HEPATITIS
A.
Many of us attended concerts this summer and picked up a few mementos
that will stay with us for a while: a t-shirt, a ticket stub, maybe even a boyfriend
or girlfriend. But did you ever imagine that one of the not-so-little mementos
might just be a disease?
Health officials in several states are scratching their heads trying to find
a link between a recent outbreak of Hepatitis A from outdoor "jam band" festivals
and camping events, with the Center for Disease Control recently documenting
25 cases of Hepatitis A in nine states, including Wisconsin. Many of the infected
victims have a common link to an outdoor music concert that involved large crowds
with poor sanitation and camping facilities. Let's look a little more closely
at Hepatitis A, as this infection is not limited to concert-goers.
What is Hepatitis A? Hepatitis A is a viral infection
that affects the liver. The liver will become inflamed, painful and swollen.
Hepatitis simply means an
inflammation or infection of the liver. Additionally, there are several different
viruses such as B, C, D and E, which also inflame the liver, but each virus has
specific characteristics with signs and symptoms.
Hepatitis A specifically is an RNA virus that is related to poor sanitation and
is passed on by person to person. This is one of the most common forms of acute
viral Hepatitis in the world. In the United States, there are approximately 138,000
cases diagnosed each year. Ten years ago, there were less than 100 documented
deaths annually from Hepatitis A.
How does it occur? The Hepatitis A virus comes from infected
stool and is passed from human to human. The passage of the virus can occur due
to poor hand washing,
poor sanitation, food handled by an infected person, sewer contaminated water,
or eating shellfish caught in contaminated waters. Many unsuspecting Americans
have been infected from shellfish over the years.
What are the signs and symptoms? It may take from
four to six weeks after exposure for any symptoms to occur. Cases can be mild
with no change in health or obvious
symptoms. Other cases may be much more serious.
In general, flu-like symptoms may eventually develop. These symptoms are very
non-specific including loss of appetite, nausea, vomiting, fever, generalized
aches and fatigue. As the disease progresses, a patient may notice dark-colored
urine, which is secondary to an elevation in a liver and blood byproduct called
bilirubin.
Bilirubin is a dark pigmented chemical that contributes to jaundice. As Hepatitis
A progresses, a patient may develop a yellow color to the skin and whites of
the eyes. Jaundice is a marker for a serious medical condition and must be evaluated
by a health care provider immediately when it is detected.
How is Hepatitis A diagnosed? The diagnosis of Hepatitis
A is made through obtaining a thorough history of travel events and exposure,
especially in the two months
prior to the evaluation. A physical examination may reveal pain over the liver,
which is in the upper right quadrant of the abdomen. The skin will be checked
for jaundice and blood work will be obtained. The blood work may reveal an elevation
in the liver enzymes and specific antibodies can be checked for the presence
of Hepatitis A.
How is it treated? There is no specific treatment for Hepatitis
A. All treatment is generally supportive. Some patients may require hospitalization
for rehydration
and intravenous therapy. It is important to avoid any liver irritants such as
alcohol and acetaminophen (Tylenol) for six months. Foods should be high-protein
and in small amounts due to the presence of nausea. Keeping hydrated with fluids
is important.
What else can I do? Prevention is essential! Avoid close
contact with infected individuals and high-risk environments. Be sure to wash
your hands frequently.
Hepatitis A vaccinations are very effective. The immunization consists of two
shots, six months apart. The shots are recommended for traveling to under-developed
countries, homosexual males, illegal drug users injecting drugs, and for those
with chronic medical problems such as liver disease.
As always, if you have a concern about this medical condition, seek advice from
your health care provider. You may be able to prevent an avoidable illness, but
if infected, your chances of recovery are good.
