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What is Hepatitis A and How Do You Get It?

San Diego County has declared a public health emergency in an effort to halt a Hepatitis A outbreak. This is a virus that can infect anyone, anywhere. What is it? How can you prevent its spread?

By
Sanaz Majd, MD,
September 21, 2017
Episode #248

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what is hepatitis A and how do you get it?

As of September 12, 2017 there have been 421 cases of Hepatitis A, along with 16 deaths, in San Diego County since early 2017. The county just recently declared a local public health emergency in an effort to help halt this Hepatitis A outbreak.

What is Hepatitis A? Are you at risk for contracting it? What can you do to prevent it?

What is Hepatitis A?

Hepatitis A is one of the three hepatitis viruses that attack the liver. “Hepa-“ refers to the liver and “-itis” reflects inflammation. Therefore, this is a virus that causes inflammation of the liver. You may have heard of the other two types, Hepatitis C and B, which can cause chronic inflammation of the liver. But Hepatitis A tends to cause an acute illness only, thankfully, and is typically transient.

It is spread from person-to-person only, via a fecal-oral route. Yep, that means through eating feces. Who in their right mind would eat feces, you may ask? Well, you may not be aware of it, but it can be ingested without your knowledge. That means an infected person preparing your food who uses the bathroom and doesn’t wash their hands can then pass on the virus to you as you ingest the prepared food. How many times have you used a public bathroom only to find that some people walk away without washing after toileting? Food handlers and contaminated water used to prepare food is the main way this virus is transmitted. In San Diego, no food or water source has yet been found for this outbreak as of this date.

Another form of transmission occurs through sexual contact with someone who is infected. Travelers, anyone living or working in a residential facility, the homeless, men who have sex with men, illicit drug users, health care workers, those with chronic Hepatitis B or C, and daycare employees are at higher risk.

The incubation period, the time from exposure until onset of symptoms, ranges anywhere from two weeks to two months for Hepatitis A. And unfortunately, infected people are contagious during this time period where the virus is brewing but symptoms have not yet developed. Patients often abruptly then experience the following:

  • Nausea/vomiting
  • Diminished appetite
  • Jaundice (yellowing of the skin)
  • Scleral Icterus (the yellowing of the white part of the eye, called the “sclera”)
  • Fever
  • Abdominal pain
  • Dark urine
  • Pale-colored stools
  • Enlarged liver on exam

Most symptoms resolve anywhere between three to six months.

Diagnosis of Hepatitis A

The symptoms are often enough to bring patients into the clinic or hospital. These patients may feel quite ill. A simple blood test is often diagnostic, however infected people will have elevated liver enzymes (from an inflamed liver) and that will prompt a Hepatitis panel testing that includes an antibody elevated during an acute infection (and may stay elevated for up to six months after the infection).

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