HEPATITIS A VIRUS

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What Is It?

Hepatitis A (also known as Infectious Hepatitis) is a disease that affects the liver. Hepatitis describes a group of diseases that cause inflammation of the liver. Inflammation occurs when tissues of the body become injured or infected, which can cause problems with organ function.

Hepatitis A is the most common type of viral hepatitis, usually seen among children or young adults. It can be a problem for fire fighters, especially if their meals are prepared by an infected person or they are infected by contaminated materials at a fire, hazardous materials incident, USAR, or SCUBA.

Hepatitis A is caused by the Hepatitis A Virus (HAV), one member of a group of viruses that cause this kind of disease. Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are other important members of this virus family.

How Can You Get It?

Hepatitis A is transmitted person-to-person via the fecal-oral route (through contact with small amounts of an infected person’s stool, usually due to inadequate hand-washing).

You can get HAV by:

  • Eating contaminated food (prepared by someone who is infected with HAV that did not wash their hands after using the bathroom)
  • Drinking unclean water or washing food in untreated water
  • By coming into contact with items and surfaces contaminated with HAV
  • Through openings in the skin such as cuts or abrasions. These opening can be visible or so small that they aren’t visible to the naked eye.
  • Through close personal contact (such as living in a home with someone who has this disease) or sexual contact, especially among men who have sex with men
  • Bloodborne transmission of hepatitis A is rare
  • Salive transmission has not been demonstrated

Firefighters are at risk of being exposed to HAV. Some specific jobs (ex. HazMat, USAR, SCUBA) place firefighters at greater risk of coming into contact with contaminated water. First responder duties, especially disaster response, also increase the chance that a firefighter will come into contact with contaminated water.

What Are The Symptoms?

While adults become infected with HAV less often than children, adults are much more likely to suffer health problems related to HAV. Children under 6 often have no symptoms and can be a silent source of infection spread. More than 80% of adults will have some symptoms of HAV infection. The signs and symptoms of Hepatitis A may include:
  • jaundice
  • fatigue
  • abdominal pain, loss of appetite, nausea, vomiting, diarrhea
  • dark yellow urine
  • fever

It takes about 15-50 days to develop symptoms of hepatitis A after exposure. Symptoms typically last two weeks or longer. Most patients recover on their own, but there average time lost from work is five weeks. Some of those that are infected may have relapsing symptoms over a six to nine month period. One in five infected adults gets sick enough to be hospitalized. Unlike Hepatitis B (HBV) or Hepatitis C (HCV), HAV does not usually cause long term health problems such as chronic infection or chronic liver disease.

How Do You Prevent It?

Hepatitis A is a vaccine preventable disease. The HAV vaccine has been available since 1995 and is recommended for certain high risk line jobs in NFPA 1581, Fire Department Infection Control Programs. The HAV vaccine can prevent disease two ways, either given before exposure or within 2 weeks after known exposure. Hepatitis A vaccine is given with 2 injections, six months apart. A combined Hepatitis A and Hepatitis B vaccine is also available and requires a series of three injections, given with 0, 1, and 6 month intervals.

Anyone exposed to hepatitis A that has not previously vaccinated can receive a shot of immune globulin (IG) to prevent infection. Post exposure IG provides less than two months protection. For adults younger than 40, post-exposure HAV vaccination is generally a better option because it can provide long term protection in those not previously vaccinated. After age 40, the CDC recommends immune globulin therapy for HAV.

You can help prevent the spread of HAV by:

  • Getting vaccinated if you are in a high risk job (ex. HazMat, USAR, SCUBA)
  • Using Universal Precautions
    • Hand hygiene (wash with soap and water or using an alcohol based hand rub)
    • Personal protective equipment (PPE) (gloves, gowns, masks and goggles that offer mouth, nose and eye protection)
    • Proper handling and disposal of instruments/devices and clothing contaminated with blood or body fluids
  • Make sure all your children are vaccinated for HAV (age 12 months and older)

What Should You Do If You Are Exposed To The Disease Or Get The Disease?

You should see a doctor or health care professional immediately if you think you may have been exposed to Hepatitis A Virus. The healthcare provider may offer you Hepatitis A vaccine or immune globulin therapy.

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