A Outbreak and its Causes
Lack of sanitation is the main cause for transmission of this viral hepatitis A disease. As a result, third world countries like Vietnam and indonesia are most affected. People living in poor sanitary condition are at risk of contracting Hepatitis A.
They are transmitted through oral-fecal route which indicates that intake of contaminated food increases the risk of acquiring the disease. Hepatitis A is much common in people living near coastal areas and riversides as they consume contaminated seafood, fishes and water.
Hepatitis A can also be transmitted by close physical contact like intimate kissing, but casual contacts are less likely to transmit it. Although precautions should be made while dealing with Hepatitis patient as according to US health department outbreak in Utah came from an infected seven-eleven employee.
Hepatitis A is much common in Indian Subcontinent because of lack of various basic amenities and hygiene. It has penetrated into developed nations like the USA because of the tourist and visitors traveling from various locations. They unintentionally become the host and carrier of these pathogens. Therefore, the FDA has mandated Hepatitis A vaccines and other vaccines if someone is traveling to any nation where it has been declared as an endemic.
Signs and Symptoms of Hepatitis A
Some of the symptoms of Hepatitis A are:-
- Low fever
- Sudden vomiting and nausea
- Abdominal discomfort especially near the liver and upper abdomen
- No urge to eat or loss of appetite
- Increased fatigue
- Intense joint pain
- Dark yellow-colored urine
- Change of color in bowel movement
- Yellowing of skin and eyes.
Symptoms like yellowing of skin and eyes match with other diseases like jaundice because they also attack the liver and inhibit the secretion of bilirubin.
Diagnosis for Hepatitis A
The symptoms of hepatitis are different hence the laboratory test may vary. The doctors may ask few questions, for example, if a patient recently has returned from abroad then the chances of Hepatitis A Virus is high, whereas in case of any unprotected sexual interaction he/she might be suffering from Hepatitis B Virus.
Following tests are used for diagnosis:
- Various blood tests are used to determine the level of certain enzymes and proteins in the liver.
- For Hepatitis B and C, a DNA or RNA test determines the speed at which the viruses are reproducing.
- A liver biopsy confirms the condition of liver and possible chances of cancer.
- Elastography is used to measure the liver’s stiffness through sound waves.
- Abdominal fluids are withdrawn and tested to identify fluid accumulation in the liver.
It should be noted that during diagnosis one should avoid recreational drugs and alcohol to optimize the recovery speed.
Treatment for Hepatitis A
A vaccine is available that prevents Hepatitis A for 10 years. Though the patient’s immune system makes antibodies to prevent the future attack of virus, vaccinations are necessary for avoiding a relapse of the disease.
Patients with Hepatitis A are advised to take rest. The incubation period of the virus is 14-28 days, by then the body clears the virus itself. The liver heals itself within 6 months without any permanent damage.
Patients are discouraged to consume any alcohol during the medication course as it can inhibit the healing process and can be lethal. High-calorie and fluid consumption are advised for a speedy recovery. Although nausea makes it difficult, taking light meals in a short interval is better for recovery.
Prevention of Hepatitis A
You can use practice some of these steps for prevention of Hepatitis:-
- Drinking water from safe water sources.
- Maintaining hygiene at a personal level, for example, proper hand washing.
- Disposing sewage properly to avoid contamination with tap water.
- Maintain proper contact with the contracted person.
- Traveling to places where the disease is endemic.
Hepatitis A and other forms are a viral disease which is curable with proper vaccination and medication. Alcohol and recreational drugs should be avoided to stop hindrance to the body. A Person with Hepatitis A should take proper rest. Maintain sanitation is the key to eradicate hepatitis. Hepatitis has become endemic in some nations and visitors should take care of the consequences of visiting these nations and should prepare themselves accordingly.
- Uchida, T. (1993). "Genetic Variations of the Hepatitis B Virus and Their Clinical Relevance". Microbiol. Immunol. 37 (6): 425–39.
- Fagan, E. A. (1994). "Acute Liver Failure of Unknown Pathogenesis: The Hidden Agenda". Hepatology. 19 (5): 1307–12.
- Bowden, S. (2001). "New Hepatitis Viruses: Contenders and Pretenders". J Gastroenterol. Hepatol. 16 (2): 124–31
- Centers for Disease Control and Prevention’s (CDC) National Notifiable Diseases Surveillance System (NNDSS). https://wwwn.cdc.gov/nndss/.
- Klevens RM, Liu SJ, Roberts H, Jiles RB, Holmberg SD. Estimating acute viral hepatitis infections from nationally reported cases. Am J Public Health. 2014;104(3):482-7.