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HEPATITISİA: Q&A
By Sean Henahan, Access Excellence SAN DIEGO (4/7/97) A nationwide outbreak of hepatitis A has been traced to strawberries shipped by a food company in San Diego. As a result, children in affected areas are being given innoculations with gamma immunoglubulin. Here is some background information on hepatitis A: Hepatitis A -- What Is It? Hepatitis A (HAV) is a highly contagious virus that attacks the liver. It is the seventh most commonly reported infectious disease in the United States (behind gonorrhea, chicken pox, syphilis, AIDS, salmonellosis, and shigellosis). HAV accounts for as many as 65 percent of all viral hepatitis cases in the U.S. each year. In 1996, approximately 29,000 cases of HAV were reported in the U.S. However, the Federal Centers for Disease Control and Prevention (CDC) estimate that there are approximately 143,000 HAV infections in the United States each year. Worldwide, there are an estimated 1.4 million cases reported annually. There are several types of hepatitis. Hepatitis A is the most prevalent. Hepatitis A and hepatitis E are mainly transmitted through the fecal-oral route, while hepatitis B, C, and D are spread through blood or other body fluids. Common Symptoms of Hepatitis A
There is currently no treatment for hepatitis A, although rest and proper nutrition can relieve some symptoms. The most important factor affecting the severity of the disease is age. Children less than a year old rarely show clinical signs of the illness. This means that parents and child-care workers handling soiled diapers can catch or transmit the disease without knowing they have been exposed. Clinical manifestations of hepatitis A often pass unrecognized in children younger than two years of age. Overt hepatitis develops in the majority of infected older children and adults. In adults, approximately 22 percent will be hospitalized. An estimated 100 deaths occur in the U.S. each year from hepatitis A. In outbreaks, three people died in northern California in December, 1995, and another person died in Canada in January, 1996. The incubation period for hepatitis A ranges from 20 to 50 days , which means that infectious patients, such as food handlers or children, can spread the disease well before they are even aware they have it. Incubation is shorter with increasing age. Most patients begin recovery within three weeks, although some have prolonged or relapsing symptoms for up to six months. How Is Hepatitis A Spread? The hepatitis A virus is transmitted by the fecal-oral route, through close person-to-person contact, or by ingesting contaminated food or water. Infection has been shown to be spread by:
Who is suceptible? In the United States and other developed countries, people potentially susceptible to catching hepatitis A include:
The highest incidence of hepatitis A is in children. Nearly 30 percent of the reported cases occur in children younger than 15. Many very young children do not show symptoms, so the unreported number is likely much higher. Many health experts suggest that children are a silent source in spreading the disease. Approximately 45% of persons with HAV cannot identify a recognized risk factor associated with their disease, but about half of them have children under five years of age living in their households. How Can Hepatitis A Be Prevented? Historically, the most common preventative has been immune globulin administration, which is effective for about three to six months. Now, however, there are two vaccines that provide longer-term protection and eliminate the need for repeated shots. These vaccines typically are administered as one initial shot followed by a booster shot in about six to 18 months. Prior infection with hepatitis A confers lifetime protection against a second attack. If in doubt, a blood test can determine if an individual has had hepatitis A in the past or needs protection. SOURCE Merck & Co., Inc. Related information on the Internet
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