Today is our topic of discussion Hepatitis A
Hepatitis A
Definition:
Hepatitis-A is an acute infectious disease caused by hepatitis-A virus.
Agent factors:
a. Causative agent: Hepatitis-A virus
b. Resistance: Resistant to heat & chemicals. Inactivated by UV ray, boiling for 5 minutes and autoclaving.
c. Reservoir of infection: Human cases
d. Period of infectivity: 2 weeks before to 1 week after the onset of jaundice.
e. Infective material: Human faeces, blood, serum and body fluids.
Host factors:
Age:
All age groups can be affected. More frequent among children than adults.
Sex:
Both sexes can be equally affected.
Environmental factors:
Predominates in poor sanitation & sewage infrastructure and faccal contamination of drinking water and overcrowding.
Mode of transmission:
1. Faeco-oral route (person to person or by eating & drinking contaminated food or water)
2. Parenteral (blood & blood products or penetration through contaminated needles)
3. Sexual route (uncommon & if oro-anal contact)
Incubation period –
2 and 6 weeks
Signs and symptoms:
May be mild or no symptom, but the faeces are still infectious; usual features are –
1. A short, mild, flu-like illness: Fever, chills, malaise & fatigue
2. Nausea, vomiting and diarrhoea
3. Loss of appetite
4. Weight loss
5. Dark urine & jaundice
6. Itchy skin
7. Abdominal pain
Investigation:
1. Anti-HAV: Detects whether the infection is current (IgM) or has been cleared (IgG)
2. Serum bilirubin: Detects the level of bilirubin in the blood
3. SGPT & SGOT: Detects severity of hepatitis and for follow-up purposes
Treatment for hepatitis A:
The disease is self limiting and returns to normal within a couple of months. Only severely affected patients need hospitalization
1. Bed rest
2. Diet:
a. Protein restricted & no spicy foods
b. Light diet supplemented by fruits, plenty of fluids, ORS, dab water & glucose drinks.
3. If severe vomiting: I.V. fluid and anti-emetic.
4. Drugs Sedatives, hypnotics and diuretics are usually avoided. If diuretics are to be used, potassium-sparing diuretics (spironolactone) should be used.
5. Clinical and biochemical follow-up
Prevention & control:
See next page.
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