Hepatitis A to Z: What We Need to Know
By Karen Sokal-Gutierrez, MD, MPH, James Bowman Associates, National Head Start Health Training Contract, San Francisco, CA
"The first we knew about it, it had already spread throughout our center. The children were only a little sick but the teachers and parents were really sick, and yellow for weeks. The Health Department said it was hepatitis A."--Head Start teacher
What is hepatitis?Hepatitis means inflammation of the liver. The liver does many different jobs to keep our bodies healthy and functioning. When the liver is "sick," it can cause jaundice (yellowing of the skin and whites of the eyes) abdominal pain, nausea, loss of appetite, low grade fever, and fatigue.
Some people with hepatitis have no obvious symptoms-this is especially true of young children. Some people are mildly to moderately ill; others are severely ill. Rarely, hepatitis causes liver failure and death.
What causes hepatitis?
Hepatitis has many different causes, including chemicals that can damage the liver (e.g., alcohol, some drugs and medications, and industrial chemicals), and infections of the liver (e.g., hepatitis A, B, and C viruses).
Many infections can cause hepatitis. Some of the hepatitis viruses have been named by letters of the alphabet- A, B, C, D, E-and more are continually being discovered. The different hepatitis viruses are actually different diseases that cause similar symptoms. Each has specific ways it spreads, a contagious period, a course of illness, treatment, and recommended measures to prevent its spread. The most common hepatitis viruses are A, B, and C.
How do the hepatitis viruses spread?
Hepatitis A spreads by "fecal-oral contact," which means that germs from the stool or feces of someone with the virus somehow find their way into someone else's mouth. This usually happens from poor hygiene during diapering, toileting, and food preparation, and not being diligent about hand washing.
Hepatitis B and C spread by blood borne and sexual contact. This can happen when blood, sexual fluids (semen and vaginal secretions), and saliva get into another person's body.
When is hepatitis contagious?
Hepatitis A is contagious in the two weeks before and until one week after the start of jaundice.
Hepatitis B and C are contagious from approximately one month before until one month after the start of jaundice. In addition, approximately 10% of people become "chronic carriers" of the virus and can remain contagious for life.
How can you tell if someone has hepatitis A, B, or C?
Many people have hepatitis with out obvious symptoms. If you see symptoms, however, see your health care provider immediately. A blood test can be done to make a diagnosis.
What is the treatment for viral hepatitis?
Most people with viral hepatitis get better without any special treatment other than rest, good nutrition, and plenty of fluids to drink. Rarely, for severe symptoms, hospitalization and special medications may be needed. If someone has been recently exposed to hepatitis but has not gotten sick yet, they may be given special vaccines to prevent the illness.
How can the spread of hepatitis be limited in Head Start and in the home?
· Become up-to-date on immunizations. (Hepatitis.B: All children now should receive 3 doses of hepatitis B vaccine as infants. Adults who are at risk for hepatitis B through blood or sexual contact should also get immunized.
Hepatitis A: A new vaccine has been developed which might be widely available in the near future.) Follow universal infection control precautions at all times with all people, whether they look sick or not. These measures can reduce the spread of hepatitis as well as many other diseases.
Through cooperation among Head Start staff, parents, children, and health professionals, the spread of hepatitis can be prevented and, as a result, communities can be healthier.
- Report cases of hepatitis to the public health department.
- Wash hands after diapering/toileting and before handling food.
- Use latex/vinyl gloves for contact with blood. Wash hands afterwards.
- If an exposure of blood occurs on broken skin, mouth, or eyes, wash the site well and report the incident promptly to a supervisor.
- Clean and disinfect spills of blood, diapering/toileting areas, mouthed toys, eating utensils, dining tables, and sinks.
- Dispose of dirty diapers and items contaminated with blood in a plastic-lined, covered trash can.
- Observe other hygiene measures, such as:
- Discouraging children from biting.
- Using sprinklers instead of wading pools.
- Using individual water basins instead of water play tables.
- Avoiding drinking water which could be contaminated.
- Not sharing toothbrushes, razors, or injection equipment.
- Encouraging safe sex practices