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You are here: Home » eGM Resources » Health News of the Day » Diseases & Conditions Facing the Survivors & Relief Efforts in Southeast Asia » Hepatitis Type A & Type E

Hepatitis Type A & Type E

Hepatits, Viral, Type A
Description: Hepatitis A is a viral infection of the liver caused by hepatitis A virus (HAV). The clinical manifestations of HAV infection range in clinical severity from no symptoms to a mild illness lasting 1–2 weeks to a severely disabling disease lasting several months. Clinical manifestations of hepatitis A often include fever, malaise, anorexia, nausea, and abdominal discomfort, followed within a few days by jaundice.

Occurence: HAV is shed in the feces of persons with HAV infection. Transmission can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested from sewage-contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling.

HAV infection is common (high or intermediate endemicity) throughout the developing world, where infections most frequently are acquired during early childhood and usually are asymptomatic or mild.

Risks for Travelers: The risk of acquiring HAV infection for U.S. residents traveling abroad varies with living conditions, length of stay, and the incidence of HAV infection in the area visited. Travelers to North America (except Mexico), Japan, Australia, New Zealand, and developed countries in Europe are at no greater risk for infection than in the United States. For travelers to low-income countries, risk for infection increases with duration of travel and is highest for those who live in or visit rural areas, trek in back country areas, or frequently eat or drink in settings of poor sanitation. Nevertheless, many cases of travel-related hepatitis A occur in travelers to developing countries with “standard” tourist itineraries, accommodations, and food consumption behaviors.

Clinical Presentation: The incubation period for hepatitis A averages 28 days (range 15 – 50 days). Hepatitis A typically has an abrupt onset of symptoms that can include fever, malaise, anorexia, nausea, abdominal discomfort, dark urine, and jaundice. The likelihood of having symptoms with HAV infection is related to the infected person's age. In children <6 years old, most (70%) infections are asymptomatic; if illness does occur it is not usually last <2 months. There is no chronic or long-term infection associated with hepatitis A, but 10% of infected persons will have prolonged or relapsing symptoms over a 6- to 9-month period. The overall case-fatality rate among cases reported to CDC is 0.3%; however, the rate is 1.8% among adults >50 years of age.

Prevention: Vaccine: Hepatitis A is one of the most common vaccine-preventable diseases in travelers. Hepatitis A vaccine, immune globulin (IG), or both, are recommended for all susceptible persons traveling to or working in countries with an intermediate or high endemicity of HAV infection.

Treatment:

No specific treatment is available for persons with hepatitis A. Treatment is supportive.
source: CDC Hepatitis Type A Health Information — Miriam Alter, Beth Bell, Anthony Fiore, Eric Mast, Linda Moyer

 

Hepatits, Viral, Type E
Description: Hepatitis E, which is caused by the hepatitis E virus (HEV), cannot be distinguished reliably from other forms of acute viral hepatitis except by specific serologic testing. Testing availability is limited.

Occurence: HEV, which is transmitted by the fecal-oral route, occurs both in epidemic and sporadic forms. Transmission is associated primarily with ingestion of feces-contaminated drinking water. The potential for HEV transmission from contaminated food is still under investigation, and there is no evidence of transmission by percutaneous or sexual exposures. Hepatitis E occurs primarily in adults. The highest rates of symptomatic disease (jaundice) have been in young to middle-aged adults. Lower disease rates in younger age groups may be the result of subclinical HEV infection. Chronic infection does not occur. Epidemics and sporadic cases of hepatitis E have been reported from areas of Asia (Afghanistan, Bangladesh, Burma [Myanmar], China, India, Indonesia, Kazakhstan, Kyrgyzstan, Malaysia, Mongolia, Nepal, Pakistan, Tajikistan, Turkmenistan, and Uzbekistan), Mexico, the Middle East, Northern Africa, and sub-Saharan Africa.

Clinical Presentation: The incubation period for hepatitis A averages 28 days (range 15 – 50 days). Hepatitis A typically has an abrupt onset of symptoms that can include fever, malaise, anorexia, nausea, abdominal discomfort, dark urine, and jaundice. The likelihood of having symptoms with HAV infection is related to the infected person's age. In children <6 years old, most (70%) infections are asymptomatic; if illness does occur it is not usually last <2 months. There is no chronic or long-term infection associated with hepatitis A, but 10% of infected persons will have prolonged or relapsing symptoms over a 6- to 9-month period. The overall case-fatality rate among cases reported to CDC is 0.3%; however, the rate is 1.8% among adults >50 years of age.

Prevention: Vaccines to prevent hepatitis E are under development, but none are currently available. IG prepared from plasma collected in HEV-endemic areas has not been effective in preventing clinical disease during HEV outbreaks. IG prepared from plasma collected from parts of the world where HEV is not an endemic disease is unlikely to be effective. The best prevention of infection is to avoid potentially contaminated water and food, using measures recommended to prevent hepatitis A and other enteric infections.

Treatment: No specific treatment is available for hepatitis E. Treatment is supportive.
source: CDC Hepatitis Type E Health Information
— Miriam Alter, Beth Bell, Anthony Fiore, Eric Mast, Linda Moyer





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