Hep A
What is it?
It is an acute infectious disease of the liver caused by the
hepatitis A virus (HAV), a RNA virus, usually spread by the fecal-oral route;
transmitted person-to-person by ingestion of contaminated food or water or
through direct contact with an infectious person.[1] HAV infection produces a
self-limited disease that does not result in chronic infection or chronic liver
disease.[1]
Transmission
The virus spreads by the fecal-oral
route and infections often occur in conditions of poor sanitation and
overcrowding. Hepatitis A can be transmitted by the parenteral
route but very rarely by blood and blood products.
More specifically:
- Travelers
to countries
with high or intermediate endemicity of HAV infection
- Men who
have sex with men
- Users of
injection and non-injection illegal drugs
- Persons
with clotting factor disorders
- Persons
working with nonhuman primates susceptible to HAV infection
Risk of contracting
For the US, Europe, and many other industrialized countries,
it is primarily contracted when travelling to areas of poor hygiene
standards.[1] 10–15% of patients might experience a relapse of symptoms during
the 6 months after acute illness. Acute liver failure from Hepatitis A is rare
(overall case-fatality rate: 0.5%). The risk for symptomatic infection is
directly related to age, with more than 80% of adults having symptoms
compatible with acute viral hepatitis and the majority of children having
either asymptomatic or unrecognized infection. Antibody produced in response to
HAV infection persists for life and confers protection against reinfection. The
disease can be prevented by vaccination, and hepatitis A vaccines have been
proven effective in controlling outbreaks worldwide.
Typical Symptoms
Hepatitis A infection causes no clinical signs and symptoms
in over 90% of infected children and since the infection confers lifelong
immunity.[1]
Worst Symptoms
Early symptoms of hepatitis A infection can be mistaken for influenza,
but some sufferers, especially children, exhibit no symptoms at all. Symptoms
typically appear 2 to 6 weeks (the incubation
period) after the initial infection.
Symptoms usually last less than 2 months, although some
people can be ill for as long as 6 months:[8]
- Fatigue
- Fever
- Nausea
- Appetite
loss
- Jaundice,
a yellowing of the skin or whites of the eyes due to hyperbillirubinemia
- Bile is removed
from blood stream and excreted in urine, giving it a dark amber colour
- Clay-colored
feces
- Abdominal
pain
- Dark Urine
- Joint pain
Vaccination
There are two types of vaccines: one containing inactivated
hepatitis A virus, and another containing a live but attenuated virus.[20]
Both provide active immunity against a future infection. The vaccine protects
against HAV in more than 95% of cases for longer than 25 years.[21]
In the USA the vaccine
was first phased in 1996 for children in high-risk areas, and in 1999 it was
spread to areas with elevating levels of infection.[22]
The vaccine is given by injection. An initial dose provides
protection starting two to four weeks after vaccination; the second booster
dose, given six to twelve months later, provides protection for over twenty
years.[22]
A recent review by an expert panel, which evaluated the projected
duration of immunity from vaccination, concluded that protective levels of
antibody to HAV could be present for at least 25 years in adults and at least
14–20 years in children.
Available for people 12 months and older.
Schedule:
2 shots: 0, 6-12 (or 18 depending on vaccine used) months
Treatment:
No specific treatment exists for hepatitis A. Your body will
clear the hepatitis A virus on its own. In most cases of hepatitis A, the liver
heals completely in a month or two with no lasting damage.
References:
Conclusion:
NO, I will not vaccinate for Hep A because I will not be
travelling to suspect countries anytime soon (I will re-evaluate if we do), so
risk of exposure is very low. If by chance I got the virus, I don’t think the effects
sound that bad and the body clears it up on its own.
