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Hepatitis A, B and C
Hepatitis A
What is Hepatitis A?
Hepatitis A is a viral liver disease caused by the Hepatitis A virus. Since 1990, Nebraska has averaged 165 people reported with Hepatitis A per year, ranging from 65 in 1995, to 263 in 1992.
How is Hepatitis A spread?
The virus enters through the mouth, multiplies in the body and is passed in the stool. If careful handwashing is not done, the virus can be carried on an infected person's hands and can be spread by direct contact, or by consuming food or drink handled by that person. Under normal circumstances, the Hepatitis A virus is not spread to classroom contacts or work associates.
What are the symptoms of Hepatitis A?
The symptoms and the severity of illness vary person to person. Symptoms can include fatigue, loss of appetite, fever, and vomiting. Urine may become dark and jaundice (yellowing of the skin and whites of the eyes) may appear. Most people recover within two to three weeks with no complications. The disease is rarely fatal (less than 1 per 1,000 infections). Infants and young children tend to have mild symptoms or no symptoms and are less likely to develop jaundice than older children and adults. Upon recovery, most affected people develop lifelong immunity to Hepatitis A.
What is the incubation period of Hepatitis A?
The time of exposure to the Hepatitis A virus, to the time of onset of symptoms ranges from 15 to 50 days. Most people will have onset of symptoms approximately one month (28-30 days) after exposure to the virus.
How long can an infected person spread the Hepatitis A virus?
The period that an infected person is contagious varies from person to person. In general, an infected person begins shedding the virus one week before onset of symptoms and continues to shed the virus up to three to four days after onset of jaundice.
Is there any treatment for Hepatitis A?
At this time, there is no medication effective against Hepatitis A. Generally, bed rest is all that is needed.
How can Hepatitis A be prevented?
The easiest method of prevention is good handwashing, especially after using the restroom and before preparing or eating food. A vaccine has been available since February 1995, but currently is not given as part of routine childhood immunizations. Household members and other close contacts can be given immune globulin (IG) which minimizes the chances of becoming ill. If given within 14 days of exposure, IG prevents clinical illness in 90% of recipients.
Hepatitis B
What is Hepatitis B?
Hepatitis B is a viral infection of the liver. About 35 people per year in Nebraska are reported as being ill with Hepatitis B. Your liver is essential to life and there are few effective treatments for life-threatening liver diseases except a liver transplant. Here's how your liver takes care of you:
- It stores your body's iron, vitamins, and minerals.
- It makes bile to digest your food.
- It detoxifies poisonous chemicals in drugs, alcohol, illegal substances, and aerosol sprays.
- It stores energy until you need it.
- It manufactures new proteins.
- It removes poisons from the air, exhaust, smoke and chemicals you breathe.
Who is at risk of Hepatitis B infection?
Anyone can get Hepatitis B, but those at greater risk include:
- I.V. drug users who share needles;
- health care workers who have contact with infected blood or body fluids;
- homosexual men, especially those with multiple partners;
- heterosexual men and women with multiple partners;
- people who are in centers for the developmentally disabled;
- hemodialysis patients; or
- household contacts of an infected person.
How do you catch it?
You can get the Hepatitis B virus if you're exposed to an infected person's blood through cuts or breaks in the skin or through the mucous membranes. If you have close personal contact where you share items such as razors, toothbrushes, or needles for piercing ears or making tattoos, you may become infected. You don't have to be sexually active or an I.V. drug user to get it. Hepatitis B is often called a sexual disease because sexual exposure is one of the primary ways of passing the virus from one person to another.
What are the symptoms of Hepatitis B?
The symptoms of Hepatitis B include loss of appetite, abdominal discomfort, nausea and vomiting, joint pain or rash. Some people develop jaundice (yellowing of the whites of the eyes and skin). Less than 10% of children and 30-50% of adults with Hepatitis B infection will have symptoms severe enough to seek medical help. The symptoms of Hepatitis B are indistinguishable from other types of Hepatitis (Hepatitis A, Hepatitis C, etc.).
About 90% of infants infected at birth, 25-50% of children infected at 1-5 years, and 10% of adults infected will develop a chronic infection. People with chronic Hepatitis B infection are at risk for developing cirrhosis of the liver and liver cancer.
The incubation period can be anywhere between 45-180 days, with an average incubation period of 60-90 days.
How long is an infected person contagious?
The virus can be shed from several weeks before onset of symptoms to several months after recovery. People with chronic infection have varying degrees of infectivity. People who are e antigen (HBeAg) are considered to be highly infectious, while those who are e antibody (anti-HBe) are sparingly infectious.
What precautions should people infected with Hepatitis B take?
People infected with Hepatitis B should follow standard hygienic practices to ensure that close contacts are not directly contaminated by his or her blood or other body fluids. These practices include not sharing razors, toothbrushes, needles, or any other object that may have become contaminated with blood. Use of latex condoms may reduce transmission during sexual activity. Susceptible household contacts, particularly sexual partners, should be immunized with the Hepatitis B vaccine. Infected people should not donate blood.
How can Hepatitis B infection be prevented?
Infection with Hepatitis B can be prevented either before or after exposure to the virus. To prevent disease before exposure, the Hepatitis B vaccine is recommended for all infants and for people in high risk groups. Hepatitis B is the only sexually transmitted disease that is vaccine preventable. The vaccine is safe and effective. You only need a series of three (3) shots over a period of six (6) months.
To prevent disease after exposure, Hepatitis B immune globulin (HBIG) is given along with the vaccine. Because infants whose mothers are infected with Hepatitis B are exposed during childbirth, all pregnant women should be screened for Hepatitis B. Infants of infectious mothers should receive HBIG and Hepatitis B vaccine within 12 hours of birth.
Is there a treatment for Hepatitis B?
Currently, there is no treatment for acute Hepatitis B infection. Alpha interferon and lamivudine (3TC) are licensed for the treatment of chronic hepatitis B infections. Other medications are under study and may be approved in the future.
Hepatitis C
What is Hepatitis C?
Hepatitis C is a viral infection of the liver. There other types of viral hepatitis including Hepatitis A (formerly called infectious hepatitis), Hepatitis B (formerly called serum hepatitis), Hepatitis D, and Hepatitis E. Hepatitis A, Hepatitis B, and Hepatitis C are the most common forms found in the U.S.
Who is at risk for getting Hepatitis C?
People who received a blood transfusion or blood product prior to 1990 and I.V. drug users who use shared needles are at greatest risk of contracting Hepatitis C.
How is Hepatitis C transmitted?
Hepatitis C is transmitted by exposure to blood from an infected individual. Donated blood has been screened for antibodies to Hepatitis C since 1990. Transfusion now accounts for less than 5% of acute Hepatitis C infection. The risk of transmission by household contact and sexual contact has not been well defined, but the efficiency of these risk factors appears to be low. Transmission from mother to child also appears to be uncommon.
What are the symptoms of Hepatitis C?
Some individuals experience appetite loss, fatigue, nausea and vomiting, vague stomach pain, and jaundice (yellowing of the skin and the whites of the eyes). Most people infected with Hepatitis C do not show any symptoms.
How soon do symptoms appear?
Symptoms may appear from two weeks to six months after exposure, but usually within six to nine weeks.
When is a person at risk of transmitting Hepatitis C?
People are at risk of transmitting from one or more weeks before onset of symptoms. However, since the majority of people infected with Hepatitis C do not have symptoms, the period of communicability is indeterminate. People remain contagious as long as they carry the virus.
Is there a test for this virus?
A specific serologic screening test for the Hepatitis C carrier state has been developed. Some people may not test positive until six to nine months after illness. Tests are not yet available to distinguish from acute illness and chronic infection.
What is the treatment of Hepatitis C?
Currently, there is no post-exposure treatment that will prevent infection, nor is there treatment for acute Hepatitis C infection. For people with chronic Hepatitis C infection, interferon alpha therapy has been beneficial in about 25% of patients. Interferon and ribavirin combination therapy is also an approved treatment. The combination therapy improves the sustained response. Both medications have significant side effects that require monitoring. Other medications and combination therapies are under study and may be approved in the future.
How can the spread of Hepatitis C be prevented?
People with Hepatitis C should be aware that their blood and possibly other body fluids are potentially infective. Sharing toothbrushes, razors, needles, or other objects that may become contaminated with blood should not be shared with other people. Also, they should not donate blood and should inform their dental and medical providers so that proper precautions can be followed.
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