Hepatitis A (HA) contracted by an estimated 23,000 Americans each year, a highly contagious liver infection caused by the HA virus (HAV). Like other hepatitis viruses, HAV causes the liver to become inflamed, which affects its ability to function. This is significant because the liver performs dozens of essential tasks, detoxifying harmful substances, aiding in digestion and manufacturing vital nutrients.
Most people contract hepatitis A from contaminated food or water or from close contact with someone who’s already infected. You’re especially at risk if you’re an international traveler, particularly if you’re visiting a developing country, or if you’re a sexually active gay or bisexual man.
Fortunately, in most cases of hepatitis A, the liver heals completely without serious problems. Mild cases don’t require treatment, and most people who are infected recover completely with no permanent liver damage. Unlike hepatitis B and C virus, hepatitis A doesn’t develop into chronic hepatitis or cirrhosis, both potentially fatal conditions. In addition, effective vaccines are available for people who are most at risk.
Signs and Symptoms Hepatitis A
Some people may have hepatitis A and never develop symptoms. Young children, especially, tend to have mild cases, while symptoms in older children and adults are likely to be more severe. In general, you will have the virus for 2 to 3 weeks before developing any symptoms. When symptoms do appear, they often come on suddenly, and you may mistake them for intestinal flu. Common symptoms include:
- Nausea and vomiting.
- Abdominal pain or discomfort, especially in the area of your liver on the right side beneath your lower ribs.
- Loss of appetite.
- Low-grade fever.
- Yellowing of the skin and the whites of the eyes (jaundice). Not all people with hepatitis A develop jaundice. It occurs when your liver isn’t able to remove the residue of old red blood cells — known as bilirubin — from your blood. Eventually, the level of bilirubin builds up and is deposited in the skin, causing a yellow color.
- Muscle pain.
You’ll likely have more energy after symptoms disappear, and your liver may be completely healed within 1 or 2 months. About 15 percent of people with hepatitis A will have relapses over a 6- to 9-month period, however.
Causes of Hepatitis A
Your liver is located on the right side of your abdomen, just beneath your lower ribs. It performs more than 500 vital functions, including processing most of the nutrients absorbed from your intestine, removing drugs, alcohol and other harmful substances from your bloodstream and manufacturing bile — the greenish fluid stored in your gallbladder that helps digest fats. Your liver also produces cholesterol, blood-clotting factors and certain other proteins.
Because of the complexity of the liver and its exposure to so many potentially toxic substances, it would seem especially vulnerable to disease. But the liver has an amazing capacity for regeneration — it can heal itself by replacing or repairing injured cells. It is also constructed so that healthy cells will take over the function of damaged cells, either indefinitely or until the damage has been repaired. Yet in spite of this, your liver is prone to a number of diseases, including viral hepatitis.
Hepatitis A is one of six currently identified strains of viral hepatitis — the others are B, C, D, E and G. The strains differ in severity and in the way they’re spread.
Hepatitis A virus is usually transmitted via the “fecal-oral” route. That means someone with the virus handles food you eat without washing his or her hands after using the bathroom. You can also contract the virus by drinking contaminated water, eating raw shellfish from water polluted with sewage or being in close contact with a person who’s infected — even if that person has no symptoms. In fact, the disease is most contagious before symptoms ever appear.
Prevention of Hepatitis A
Hepatitis A is highly contagious. Preventing the spread of the virus involves protecting both yourself and others from infection.
Protecting yourself from Hepatitis A
The following measures can help protect you from HAV infection:
- Receive immune globulin or a hepatitis vaccine.The best way to protect yourself is to receive an injection of immune globulin — a preparation of antibodies — or a hepatitis vaccine. Immune globulin provides short-term protection, while a hepatitis vaccine may protect you for up to 20 years. The Food and Drug Administration (FDA) approved the first vaccines for hepatitis A in the mid-1990s. These vaccines — Havrix and Vaqta — contain inactivated forms of HAV and are safe for children over age 2 as well as for most adults, including those with compromised immune systems. At-risk children under 2 years of age should receive immune globulin. The vaccine causes only minor side effects, although allergic reactions can sometimes occur. Because it takes 4 weeks for the vaccine to take effect, get an immune globulin shot if you’re traveling to a high-risk region before you’re fully immunized. In addition, get a booster shot in 6 to 12 months.The FDA approved another hepatitis vaccine, Twinrix, in May 2001. Twinrix protects people 18 years of age and older against both HAV and the hepatitis B virus (HBV). Studies have shown Twinrix to be as effective as the separate HAV and HBV vaccines. The side effects are usually minor and include soreness at the injection site, headache and fatigue. These symptoms should disappear within 48 hours.If you’re at high risk of this disease and don’t have health insurance, talk to your state or county health department. In most areas, free or low-cost vaccines are available.Keep in mind that if you’ve already had H-A, you won’t need to be immunized because you’ve developed your own protective antibodies. These antibodies won’t protect you from other forms of hepatitis, however.
- Follow safety precautions for international travelers.
If you’re traveling in regions where h-A outbreaks occur, you can help prevent infection by peeling and washing all fresh fruits and vegetables yourself and by avoiding raw or undercooked meat and fish. Be sure to drink bottled water and avoid ice cubes in beverages. If bottled water isn’t available, boil tap water for at least 10 minutes before drinking. Don’t forget to use bottled water for tooth brushing and try not to sing in the shower!
- Follow good hygiene practices.
Simply washing your hands well and often can help protect you from infection with a number of viruses and bacteria. Wash after using the bathroom, before preparing food or eating, and after changing a child’s diaper. In addition, don’t share towels, eating utensils or toothbrushes.
Protecting others from Hepatitis A
If you have hepatitis A, the following measures can help prevent you from passing the virus to others:
- If you’re a gay or bisexual man, avoid sexual activity. Because HAV can be transmitted through oral-anal and digital-anal activity, using a condom won’t necessarily protect your partner.
- Wash your hands thoroughly after using the bathroom. Scrub vigorously for at least 10 seconds and rinse well. If possible, dry your hands with a disposable towel.
- Keep your utensils separate from those used by other members of your household. Wash utensils and dishes in a dishwasher or with plenty of hot, soapy water.
- Don’t prepare food for others while you’re actively infected.
Treatment for Hepatitis A
No specific treatment exists for hepatitis A. Instead, the main focus is on making sure you get adequate nutrition and avoiding any permanent liver damage. If you’re nauseated, eating small snacks throughout the day instead of three large meals may help. Soft, easily digested foods such as soup or broth, yogurt and toast may be the most appealing. You may also find you can tolerate food better in the morning than later in the day.
As soon as you’ve received a diagnosis of hepatitis A, talk to your doctor about any medications you take, including those you buy over-the-counter. Your doctor may recommend stopping or changing some of them. Also, avoid drinking alcohol during the acute phase of your illness. Even after you’ve recovered, don’t mix alcohol and acetaminophen (Tylenol, others), which can cause liver damage even in people who haven’t had hepatitis.
Complementary And Alternative Medicine
In Europe, the herb milk thistle ( Silybum marianum ) has been used for centuries to treat jaundice and other liver disorders such as HA. Today, scientific studies have confirmed that the chief constituent of milk thistle, silymarin, may aid in healing and rebuilding the liver while suffering from HA. Silymarin seems to stimulate the production of antioxidant enzymes that help the liver neutralize toxins. It also seems to increase the production of new liver cells and may even improve the severe scarring of cirrhosis. But although milk thistle can help the liver, it won’t cure hepatitis and it won’t protect you from contracting the virus.
Milk thistle is available in capsules or alcohol-free extracts. Check with your doctor before trying this or any other herb to make sure it won’t interact with other medications you’re taking for your treatment of HA.
Below is a link that provides documentation to what we believe to be a safe and effective alternative to protecting yourself from the Hepatitis A virus and an aid in healing and rebuilding the liver. Also provided are links to the top selling resource books when fighting the battle of Hepatitis A.
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