Everyone wants to be he althy. However, sadly, none of us can ever avoid disease. And a person who once proclaimed himself the "king of nature" becomes completely defenseless in front of the smallest living creatures on our planet - various bacteria and viruses.
One of their huge number, dangerous to humans, is the causative agent of such a disease as Hepatitis A. "What is this disease?" - you ask. In the common people, it is known as Botkin's disease, or jaundice. This article will focus on this disease, in particular, what the causative virus is, how you can get infected, what signs and symptoms should make you alert and see a doctor, and, most importantly, how to successfully deal with it.
General information about the disease. What is hepatitis A virus?
As already mentioned in the introduction, the causative agent of jaundice is an enterovirus, that is, a virus with an acid-resistant shell, notexposed to the destructive environment of the stomach. It is not difficult for him, for example, with unwashed vegetables, fruits or contaminated water, to pass through the protective acidic environment in the stomach and end up in the intestines, which causes the disease of the carrier of the virus. For those who have little idea (or none at all) about such a disease as hepatitis A, what it is and how it is transmitted, we inform you: this pathogen has a powerful immunity to the aquatic environment, which often provokes its transmission through the liquid. There is also good news: the virus has a very high immunogenicity, which contributes to the formation of stable lifelong immunity after an illness.
Prevalence
Statistics impartially says that, despite the fact that some do not even know what hepatitis A is, what kind of disease it is, it is the most common infection among those that pose a he alth hazard person. In countries with warm climates and poor sanitation, the incidence of type A hepatitis is very high. According to official data, in the Central Asian states, almost 100% of the child population is ill with this infection. In Eastern European countries, the rate of infection with jaundice is 1:400, that is, for example, 250 out of 100,000 people fall ill there every year.
Of course, everyone wants to avoid infection, especially hepatitis A. How is the virus that causes it transmitted? With a high degree of probability, you can get sick while relaxing in countries with a hot climate, including your favorite placesfor recreation and tourism. These are African countries, including Tunisia and Egypt, Asian states and islands, among which are Turkey and India, which are popular among Russians, as well as the countries of Southeast and Central Asia. There is a risk of infection when traveling to South American states located in the Caribbean.
Ways and mechanisms of infection and development
Oddly enough, even without leaving our homeland, you can easily catch hepatitis A. How is it transmitted in this case? Infectious agents can be on the surface of vegetables and fruits. Therefore, before eating them, be sure to thoroughly wash them under running water and dry them. This will give, albeit small, but a guarantee that you will not get sick by eating an apple or a tomato. If you have a weakness for seafood, then when buying them fresh or frozen, remember: before they get to your table, they must undergo heat treatment, which will kill all bacteria and viruses that are on their surface.
The main source of hepatitis A is a person who catches this virus and becomes ill with jaundice. Together with his feces, a huge amount of viruses is released into the environment, the number of which goes into the billions.
If a person does not follow generally accepted rules of hygiene, consumes contaminated water and food (especially thermally poorly processed seafood), the virus can enter the intestines, and after that, being absorbed into the bloodstream, it enters the liver and being introduced intohepatocytes are her cells.
Reproduction of virus particles occurs in the cytoplasm of liver cells, leaving which and entering the bile ducts, they, along with bile, enter the patient's intestines.
Inflammatory processes that have begun in the liver, leading to damage and even destruction of hepatocytes - its cells, are of an immunological nature. T-lymphocytes, cells of the human immune system, attack the liver cells that the virus has attacked by recognizing them. As a result, infected hepatocytes die, normal functioning of the liver is disturbed and hepatitis A develops. We have already discussed how this disease is transmitted.
Probability of infection
In developing countries, where the level of both economic and social development is low, jaundice is primarily a childhood infection. Most children in such countries have been ill with it by the age of 10 years and acquire a strong lifelong immunity to this disease.
According to epidemiological studies, the manifest forms in which jaundice, also known as hepatitis A, typically manifest symptoms, are now much less common. The course of infection in the so-called anicteric form, in which it is impossible to diagnose the disease, has become more common.
Inhabitants of developed countries call jaundice nothing but "dirty hands disease". The probability of infection is extremely small, which is facilitated by the high-quality work of housing and communal services and the high culture of the population. In this regard, the majority of the population does not have antibodies to this infection in the body, which makes the riskinfection is very high.
Even those who do not know about such a disease as hepatitis A, what it is and how it is transmitted, are not immune from infection if they go to rest and work in the warm countries of Africa and Asia, while not observing generally accepted hygiene rules.
If you want to find out the likelihood and degree of risk of getting sick, as well as decide on the introduction of a vaccine, you should donate blood for an analysis that detects antibodies to the hepatitis A virus - immunoglobulin G (anti - HAV IgG). If the result showed their presence in the biomaterial, then the person has immunity to the virus, the probability of infection is zero and vaccination is not required. If antibodies were not found, there is a risk of developing jaundice. To avoid this, you need to get vaccinated.
Who is at risk?
Epidemiologists identify several groups of people who are highly likely to be diagnosed with hepatitis A. What does it give? If you identify yourself with any of the following groups, we strongly recommend that you get tested for antibodies to the virus and, if necessary, get vaccinated. This list includes:
- household and family members of a person infected with hepatitis A virus;
- persons who had intimate relationships with patients;
- people (especially children) who live in areas where hepatitis A is widespread;
- persons who travel to high incidence countries;
- men who have homosexual intimate relationships.
When there is a sick person in the house. Answers to common questions
People who do not fully understand the specifics of an infection such as hepatitis A, what kind of disease it is and how it is transmitted, sometimes questions arise that require an answer within the framework of this article. These questions are especially acute when a family member develops jaundice.
First of all, most people are concerned about the question: is it possible not to get infected by contact with an infected person? Of course, yes, if you adhere to generally accepted hygiene rules. But it should be remembered that it is better to limit the contacts of children with the patient to a minimum, and ideally stop until complete recovery.
The second important question concerns the possibility of contracting jaundice without disease. In this case, a person will not get sick only if he has been vaccinated against hepatitis A and the level of antibodies in his blood is sufficient to fight the infection. If antibodies are not present in the blood, but the virus has already entered it, then the person will inevitably get sick.
In order to quickly protect against possible infection or prevent the development of the disease in case of infection, a person is injected with a special drug, immunoglobulin, shortly before a possible infection or within 14 days after it. Such a measure can be considered not only as one of the methods of treatment, but also as a prevention of hepatitis A. If you have already suffered from it, then the probability of re-transferring it is negligible.
As mentioned earlier, an analysis for the presence of immunoglobulin G (anti-HAV IgG) can detect antibodies in the blood. Themthe presence indicates infection or vaccination of a person. It is recommended that all members of the family where there is an infected person be examined for the presence of immunoglobulin in the blood, and vaccination if necessary.
And, of course, we should not forget about the basic rules of hygiene: wash your hands with soap and water after using the toilet, after taking care of small children, before preparing and eating food.
Consequences of infection and duration of illness
If the hepatitis A virus gets into the blood of a person who has not been vaccinated, he will inevitably get sick with jaundice. However, it is quite difficult to accurately determine the time of infection, unless it is an epidemic caused, for example, by an accident in sewer networks.
The incubation period lasts about a month from the moment of the alleged infection, after which hepatitis A begins to appear. Symptoms by which it can be recognized by the layman: fever, dyspepsia (disturbance of the normal functioning of the stomach), discoloration of the skin.
After the appearance of jaundice, the general condition and well-being of the patient improves. Within 3-6 weeks, and sometimes longer, it lasts, and after its disappearance, in most cases, a person recovers. The following photo is for those who have never come face to face with an infection like hepatitis A. What is it? The photo clearly shows what the skin of a sick person looks like in comparison with the skin of a person not infected with jaundice.
Many are concerned about the danger of the disease for certain individuals. Heavieronly children under 1 year of age, the elderly and adults carry hepatitis. In the latter, the infection is often accompanied by pronounced intoxication and jaundice, and its duration is on average about three months.
In most cases, a person is sick for a little more than a month - 40 days. But the duration of the disease depends on many factors: the age of the patient, the state of his immunity, concomitant chronic diseases (their presence or absence). A very important role is played by the strict implementation of the recommendations and prescriptions that will be given by the doctor. 15% of the general population has a chronic form of hepatitis, which can last from 6 to 9 months.
Possibility of death and self-treatment
An interesting question is about the possibility of death in case of illness. Many people think that this is impossible, thinking: “Lethal outcome and hepatitis A? What's this? Jaundice? What danger can she carry? Indeed, a fatal outcome in this disease is rare, but it is possible if the infection proceeds in a fulminant (fulminant) form. In this case, there is a rapid development of acute liver necrosis, which accompanies acute liver failure.
Statistics show that hepatitis A is fatal in 0.1% of the child population, 0.3% of deaths from infection in adolescents and adults under 40, and already 2.1% in those who is over 40.
Often, patients and their relatives ask about the possibility of the patient's self-recovery without treatment. In most cases, this is exactly what happens becausemodern treatments are not aimed at fighting the virus. It will not surprise people who know the specifics of an infection such as hepatitis A, what it is and how it is transmitted, a treatment aimed at removing harmful substances from the body that appear as a result of damage and disruption of the normal functioning of the liver. The fight against the infection itself in this case falls on the patient's immune system.
Signs and symptoms of the disease, the time of their appearance, tests
As mentioned above, the first signs by which one can suspect the presence of a virus in the human body appear after about 30 days, but this period can vary from 15 to 50 days.
The first signs that should alert you are a deterioration in general well-being, an increase in body temperature and significant changes in the color of urine. Sometimes, after going to the toilet, people do not understand what happened to its color, and are surprised, not yet suspecting that they have hepatitis A, what it is. The photo of urine color below is a vivid example of how it looks in a sick person. As you can see, it resembles strongly brewed black tea and foams a lot.
If you have these signs, you should immediately consult a specialist. Remember that only a qualified doctor can determine if a patient actually has hepatitis A. What is it? The symptoms in this case speak for themselves: fever, which is accompanied by dyspeptic syndrome (nausea, a feeling of heaviness in the right hypochondrium and stomach,vomiting), weakness, dark urine, which we talked about earlier, jaundice (yellowing of the sclera, skin, discoloration of feces). When the latter appears, there is a slight improvement in the general condition and well-being of the patient. Other acute hepatitis of any type manifests itself in a similar way.
To detect the hepatitis virus in the blood of a patient, a biomaterial is taken and checked, showing the presence of antibodies that belong to class M immunoglobulins (anti - HAV IgM). They can be detected only during a relapse (acute period during the course of the disease), with the improvement of the patient's condition, their content in the blood becomes lower.
Diagnosing process
The first step in this procedure is to find out the epidemiological history, which will either confirm or deny hepatitis A. What does this mean? The doctor finds out what places the person has visited recently, what food and water he has consumed, whether there have been contacts with a patient with jaundice.
After that, the doctor carefully examines the patient in daylight, noting:
- general he alth and condition of the patient, possible signs of intoxication;
- presence of digestive disorders - dyspepsia;
- presence of elevated body temperature – fever, sweat, chills;
- presence of jaundice of the skin, tongue, eyes.
This is exactly what the skin of a person diagnosed with hepatitis A looks like, as this photo below clearly demonstrates.
In addition to all of the above, the doctorthe state of all internal organs and systems of the patient is assessed in accordance with generally accepted diagnostic methods, both the color of the urine and the patient's feces are noted. Palpation (palpation) of the abdomen may reveal an enlarged liver.
After that, the results of the analyzes are studied, which include:
- CBC - complete blood count;
- BAC - biochemical blood test;
- kaogulogramma - a blood test for its coagulability;
- OAM - urinalysis.
If antibodies to hepatitis A (anti - HAV IgM) are detected in the blood, which is accompanied by pronounced changes in liver tests, then the diagnosis of hepatitis A is fully confirmed.
Treatment and prognosis after recovery
In the previous parts we talked about what hepatitis A is, what it is. How to treat it is the main question that worries everyone who has encountered it. If the disease proceeds in a mild and moderate form, then the body is able to independently cope with the infection that has got inside it. The main goal of treatment in this case is to reduce the concentration of toxins and provide liver cells with material for their recovery and energy. An important part of therapy is the introduction of detoxification solutions, glucose, vitamins and hepatoprotectors (drugs that protect liver cells). No antiviral treatment is given. If the disease is severe, then much attention is paid, along with detoxification, and symptomatic therapy.
The above methods arethe most modern today. Together, these two therapies help reduce intoxication that occurs as a result of liver damage, dilute the blood with toxins and remove harmful substances, and eliminate the symptoms of the disease. All this leads to an improvement in the general condition and well-being of the patient.
During a relapse, Pevzner's diet 5 should be followed. This is a large number of vegetables, fruits, cereals, lean meat, fish and cottage cheese, egg white, soy, apples, giving the body fiber, lipotropic substances, pectin. It also shows the consumption of large amounts of fluid and the observance of complete physical and mental rest.
Many parents do not know how to treat their child in case of infection, although they are well acquainted, and sometimes firsthand, with such a disease as hepatitis A, what it is and how it is transmitted. In children, as we said earlier, the disease can be more severe than in adults. And although the treatment tactics for a patient of any age is the same, it is strongly recommended to consult a local pediatrician who will examine the child and prescribe those drugs that will help to successfully fight the disease and will not cause even more harm to he alth.
After recovery, doctors usually give the most favorable prognosis, as the normal functioning of the liver is fully restored.
Protection against disease: vaccination and its effectiveness
Earlier we talked about a virus that causes a disease like hepatitis A, what kind of infection, howtransmitted and how to treat it. It's time to talk about how to prevent it.
Today, the most effective method of preventing infection is vaccination, and several fairly effective vaccines have been created that adequately protect against jaundice.
Such a vaccine is nothing but killed hepatitis viruses with high immunogenicity. It is administered twice, and the interval between the first and second vaccination is 6 to 12 months.
About 14 days after the first dose of the vaccine has been given, most people develop antibodies ready to fight the virus. This method is by far the most effective and, perhaps, the only prevention of hepatitis A.
The introduced vaccine stimulates the production of a large number of antibodies, which provides reliable protection against infection for both children and adults. The vaccine lasts between 6 and 10 years.
Who should get vaccinated?
The jaundice vaccine should be mandatory for people who have not previously had hepatitis A - both adults and children, as well as those who are at increased risk of infection.
Including:
- tourists and military personnel who travel to areas with a high incidence of hepatitis A;
- med. personnel working in infectious diseases departments;
- persons working in preschool institutions;
- Employees of catering and water facilities.
Regulatory documents provide for the vaccination of children livingin areas with a high incidence of disease. They begin to administer the vaccine, starting at the age of 3 years. Patients suffering from chronic liver diseases are also required to be vaccinated.
I would like to believe that all of the above will help those who have already had the misfortune to get sick, cope with the infection, and those who have not been affected by this attack yet, make the right decision and protect themselves from it in a timely manner. Stay he althy!
