What is Hepatitis A and How Do You Get It?
San Diego County has declared a public health emergency in an effort to halt a Hepatitis A outbreak. This is a virus that can infect anyone, anywhere. What is it? How can you prevent its spread?
Sanaz Majd, MD
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What is Hepatitis A and How Do You Get It?
As of September 12, 2017 there have been 421 cases of Hepatitis A, along with 16 deaths, in San Diego County since early 2017. The county just recently declared a local public health emergency in an effort to help halt this Hepatitis A outbreak.
What is Hepatitis A? Are you at risk for contracting it? What can you do to prevent it?
What is Hepatitis A?
Hepatitis A is one of the three hepatitis viruses that attack the liver. “Hepa-“ refers to the liver and “-itis” reflects inflammation. Therefore, this is a virus that causes inflammation of the liver. You may have heard of the other two types, Hepatitis C and B, which can cause chronic inflammation of the liver. But Hepatitis A tends to cause an acute illness only, thankfully, and is typically transient.
It is spread from person-to-person only, via a fecal-oral route. Yep, that means through eating feces. Who in their right mind would eat feces, you may ask? Well, you may not be aware of it, but it can be ingested without your knowledge. That means an infected person preparing your food who uses the bathroom and doesn’t wash their hands can then pass on the virus to you as you ingest the prepared food. How many times have you used a public bathroom only to find that some people walk away without washing after toileting? Food handlers and contaminated water used to prepare food is the main way this virus is transmitted. In San Diego, no food or water source has yet been found for this outbreak as of this date.
Another form of transmission occurs through sexual contact with someone who is infected. Travelers, anyone living or working in a residential facility, the homeless, men who have sex with men, illicit drug users, health care workers, those with chronic Hepatitis B or C, and daycare employees are at higher risk.
The incubation period, the time from exposure until onset of symptoms, ranges anywhere from two weeks to two months for Hepatitis A. And unfortunately, infected people are contagious during this time period where the virus is brewing but symptoms have not yet developed. Patients often abruptly then experience the following:
- Nausea/vomiting
- Diminished appetite
- Jaundice (yellowing of the skin)
- Scleral Icterus (the yellowing of the white part of the eye, called the “sclera”)
- Fever
- Abdominal pain
- Dark urine
- Pale-colored stools
- Enlarged liver on exam
Most symptoms resolve anywhere between three to six months.
Diagnosis of Hepatitis A
The symptoms are often enough to bring patients into the clinic or hospital. These patients may feel quite ill. A simple blood test is often diagnostic, however infected people will have elevated liver enzymes (from an inflamed liver) and that will prompt a Hepatitis panel testing that includes an antibody elevated during an acute infection (and may stay elevated for up to six months after the infection).
Treatment of Hepatitis A
Unfortunately, a cure for Hep A doesn’t currently exist. Just like some other viruses, such as the common cold or flu, once infected with Hepatitis A it needs to simply play out its course. The treatment is really supportive, which means that you can treat the symptoms in order to make the patients feel as comfortable as possible, prevent dehydration, rest, etc.
If it’s transient and self-resolving, then why is there such a commotion over this outbreak? Well, there’s a risk of liver failure and even death with Hep A, although rare and in < 1%. And it is more risky in those with other liver disease like Hepatitis B or C.
Prevention of Hepatitis A
The best way to treat Hepatitis A is to really prevent it in the first place
The best way to treat Hepatitis A is to really prevent it in the first place—something I’ve emphasized with numerous other preventable illnesses. Fortunately, there’s a vaccine for Hepatitis A. Kids receive this series through their scheduled immunizations, starting at age 1. And adults who have never been vaccinated can ask their doctor to get immunized. It’s a series of two shots, six months apart.
High risk groups mentioned previously should highly consider vaccination.
Hepatitis A: Prevention Tips
- Wash your hands with soap and water for at least 20 seconds, especially if you are a food handler. Wash after using the bathroom, before preparing food, after changing a diaper, taking out the trash, etc.
- Wash your fruits and vegetables thoroughly.
- Thoroughly cook any animal products.
- Check out the USDA’s website for food handling guidelines, including a useful food storage chart with instructions on how long to keep various types of foods refrigerated.
The good news is, however, that once you’ve been infected, you’re immune to it for a lifetime—that means if you become exposed to Hepatitis A once more in the future, your immune system will attack it and destroy it before any symptoms develop.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Hep A Image © Shutterstock
