World Hepatitis Day (WHD) is observed on the 28th of July every year and aims to raise awareness about hepatitis, as well as encourage prevention, diagnosis and treatment1.
In keeping with the aim of WHD to create awareness about hepatitis, we thought it would be appropriate to bring you some information about Hepatitis A in particular, which affects both children and adults2.
What is Hepatitis?
Hepatitis is most often caused by a viral infection that results in swelling and inflammation of the liver3. The 5 strains of Hepatitis are: A, B, C, D and E4.
Hepatitis A and E are usually caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of contact with infected body fluids4.
What is Hepatitis A?
Hepatitis A is the one of the oldest diseases known to humankind, and is a liver disease caused by the Hepatitis A virus2. The disease can be mild, but it can also be severe in some patients2. A proportion of patients may even come down with sudden liver failure and even death2.
Here are some key facts about the disease:
- There are around 1.4 million cases of diagnosed Hepatitis A every year, globally.
- The Hepatitis A virus is abundantly found in faeces2.
- Being very hardy, the Hepatitis A virus can survive in the environment for prolonged periods of time2.
- Heat and detergent may not be sufficient to destroy the virus2.
How contagious is Hepatitis A?
Hepatitis A is contagious and is most prevalent in areas with poor sanitation and hygiene2. The disease may be transmitted through2:
- Eating fruits, vegetables, or other foods that were contaminated during handling;
- Eating raw shellfish harvested from water contaminated with the virus;
- Consuming contaminated water or ice.
In addition to spreading through contaminated objects, food and water, Hepatitis A can also spread through direct contact with people2.
Since kids may not practice good hygiene, often touching their mouths with their fingers, they maybe unknowingly exposing themselves to this disease. As you can imagine, Hepatitis A can also spread easily from one family member to another2.
Fortunately, your child cannot get Hepatitis A from5:
- Being coughed or sneezed on by an infected person;
- Sitting next to an infected person;
- Breastmilk.
Common sites of Hepatitis A outbreaks
Outbreaks of Hepatitis A are most often found in countries or areas with poor sanitary conditions and low standards of hygiene2.
The Hepatitis A virus is also one of the most common causes of infections caused by contaminated food3. Outbreaks have been reported when people eat food contaminated with the virus, resulting in epidemics that can affect hundreds of thousands of people2.
In Singapore, while we may have high standards in health and hygiene, this does not mean we should be less vigilant about the disease and how it spreads.
Most of the reported Hepatitis A cases here had histories of consuming contaminated food from raw or partially cooked cockles (hum)7.
However, the spread of Hepatitis A is not just restricted to cockles. Cold cuts, sandwiches, fruits, milk, milk products, vegetables, and iced drinks have also been implicated in outbreaks6.
Signs and symptoms of Hepatitis A
The incubation period of the Hepatitis A virus is usually 14-28 days3. This means that symptoms may only start to show long after the virus have been contracted. Infected children under 6 years of age do not usually experience noticeable symptoms5.
Because hepatitis A can be a mild infection, especially in children, some people might not know that they’ve had it2. Adults and older children with Hepatitis A may have mild, flu-like symptoms5.
Hepatitis A does not cause chronic liver disease3. In milder cases, symptoms may be similar to a stomach virus (with vomiting and diarrhoea). The most common symptoms are3:
- Jaundice
- Fatigue
- Fever
- Loss of appetite
- Nausea and vomiting
- Pale coloured stools and dark urine
Treatment and Prevention of Hepatitis A
There is no specific medication for the Hepatitis A virus. Hepatitis A vaccination is the best protection against the disease7.
If your child gets Hepatitis A, try the following at home7:
- Ensure your child gets plenty of bed-rest.
- Make sure your child drinks plenty of fluids to avoid dehydration, especially if she is vomiting or has diarrhoea.
- Do not give any medications without consulting with your child’s doctor first.
- Ensure strict hygiene practices at home for all, such as washing hands after going to the toilet and before eating.
- Parents, don’t forget to wash your hands after changing your baby’s diaper.
Also, if you travel a lot to developing countries with your children and are not sure how clean the water is, ensure that:
- All drinking water is boiled and cooled.
- All fruits and vegetables are washed in clean boiled water
- Ice is made with boiled and cooled water.
- Use bottled water for drinking, making ice cubes, and washing fruits and vegetables when you are in a developing country .5
See a doctor right away if you or your child has symptoms of Hepatitis A. The doctor will discuss the best course of management of the disease with you.
Image is obtained from reference 8.
References:
1. World Health Organisation; World Hepatitis Day; Available from www.who.int/csr/disease/hepatitis/world_hepatitis_day/en/; last viewed 16/4/2014.
2. World Health Organization. WHO/CDS/CSR/EDC/2000.7: Hepatitis A.
3. World Health Organization; Hepatitis A Factsheet No 328; Available from www.who.int/mediacentre/factsheets/fs328/en/; last viewed 16/04/14.
4. Word Health Organisation; Hepatitis; Available from www.who.int/topics/hepatitis/en/; last viewed 16/4/14.
5. National Institute of Health; What I need to know about Hepatitis A; Available from digestive.niddk.nih.gov/ddiseases/pubs/hepa_ez/HepA_508.pdf.; last viewed 16/4/14.
6. FDA badbug book: Food borne Pathogenic Microorganisms and Natural Toxins Handbook: Hepatitis A virus; Available from: www.fda.gov/downloads/Food/FoodborneIllnessContaminants/UCM297627.pdf; last viewed 30/4/14.
7. Health Promotion Board; Hepatitis A; Available from www.hpb.gov.sg/HOPPortal/dandc-article/534; last viewed 02/05/14.
8. World Hepatitis Alliance; Posters; Available from www.worldhepatitisalliance.org/en/posters-990.html; last viewed 15/05/14.
SG/VAC/0002/14b Certified 14/07/14