What is Hepatitis A?
Hepatitis A is a viral inflammation of the liver. The spread of the Hepatitis A virus is closely related to hygiene conditions and is rarely seen in countries with high hygienic standards. In most cases, infected individuals contract the virus while traveling to regions where Hepatitis A is endemic or to countries with limited access to healthcare. Commonly referred to as "jaundice" among the public, Hepatitis A is a preventable and fully treatable disease with timely medical intervention.
How is Hepatitis A transmitted?
Person-to-person transmission:
- Hepatitis A viruses are excreted in the faces of infected individuals, even before any symptoms of the disease appear.
- Transmission occurs through close contact between people living together in the same household and in places such as kindergartens.
- In individuals with poor hygienic habits, the virus can enter the mouth through fecal residues left on hands or surfaces, leading to infection.
- In rare cases, it can also be transmitted through blood and blood products.
Through food and water:
Viruses can be transmitted through contaminated food:
- For example, when consuming salads, vegetables washed with water contaminated by feces, or contaminated seafood (such as mollusks, oysters, etc.).
- An infected person who prepares food without properly washing their hands can transfer the virus to the food.
- Contaminated drinking or household water can also be a source of infection.
- In recent years, some imported products, such as:
- Frozen berries, sweets, dried dates, and tomatoes have also been found to be carriers of the virus, mainly at the point of export.
What are the symptoms of the disease?
The disease usually presents with mild or no symptoms in children, while adults experience more pronounced symptoms.
- Early and non-specific symptoms:
- Nausea
- Vomiting
- Abdominal pain
- Fatigue
- Sometimes fever
- Later and more specific symptoms:
- Jaundice (yellowing of the skin and visible mucous membranes)
- Darkening of urine color
- Itching of the skin
- Clay-colored stools
- Weight loss
Symptoms can last from several days up to several weeks. Complete recovery may take 2–4 weeks. In 10% of cases, the disease can be prolonged but eventually resolves without complications. The risk of severe illness increases with age and, in rare cases, it can be life-threatening.
The encouraging fact is that once infected, a person develops lifelong immunity.
Incubation period and infectiousness:
- The incubation period—the time between infection and the appearance of symptoms—lasts 15–50 days (average 4 weeks).
- Most infectiousness period: 1–2 weeks before and 1 week after symptoms appear
- Infants can excrete the virus in their feces for a longer period compared to adults, which may lead to transmission to others.
Diagnosis and tests performed
- Laboratory tests:
After a physical examination of the patient, the most appropriate option for making a diagnosis is to conduct blood tests. The diagnosis is made if antibodies to the Hepatitis A virus are found in the blood. These antibodies can be in 2 forms:
1. Anti-HAV IgM: The virus is shed as soon as the person is first exposed, serving as an indicator of acute infection.
2. Anti-HAV IgG: It appears later than infection, can remain in the body for a long time, and is an indicator of a previous infection.
Virus infections cause functional and structural damage to the liver. Therefore, liver function tests (ALT, AST, GGT, ALP, Bilirubins, etc.) should be performed.
- Instrumental tests:
Abdominal ultrasound examination is useful to identify structural changes that occur.
Who is at higher risk?
- Anyone who has not previously had hepatitis A and has not been vaccinated is at risk of infection. However, certain high-risk groups should be highlighted:
- Travelers to endemic (virus-specific) regions
- Individuals in close contact with infected persons
- People with liver disease
- Elderly individuals
What should an infected person do?
- There is no specific treatment – only symptoms are alleviated.
- Rest is recommended, along with a light diet low in fat and rich in carbohydrates to reduce the burden on the liver.
- It is important to avoid alcohol and smoking.
- Medications that burden the liver should not be taken without consulting a doctor.
- Hands should be washed frequently and thoroughly.
- The infected person should use a separate toilet.
- For 2 weeks, avoid public places such as schools, kindergartens, and workplaces. Patients or suspected individuals should temporarily refrain from attending school, kindergarten, or working in the food sector.
Prevention methods
Vaccine:
- Hepatitis A vaccine should be given to children in 2 doses, 6 months apart. (usually at 18 and 24 months)
- This is the same for adults, but some tests should be done before vaccination.
- Combined Hepatitis A and B vaccines are also available.
- If exposure to the virus is suspected, vaccination within the next 14 days is effective in preventing the disease.
Hygiene measures:
- Wash hands frequently and properly,
- Use disposable gloves when caring for a patient,
- Strictly maintain kitchen and toilet cleanliness,
- When traveling, use only boiled or packaged water and well-cooked foods,
- Avoid eating raw salads, unpeeled fruits, and fresh fruit juices.