Hepatitis can be referred to as an inflammatory disease or conditions that affect mostly the liver. It is usually caused by a viral infection, yet there are other causes which may include autoimmune hepatitis and secondary hepatitis complications (this is usually caused by drugs, toxics and alcohol). Autoimmune hepatitis occurs as when diseases make the human body antibodies against liver tissues.

Infectious Hepatitis, unlike other viral hepatitis usually occurs through contamination of food, water or other edible things by the faeces of an infected person. This type of hepatitis is of two types i.e. Hepatitis A and Hepatitis E.

Hepatitis A is caused by an infection with the hepatitis A virus (HAV); and is commonly transmitted by consuming food or water contaminated by faeces from another person with hepatitis A. Hepatitis E on the other hand is a waterborne disease caused by the hepatitis E virus (HEV), and mostly found in geographical areas with poor sanitation (especially in the less developing world). Like Hepatitis A, it is transmitted in consuming contaminated water or food.

Hepatitis A

Hepatitis A is a highly contagious liver infection that is caused by the hepatitis A virus (HAV). It is one of the different types of hepatitis viruses that cause inflammation and thus affecting the liver from functioning appropriately. It is primarily spread when an uninfected and unvaccinated person consume food or water that had already been contaminated with the faeces of an infected person. This virus infectious disease is usually linked to unsafe water, food, poor hygiene and environmental sanitation, and the anal-oral sex among human being.

It can be mild or severe dependent on if the affected person has been vaccinated or not, or if there aren’t cases of other form of chronic diseases in the body. Whenever an individual has a mild case of hepatitis A, it usually don’t require any form of treatment; thus making it possible to recover completely from such diseases.

Hepatitis A, unlike other types of hepatitis such as B and C, doesn’t cause chronic liver disease and isn’t fatal, yet it can cause debilitating symptoms and acute liver failure. The best way to be protected against hepatitis A is the practice of good hygiene, including washing of hands frequently; and also getting vaccinated against hepatitis A.

Globally, hepatitis A usually occurs occasionally or in intervals and in epidemic, with the tendency of certain recurrences (especially in cases of foodborne infection). This can lead to significant socio-economic breakdown, causing people who have been infected to recover after several weeks or month to their various daily lives.

In 2016, the World Health Organisation (WHO) estimated that a total number of 7,134 persons died from the hepatitis A infection globally; thus accounting for only 0.5% of the mortality due to viral hepatitis.

Transmission of Hepatitis A

Hepatitis A virus is mainly transmitted through faeces, thus when an uninfected person digest or consume food or water that has been contaminated with the faeces of an infected person. Also, whenever an infected person prepares food with his/her dirty hands, there is a high chance of transmission to other persons who eats the food. Waterborne outbreaks, through infrequent, are usually associated with sewage-contaminated or inadequately treated water.

Also, the virus can also be transmitted through close physical contact i.e. sexually with an infected person (through oral-anal sex). Other form of casual physical contact among people does not spread the virus among individuals.

Geographical Distribution of Hepatitis A

According to World Health Organisation (WHO) data collection team, Hepatitis A geographical distribution areas can be characterized as having high, intermediate or low levels of hepatitis A virus infection. However, infection does not mean disease because children infected young do not experience any noticeable symptoms.

• Areas with High Levels of Infection

In low- and middle-income countries with poor sanitary conditions and hygienic practices, infection is common and most children (90%) have been infected with the hepatitis A virus before the age of 10 years, most often without symptoms. Epidemics are uncommon because older children and adults are generally immune. Symptomatic disease rates in these areas are low and outbreaks are rare.

• Areas with Low Levels of Infection

In high-income countries with good sanitary and hygienic conditions, infection rates are low. Disease may occur among adolescents and adults in high-risk groups, such as PWIDs, MSMs, people travelling to areas of high endemicity, and in isolated populations, such as closed religious groups.

• Areas with Intermediate Levels of Infection

In middle-income countries, and regions where sanitary conditions are variable, children often escape infection in early childhood and reach adulthood without immunity. Ironically, these improved economic and sanitary conditions may lead to accumulation of adults who have never been infected and who have no immunity. This higher susceptibility in older age groups may lead to higher disease rates and large outbreaks can occur in these communities.

Symptoms of Hepatitis A

Typically, whenever an individual is infected with the Hepatitis A disease, signs and symptoms don’t usually surface until some weeks after infection. Sometimes it can also be asymptomatic i.e. not showing any sign or symptoms in the human body.

Symptoms of Hepatitis A can grow from mild (i.e. it tends to go away after some weeks) to severe (severe illness that might last up to months), and they include:

• Fatigue
• Sudden nausea and vomiting
• Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs (by your liver)
• Clay-colored bowel movements
• Loss of appetite
• Low-grade fever
• Dark urine
• Joint pain
• Yellowing of the skin and the whites of your eyes (jaundice)
• Intense itching

Adults have signs and symptoms of illness more often than children. The severity of disease and fatal outcomes are higher in older age groups. Infected children under 6 years of age do not usually experience noticeable symptoms, ad only 10% develop jaundice. Among older children and adults, infection usually causes more severe symptoms, with jaundice occurring in more than 70% of cases; and sometimes cases of Hepatitis A may relapse.

Treatment and Prevention of Hepatitis A

Treatment of Hepatitis A

At the moment, there is no existing treatment for hepatitis A. The human body can clear the hepatitis A virus on its own, and keeping a healthy hygiene system helps. Also, the following could help:

• Rest: Whenever an individual is infected with the hepatitis A infection, there is a need to properly rest and save energy because there is always the feeling of being tired and sick, and thus losing energy.
• Nausea Management: Having nausea can cause a lot of difficulty like loss of appetite, drowsiness etc. Eating food with high calories, juice or milk is more advisable than water. Drinking plenty of fluids is important to prevent dehydration if vomiting occurs.
• Alcohol Intake: In case of hepatitis A, it is advisable to avoid all sort of alcohol intake as they tend to cause more liver damage.
• Avoid Sexual Activity: Persons with hepatitis A should avoid all sexual activity. Having sex during infection can spread the infection to one’s partner as condoms don’t offer adequate protection.
• Washing of Hands: Keeping safe hygiene like washing of hands after the use of toilet is quite important. Infection can easily be passed to others if food is prepared if hands are not properly washed.

Prevention of Hepatitis A

Hepatitis A can only be prevented through improved sanitation, food safety and immunization through the hepatitis A vaccine which is available globally. The vaccine helps to protect the human body from the virus and thus have no side effects. Spreading of hepatitis A can only be reduced by:

• Adequate supplies of safe drinking water
• Proper disposal of sewage within communities
• Personal hygienic practices such as regular hand – washing before meals and after using the toilets

[Next Article on Infectious Hepatitis: Hepatitis E]