Symptoms

1. Intense weakness, fatigue

2. Jaundice (yellowing of the skin and eyes)

3. Nausea, Vomiting, Diarrhea

4. Feeling of heaviness in the right upper quadrant of the abdomen

5. Dark urine (like cognac)

6. Pale stool (like clay)

7. Loss of appetite

8. Fever

Acute hepatitis appears a few weeks to months after the virus of hepatitis has first entered a human body. There may be no symptoms at all, or the symptoms may be mild and non specific. Sometimes acute hepatitis is cleared without causing any permanent damage to the liver. Other types of the disease may remain for many years (chronic hepatitis) causing scar tissue in the liver (cirrhosis) and in more severe cases may lead to liver failure, cancer and death. Chronic hepatitis is caused by viruses of hepatitis B, C and D and is an important public health issue worldwide.

Transmission

The virus of hepatitis Α and hepatitis Ε is spread by:

  

• Consumption of food or water that is contaminated with the feces of a person infected with hepatitis A
• Close physical contact with a person infected with hepatitis A or through sexual (mouth-anus) contact
• Rarely through blood (sharing needles to inject drugs) during the initial phase of the disease

Hepatitis B virus is spread by:

• Having sexual intercourse with a person that is infected with the virus without using a condom
• Sharing syringes and needles or other sharp items
• From an infected mother to her baby during childbirth
• Sharing personal items (razors, toothbrush, nail clippers)
• Blood or blood product transfusions (extremely rare due to the systematic screening at Blood Donation stations)

Hepatitis C virus is spread by:

• Contaminated objects (e.g. sharing syringes to inject drugs, razors, toothbrush, needles)
• Blood or blood products' transfusion (extremely rare nowadays due to the systematic screening at Blood Donation Stations)
• Rarely through unprotected sexual intercourse with a person infected with the virus
• Rarely from an infected mother to her baby during childbirth

The virus of hepatitis D will remain in the body only if hepatitis B virus is also present, and is spread by:

• Contact with contaminated blood (use of intravenous drugs, blood transfusion)
• Through sexual intercourse
• From an infected mother to her baby during childbirth

Treatment

For the treatment of the disease, seek medical assistance. Special treatment with medication is required for a considerable percentage of patients with chronic hepatitis. Medicines for hepatitis should be prescribed only by specialized doctors, and only under medical supervision.

Prevention

Hepatitis Α and hepatitis E

• Wash your hands before preparation or consumption of food, and after using the restroom, after diaper change, or condom use
• If you are travelling to countries where hepatitis is common, drink only bottled water, do not use ice cubes and don't wash fruit and vegetables with tap water
• Avoid sharing food, beverages and cigarettes with others
• In case of natural disasters where water supplies and sewage systems may be disrupted, ask local authorities for assurance on the safety of drinking water
• Hepatitis A virus is inactivated instantly through boiling water and food, pasteurization and with the use of household chlorine bleach (for surfaces)

Hepatitis Β

• Vaccination is the most effective way of prevention
• In case you use intravenous drugs, do not share needles, syringes or other items and get immunized against hepatitis A and B
• Use a condom during sex
• Do not share razors, toothbrush, nail clippers etc.
• Consider the risks if you wish to get a tattoo or body piercing (make sure that all instruments are sterilized)
• If you are a health professional, get vaccinated against hepatitis B
• If exposure to the hepatitis B virus does occur, there is appropriate prophylactic treatment with the administration of immune gamma globulin in addition to the vaccine

If you are carrier of the hepatitis B virus:

• Do not become a blood or organ donor
• Do not share with anyone personal items which may be contaminated with blood (e.g. razors, toothbrush, nail clippers)
• Cover any open wound or injury and clean any blood spots on surfaces with household chlorine bleach
• Get vaccinated against hepatitis Α

If you are pregnant:

• Get tested for hepatitis B. Mothers with hepatitis B may transmit the disease to their children during childbirth

Hepatitis C

• If you are using intravenous drugs, do not share needles, syringes or other items
• Do not share any personal items that may be contaminated with blood with others (e.g. razors, toothbrush, nail clippers)
• Consider the risks when you want to have a tattoo or body piercing (see that the instruments used are sterilized)
• Use a condom during sexual contact

Hepatitis D

• Vaccination against hepatitis B is the only way of prevention
• Chronic carriers of hepatitis B are recommended to avoid habits with a high risk of infection with the hepatitis D virus (e.g. avoid intravenous drug use)

When to seek medical advice

If there are serious problems (persistent vomiting, yellowing of the skin, complications), hospital admission is necessary. If exposure to hepatitis virus is suspected, seek medical assistance immediately because therapy is available which is more effective during the first 48 hours.

Vaccines

Hepatitis Α

There is an effective and safe vaccine against hepatitis A. Two doses of the vaccine are required in a time period of 6 months to 1 year, providing long term protection (20 years). Protection is effective 4 weeks after the first dose of the vaccine, a fact which should be considered by travellers to countries where hepatitis A is common.

Vaccination against hepatitis A is recommended mainly for:

• Travellers to countries with high endemicity of hepatitis A
• All susceptible people coming into contact with acute hepatitis A patients
• Inmates and the staff of institutions for persons with special needs
• Intravenous drug users, homosexual men, patients with chronic liver disease
• Employees of laboratories handling materials that may potentially transmit the disease

Ηepatitis Β

A safe and effective vaccine is available against hepatitis B. It is administered in 3 doses intramuscularly (at 0, 1 and 6 months). The vaccination of infants and children nowadays is mandatory and is recommended for individuals at high risk such as:

• Employees of nursing institutions (doctors, nurses, laboratory staff, students of medical professions)
• Dentists and dental associates coming into direct contact with patients
• Personnel and inmates of institutions for the mentally retarded
• Personnel of Refugee and Immigrant Reception Centres, prisoners and personnel of prisons coming into close contact with individuals at high risk (e.g. users of intravenous drugs)
• Patients undergoing hemodialysis or having multiple transfusions
• Individuals coming into close contact (sexual or family) with carriers of the virus
• Homosexuals, prostitutes, users of intravenous drugs
• Persons with multiple sexual partners, in particular when having another sexually transmitted disease
• Travellers to countries where the disease is common
• Persons with chronic liver disease (with no hepatitis Β)
• Patients planned to have an organ or tissue transplantation

Ηepatitis C

There is no vaccine against hepatitis C.

Ηepatitis D

The vaccine against hepatitis B is also recommended against the hepatitis D virus because the virus of hepatitis D can only propagate in the presence of hepatitis B virus.

Ηepatitis Ε

There is no available vaccine against hepatitis E.

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References
keelpno
nhs
cdc