Hepatitis A
Hepatitis A is usually transmitted by drinking water or eating food that has been contaminated with fecal matter containing the virus. Thus, the risk of contracting hepatitis A generally depends on the hygenic and sanitary conditions in a given area. The Centers for Disease Control estimates that 150,000 people in the United States are infected each year by hepatitis A, a low rate compared to the underdeveloped countries. There are two approved vaccines available in the U.S. for protection against hepatitis A.
As is common with the other forms of viral hepatitis, the infected person may not have any symptoms. When they do occur, symptoms resembling the flu normally appear during the first four weeks of infection. These include fatigue, nausea, vomiting, pain in the liver area, dark urine or light colored stools and fever. Liver function tests are elevated, with many adults developing jaundice. Most people recover from the hepatitis A virus within six months without any serious health problems.
Fecal matter from an infected person has a high concentration of the virus. The virus can survive in fecal matter on a person's hand or other surfaces for three to four hours at normal room temperatures. Eating utensils are a frequent source of infection, as are contaminated shellfish and I.V. drug use. Intimate contact of any kind with an infected person can also transmit the virus.
A very small percentage of people, frequently those having pre-existing liver disorders, risk serious complications from hepatitis A. Federal mortality statistics for 1992 listed hepatitis A as the primary
cause of death for 82 people in the United States.
Hepatitis E
Hepatitis E, whose symptoms and methods of transmission resemble hepatitis A, is caused by a virus commonly found in the Indian Ocean region, Africa, and in underdeveloped countries. Testing for hepatitis E is being developed but is not yet available commercially. The symptoms of hepatitis E are like those of hepatitis A, although the period of illness may be as long as several months. Hepatitis E is rarely, if ever, responsible for causes of chronic hepatitis.
Adequate sanitation and good personal hygiene reduces the risk of hepatitis A and E. Water should be boiled prior to its use if any question of safety exists. Similarly, in areas where sanitation is questionable, food should be cooked well and fruits peeled. Those planning to travel to areas where hepatitis A or E is widespread are advised to take immune globulin before leaving.
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