Hepatitis A is relatively common because this liver infection affects everyone and can affect anyone. Travelers are especially at risk. You can be vaccinated against this contagious viral disease and you can try to avoid it by taking hygiene measures. Hepatitis A is manifested by jaundice and inflammation of the liver. It is treated in hospital infectious wards. Hepatitis A usually cures without problems if treated properly.
What is hepatitis A?
Hepatitis A, an inflammation of the liver, is a global and common contagious disease. Every year, millions of people worldwide contract this infectious viral liver inflammation. There are several ways to become infected with hepatits A. Normally, hepatitis A is curable and does not leave severe damage if treated in a timely and consistent manner. However, infection with hepatitis A is also preventable, namely through appropriate vaccination protection, which, however, is only paid for by health insurance companies in certain cases.
Causes
Hepatits A, like all viral hepatitis diseases, is caused by a virus from the Picornaviridae virus strain. Unlike hepatitis B and hepatitis C, which are also common viral diseases, hepatitis A is much easier to contract. Contaminated shellfish, smear infections, but also sexual contact are the main sources of infection in this type of jaundice. Infection can occur, for example, through the consumption of food, the use of contaminated water, as well as directly from person to person. Poor hygienic conditions play a major role in the transmission of the virus. Children and the elderly, as well as people with weakened immune systems, are particularly at risk. In many cases, however, the exact routes of transmission cannot be traced at all. Hepatitis A occurs more frequently in the southern hemisphere in particular, with some regions of Asia and Africa experiencing downright pandemics every year. This means that people fall ill in rows in entire regions. However, people in Central, Southern and Eastern Europe also fall ill with hepatitis A time and again. In the Scandinavian countries, this infectious disease also exists, but it is noticeably rare there.
Symptoms, complaints, and signs
Hepatitis A often progresses without symptoms, especially in children. In adults, symptoms may occur, initially manifested by nonspecific complaints in the initial phase. These include a slight rise in temperature, nausea, vomiting, loss of appetite, poor performance, and sometimes mild pressure pain in the right upper abdomen. After about two weeks, the symptoms of jaundice may appear. This involves yellowing of the skin and eyes. The stool discolors and becomes whitish to clay-colored. At the same time, the urine turns dark due to increased excretion of bilirubin. After a few weeks, the disease usually heals on its own. A chronic course has not yet been observed. In the majority of cases, the symptoms remain very mild. Asymptomatic courses occur not only in children, but less frequently also in adults. Two thirds of patients do not develop jaundice. This mainly affects children. The likelihood of jaundice increases with the age of the patient. In very rare cases, however, severe courses of the disease are possible. This is particularly the case with pre-damage to the liver or in severely immunocompromised individuals. In the case of a fulminant course of the disease, even deaths are possible. Extremely rare courses of the disease include potentially fatal agranulocytosis, which is characterized by acute decay of stem cells located in the bone marrow.
Course
Individuals infected with hepatitis A virus will usually become ill after ten days to eight weeks. Affected patients show symptoms such as vomiting, abdominal pain and fever. In most cases, they also develop jaundice. The eyeballs are discolored yellow, the stool is very pale and the patient’s urine is very dark. People infected with hepatitis A are treated in the hospital in the infection ward because they are contagious for up to two weeks in the acute stage.
Complications
Hepatitis A can have a harmless course.The disease spontaneously heals completely and the affected person then acquires immunity to the virus, so that he or she is no longer affected by hepatitis A. A chronic course of hepatitis A has not yet been observed. In the rarest, but also most severe cases, liver failure can occur due to hepatitis A. The liver is no longer able to function properly. As a result, the liver is no longer able to carry out the important biochemical processes, so that the body subsequently lacks many proteins and the detoxification function also fails. As a result, edema can develop and clotting can no longer function properly. The cell toxin ammonia, for example, can also pass into the brain, resulting in hepatic encephalopathy. Hepatitis A is also contagious. Travelers who have contracted the virus abroad can transmit it fecal-orally in their home country, leading to a local outbreak. Normally, in 90 percent of cases, the disease heals quickly; only in ten percent can the illness stretch to twelve months. The number of infections, as well as deaths, due to hepatitis A increases with age.
When should you go to the doctor?
Hepatitis A is a serious disease, which in the worst case can lead to the death of the affected person. For this reason, a doctor must be consulted immediately at the first signs of hepatitis A to avoid further complications. The disease is characterized by jaundice and severe fatigue. The fatigue and weakness cannot be counteracted by sleep. Furthermore, severe headaches and a loss of appetite also indicate hepatitis A and must be investigated. Pain is equally common in the abdomen and is usually accompanied by fever. The urine can become dark in color in hepatitis A. The doctor should already be consulted when jaundice occurs. Immediate treatment is necessary, especially after spending time in affected areas. Diagnosis and treatment can be done in a hospital or by a general practitioner. However, because the disease is contagious, affected individuals must always be admitted to an infectious disease ward.
Treatment and therapy
As with any liver disease, the patient with hepatitis A must maintain absolute bed rest or at least take it easy physically. The physician makes the final diagnosis based on blood tests that detect the virus. Depending on the level of the viral load, the clinical picture is more or less pronounced. In the blood, the physician detects elevated bilirubin levels in addition to other liver values. The blood cell sedimentation rate is also increased, indicating the inflammation of the liver cells. The patient is given strengthening infusions, depending on his general condition. After possible food deprivation, the patient is slowly built up on a liver diet. Hepatitis A becomes difficult to treat only in rare cases, for example, in the presence of another infection with hepatitis B or C. Here, additional and long-term treatment must be given, if necessary with a combination therapy of interferon and ribavirin.
Outlook and prognosis
Hepatitis A has a good prognosis. The disease heals completely if the patient receives medical care. Chronic disease progression can be ruled out in hepatitis A. The distinctive feature of the disease is a lifelong immunity to the pathogen. A recurrence or relapse of the disease is therefore impossible. The healing process usually lasts for several months. The patient should maintain strict bed rest for a good prognosis. Delays or complications occur if alcohol is consumed or harmful medications are taken. These can lead to destruction of liver tissue and cause dysfunction of the organ. In rare cases, hepatitis A disease requires liver transplantation. The mortality rate is low, at one to two percent of patients. With increasing age, the likelihood of fatal disease progression increases. In people over the age of 50, it is three percent. Without medical treatment and adherence to sparing, the risk of permanent liver damage increases. The patient’s condition worsens and a fatal outcome becomes more likely. Alternative cures are not recommended for hepatitis A.The virus is best controlled by administering medication and maintaining rest.
Prevention
Hepatitis A is preferably avoided by preventive vaccination. In this case, a combination agent against hepatitis A and B is usually administered. This vaccination must be given multiple times, as directed by the attending physician or vaccination center. When traveling to African, South American and Asian countries, it is recommended in any case, if there is nothing against it on the part of the doctor, to have these vaccinations performed. People suffering from chronic hepatitis C should also be vaccinated against hepatitis A and B as a preventive measure, if possible, in order to avoid complications. If no vaccination protection is available, at least the necessary caution should be exercised. This includes, above all, very careful hygiene and responsible handling of the food offered in exotic vacation countries. Raw food and shellfish should not be eaten at all, and fruit should only be eaten peeled. Drinks should only be consumed from unopened bottles, and ice cream and desserts should be avoided. Vaccination and hygiene thus largely protect against hepatitis A.
Follow-up
There is no specific treatment for hepatitis A. Recovery from symptoms after infection can be slow and may take several weeks or even a few months. The focus here is on avoiding unnecessary medications. Acetaminophen or acetaminophen, as well as other medications for vomiting, should not be given. Hospitalization is unnecessary if there is no acute liver failure. Therapy is aimed at maintaining well-being and adequate nutrient balance, including replacement of fluids lost through vomiting and diarrhea. Improved hygiene, food safety, and vaccination are the most effective means of controlling hepatitis A. The spread of hepatitis A can be contained through proper supply of clean or treated drinking water, lawful disposal of sewage in urban areas, and personal hygiene measures such as regular hand washing with clean water. Several injectable inactivated hepatitis A vaccines are available internationally. How work quite similarly in terms of how well they protect each individual from the virus and its accompanying symptoms. No vaccine is licensed for children under one year of age. The vaccine is administered by injection. An initial dose provides protection for one year beginning two to four weeks after vaccination; the second booster dose, given six to 12 months later, provides protection for more than 20 years.
Here’s what you can do yourself
If infection with hepatitis A has been diagnosed, rest and rest are the order of the day. Affected persons should pay attention to a healthy and balanced diet and avoid alcohol. Those who regularly take medications that stress the liver should change the medication in consultation with their doctor. The liver can also be relieved by avoiding very fatty foods and stimulants. Supportive measures from naturopathy and homeopathy are also available: Milk thistle to improve liver values, Shiatsu applications to promote relaxation or the ozone own blood treatment to eliminate toxins. Friends and relatives of patients should also be vaccinated against hepatitis A immediately. Comprehensive hygiene measures such as regular hand washing, cleanliness in food preparation, and separate towels and, if possible, separate toilets are also important. If the ill person requires assistance with personal hygiene, disposable gloves and disinfectant soap should be used. In any case, the sick person’s laundry should be washed hot and kept separate. The doctor in charge can provide further tips and assistance on how people in the affected person’s environment can protect themselves against infection with hepatitis A.