Hepatitis A is a nonenveloped RNA
virus that classified as a picornavirus. The virus is transmitted person to
person through fecal oral or through ingestion of contaminated water. HAV is able
to survive in the environment for long periods of times at low pH levels. HAV
is able to be transmitted uncooked food or improperly cooked food. People are
most infectious 1-2 weeks before the onset of symptoms such as jaundice or
elevation or liver enzymes. When the person is at their most infectious the
virus is at the highest concentration in the stool and blood. Infants and
children can shed the virus for up to 6 months after becoming infected (3).
Incubation is on average 28 days and
the infection can be asymptomatic or be sever lasting 1-2 weeks. People may
experience fever, malaise, anorexia,
nausea, and abdominal discomfort, followed by after few jaundice. If people
have prolonged infection then sever complication can happen such as fulminant
hepatitis, and liver failure; which is rare but more common in older adults and
people with underlying liver disease. Chronic infection does not occur (3).
(1).
There are
two whole virus hepatitis A vaccines called HAVRIX (GlaxoSmithKline) and VAQTA
(Merck). Both are available in pediatrics 12 months to 18 years old and adult
formulas for 19 years old and older. They are approved for a 2 dose schedule.
The second dose of VAQTA is given 6-18 moths while HAVRIX is given 6-12 months.
Both vaccines have shown to be effective in protecting against hepatitis A.
HAVRIX is 94% among 40,000 Thai children and VAQTA was shown to be 100%
effective among 1,000 New York children (2).
Since the
only host for this disease is human it can in fact be eradicated with successful
employment of widespread prevention strategies (4).
Resources:
- Baute, S. (n.d.). Health Department addresses Hepatitis A outbreak in Grayson County. Retrieved May 07, 2020, from https://www.wbko.com/content/news/Health-Department-addresses-Hepatitis-A-outbreak-in-Grayson-County-489808091.html
- Centers for Disease Control and Prevention. (2019, April 15). Pinkbook. Retrieved May 07, 2020, from https://www.cdc.gov/vaccines/pubs/pinkbook/hepa.html
- Centers for Disease Control and Prevention. (2019, July 1). Hepatitis A - Chapter 4 - 2020 Yellow Book. Retrieved May 07, 2020, from https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/hepatitis-a
- Chopra, S., & Lai, M. (2020, March 05). Hepatitis A virus infection: Treatment and prevention. Retrieved May 07, 2020, from https://www.uptodate.com/contents/hepatitis-a-virus-infection-treatment-and-prevention
