In the United States, the Centers for Disease Control (CDC) estimates 125,00-200,000 total infections with 84,000-134,000 being symptomatic and 100 attributed death to hepatitis A each year.

TESTING:

The earlier you are diagnosed and begin to treat hepatitis, the more likely you are to prevent complications from the disease, minimize potential damage to your body, and avoid spreading the disease to others. If you think you may have been recently exposed to hepatitis, have symptoms (yellow eyes, dark urine, stomach ache, fatigue, loss of appetite, nausea, vomiting, fever) or suspect that you might have had hepatitis at some point in your past, it's a good idea to get tested.

A blood tests screens for specific antibodies. Your doctor can determine exactly what type of hepatitis you have as well.

Who should be tested?

The following persons are at risk for hepatitis A:

• Persons who share a household or have sex contact with someone who has HAV;
• Travelers to countries where Hepatitis A is common and where clean water and proper sewage disposal are not available;
• Men who have sex with men;
• Persons who use street drugs;
• Children and employees in child care centers (especially centers that have children in diapers) where a child or an employee has HAV;
• Residents and staff of institutions for developmentally disabled persons when a resident or an employee has HAV;
• Workers who handle HAV-infected animals or work with HAV in a research laboratory setting. (This does not include laboratories doing routine testing); and
• Persons with clotting factor disorders who receive factor concentrates.

Three of every four adults who get HAV have symptoms that usually develop over a period of several days. Children who are infected often have no symptoms. If you have symptoms your eyes may turn yellow and you may have dark urine; you may be tired; you may lose your appetite; you may have nausea, vomiting, fever, or stomach ache. If you have any of these symptoms, contact your health care provider for a test.

Where to go for testing?

Hepatitis tests are available at most doctor's offices, Planned Parenthood, medical clinics and at some public-health clinics.

More Information on Testing:

• National Guidelines for the Management of the Viral Hepatitises A,B, and C.

PREVENTION/IMMUNIZATION

A person can spread HAV about one week before symptoms appear and during the first week of symptoms. Persons with no symptoms can still spread the virus. This often happens with young children who unknowingly spread HAV to older children and adults. There is no chronic carrier state with Hepatitis A. Having had the disease produces lifelong immunity from future HAV infection.

In addition to immunization, HAV can be prevented by

• Always washing hands after using the bathroom, changing a diaper, and before eating or preparing food.
• Avoid eating raw shellfish harvested from sewage-contaminated water;
• Avoid eating fruits, vegetables, or other food that may have become contaminated during handling; and
• Practicing safe food handling.

HAV is killed by boiling at 85 degrees C (185 degrees F) for 1 minute. However, the disease can still be spread by cooked foods if they are contaminated after cooking. Adequate chlorination of water, as recommended in the United States, kills HAV.

Immunization information

Hepatitis A vaccines provide long-term protection against Hepatitis A and are licensed for use in persons 2 years of age and older. Children and adults need two shots of Hepatitis A vaccine for long-term protection. Your doctor or nurse will tell you when to return for the second shot.

Immune globulin, a preparation of antibodies, is recommended for short-term protection against Hepatitis A and for persons who have already been exposed to HAV. Immune globulin must be given within two weeks of exposure to HAV for maximum protection. As immune globulin is in short supply, vaccine is preferred for travelers 2 years of age and older.

The following should receive immunization for HAV:

• Persons who work in or travel to areas where Hepatitis A is common (first dose should be given at least 4 weeks before travel;
• Children in communities with high rates of Hepatitis A, such as Alaska Native villages, American Indian reservations, and Pacific Islander and selected religious communities.
• Men who have sex with men
• Persons who use street drugs
• Persons with chronic liver disease, including HBV and HCV
• Persons with clotting factor disorders, such as hemophilia
• Persons who work with HAV-infected animals or work with HAV in a research setting (Hepatitis A vaccine is not generally recommended for health care workers).
• Persons with HIV

For more information

Centers for Disease Control and Prevention's guidelines for Hepatitis A Vaccination

TREATMENT:

National Guidelines for the Management of the Viral Hepatitises A,B, and C