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Every year, thousands of people get infected with hepatitis A, a disease associated primarily with poor hygiene. Though unpleasant, this disease usually resolves on its own after a few weeks. But, in some cases, it can result in death.

Hepatitis A is a viral disease of the liver caused by hepatitisvirus A. This disease is associated with poor hygiene, and is caused when a healthy, unimmunized person ingests particles of feces coming from an infected person. There are several ways in which this can happen — drinking water contaminated with feces, eating contaminated food, or even eating food prepared by an infected person, if that person didn't wash their hands. This type of hepatitis does not cause a chronic disease (unlike hepatitis B and C), and can be cleared out of the organism in a few weeks. But, sometimes, the disease can take form of fulminant hepatitis, or acute liver failure, which can be deadly.

Transmission: How does hepatitis A spread?

After the virus has entered the organism, it travels to the liver and replicates in the liver cells. Once the replication is complete, the cell is destroyed, and virus particles enter the bile, which then travels to the intestines and into the stool. A person infected with hepatitis A excretes the virus through feces. The virus is able to survive outside of the body for months, and is resistant to very low temperatures, although high temperature kills it. Once outside of the body, the virus can contaminate water, food and other objects.  

This has lead to several outbreaks of hepatitis A in the United States in the past years. In the outbreak of 2016, there were 15000 cases reported, 8500 people needed to get hospitalized, and 140 people died until March 2019. 

  • The most common ways of getting infected include eating contaminated food and drinking contaminated water.
  • Other ways include drug use, having sex, or via close contact with an infected person.
  • In the United States, there have been many reported cases of people getting infected with hepatitis A by eating raw or frozen imported food. Eating raw or undercooked shellfish is also a common way of infection.
  • Although hepatitis A is a global problem, there are some areas in which the occurrence of the disease is higher: India, Pakistan, Bangladesh, Nepal, Africa, Far East (except Japan), the Middle East, South and Central America. 

Symptoms of hepatitis A: What should you watch out for?

While younger children rarely have any symptoms, older children and adults may experience several symptoms related to the liver disease, including:

  • Pain in the upper right quadrant of the abdomen
  • Fatigue
  • Jaundice
  • Fever
  • Nausea
  • Loss of appetite
  • Joint pain
  • Dark urine
  • Light colored stool
  • Diarrhea

The disease usually lasts for a couple of months, but can last for up to six months. Also, some people are more susceptible to the disease than the others. The risk groups include:

  • People living in areas with poor sanitation
  • Drug users
  • People sharing a household with an infected person
  • Sexual partners of people infected with hepatitis A
  • People lacking access to safe water
  • People traveling to areas with higher occurrence of the disease

Not all people who get infected have the symptoms of the disease, but since the incubation period is from 14 to 28 days, an infected person usually experiences symptoms from to to four weeks after the infection.

Diagnosis: How will you know if you have hepatitis A?

If you experience some of the symptoms that could point to hepatitis A, you should visit a doctor. There are several different ways in which the disease can be diagnosed. The serum levels of ALT, an enzyme produced in the liver, will be elevated for the first few weeks after the infection. There are tests which can detect the anti-hepatitis A antibodies in your blood. PCR is also available, since the virus RNA can be detected not only in the feces of an  infected person, but in serum and saliva of the infected person too.

Treatment: If you have hepatitis A, what's next?

There is no specific treatment for hepatitis A. The therapy can manage the pain and discomfort patients experience. Since vomiting and diarrhea are present, fluid and electrolytes are lost, and it is important to replace them. It is also important to avoid drinking alcohol or taking drugs during the illness, since they too damage the liver, and can cause more serious complications, including liver failure. If liver failure occurs, the only available treatment is liver transplantation.

Prevention: What can you do to avoid hepatitis A?

There is a vaccine available with very high success rate. Almost 100 percent of people who got only one shot develop high levels of antibodies that protect them against the disease, but doctors usually give you two shots, just to make sure that you are fully protected. Even if administered up to two weeks after the infection, the vaccine can protect against the disease. The vaccine is injected, and contains the dead virus, which is used to train our white blood cells to recognize the pathogen. There are also vaccines administered orally, but they're available only in China.

It is recommended that all children at the age of one get the vaccine. Other groups of people who should get vaccinated include: 

  • People who travel to the areas where hepatitis A is more prevalent
  • Men who have sex with men
  • Drug users (both IV and other)
  • People with chronic liver diseases
  • People who live, or take care of hepatitis A patients
  • Sexual partners of people who have hepatitis A
There are other ways to lower the chance of getting infected or spreading the disease. Be sure to always use clean, safe water for drinking and washing the food you're preparing. Always wash your hands after you use the toilet, and before you prepare food. Never eat raw shellfish. Be careful when using ice in unsanitary conditions (since the virus can survive freezing temperatures). The virus is killed in one minute when exposed to boiling temperatures, so be sure to cook your food properly. Practice safe sex.

In conclusion

Hepatitis a is a disease spread by ingesting feces of an infected person. These fecal particles can be virtually invisible and undetectable, and yet, they can cause the infection. The virus can survive for months outside the body, but boiling temperatures kill it very quickly. If you're not vaccinated, you should consider getting a shot, since this is the only way to get 100 percent protected. You should also avoid eating raw shellfish, or any other raw food coming from areas where hepatitis A is more common. Always wash your hands after using the toilet or changing diapers, and before you prepare food.

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