On Sunday, 28 July 2019, the world will observe World Hepatitis Day in the pursuit to eliminate viral hepatitis. Hepatitis is an inflammation of the liver and 325 million people live with the condition globally.
While the condition can be self-limiting (heals itself), it can also cause chronic disease and progress to scarring of the liver, cancer and death. Hepatitis viruses are the most common cause of hepatitis but other infections and toxic substances such as alcohol and certain drugs can also cause hepatitis. We find 5 main hepatitis viruses, referred to as types A, B, C, D and E. In recent months, the outbreak of Hepatitis E caused havoc and even death in some communities in Namibia, and was covered widely in the media. We will cover the basics of all 5 main types of viral hepatitis in the coming Mondays preceding World Hepatitis Day, starting with Hepatitis A in this edition.
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV), which is present in the stools of infected persons.
Transmission: The HAV is transmitted through the fecal-oral route, and mostly happens through drinking and eating contaminated water or food and through certain sexual practices.
Symptoms: the incubation period (time for the virus to mature and show symptoms) of Hepatitis A is usually 14-28 days, but the virus can be spread already two weeks before the symptoms show. Symptoms range from mild to severe, and can include fever, malaise (general feeling of being unwell), loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine and jaundice (yellowing of the skin and whites of the eyes). Not everyone who is infected will have all of the symptoms. While the disease is more serious in older age groups, infected children under 6 years of age do not usually experience noticeable symptoms, and only 10 percent develop jaundice.
Risk factors: The risk of infection increases with poor sanitation; lack of safe water; use of recreational drugs; living in a household with an infected person; being a sexual partner of an infected person and travelling to areas where the level of infection is high.
Diagnosis: a blood test is done to detect the HAV-specific antibodies in the blood.
Treatment: There is no specific treatment for hepatitis A, as the virus clears itself within 6 to 12 months and bedrest may be sufficient to deal with the feelings of tiredness and malaise. Avoid self-medication and alcohol, as it puts more strain on the liver. Maintaining comfort and nutritional balance, including replacement of fluids that are lost from vomiting and diarrhea is vital.
Prevention: Improved sanitation, food safety and vaccination are the most effective ways to fight hepatitis A, hence adequate supplies of safe drinking water; proper disposal of sewage within communities; and personal hygiene practices such as regular hand-washing with safe water are key preventive practices.
Key points: The following are key facts regarding HAV:
Hepatitis A is a viral liver disease that can cause mild to severe illness.
HAV is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person.
Almost everyone recovers fully from Hepatitis A with lifelong immunity. While a very small proportion of people could die from liver failure.
The risk of HAV-infection is associated with a lack of safe water and poor sanitation.
A safe and effective vaccine is available to prevent Hepatitis A.
Safe water supply, food safety, improved sanitation, hand washing and the Hepatitis A vaccine are the most effective ways to combat the disease.
Source: World Health Organization