FINAL Hepatitis A Flashcards
How is Hep A transmitted?
Typically through fecal-oral route from contact with infected feves, either directly or indirectly (Contaminated food and water). It can also be through infected blood or blood products has also been reported.
When does the infectious period start?
The infectious period typically starts 2 weeks before the onset of symptoms until 1 week after onset of jaundice. The virus may also remain infectious for several weeks in the environment.
What is the clinical presentation?
- Fever, fatigue, myalgia, arthralgia, loss of appetite, right upper quandrant pain, jaundice, dark urine, lab finding - elevation of serum transaminase with alanine (ALT) >aspartate transaminase (AST), total and direct bilirubin and ALP
what is the concern with hepatitis A and young children?
Most children <6 years old who are infected with Hep A are asymptomatic but remain an important source of infection for others.
How is Hepatitis A managed?
NSAIDS for pain and fever, Unless there is presence of acute filminant hepatic failure.
How long do symptoms last after a Hep A infection?
They appear after an incubation period of 28 days, and last 1 to 2 weeks and do not lead to chronic infection.
How long does it take to recover from infection?
Recovery from the infection may take months and 25% of adult cases may require hospitalization.
How is Hepatitis A diagnosis made?
Diagnosis of hepatitis A is made by detection of serum antibodies. Presence of immunoglobulin M (IgM) represents acute infection with sensitivity and specificity >95%. It is also present when patients recently received hepatitis A vaccine. Total anti-HAV (IgM and IgG) remains positive after an infection or vaccination and this indicates immunity.
What are non pharm and pharm ways of preventing Hep A?
Practice good hand hygiene
Avoid drinking water from an unsafe supply or eating raw fruit or vegetables when travelling in HA-endemic countries (see map below)
Cook food to a safe internal temperature
Vaccine (protective concentration of Hep A antibodies will likely persist for at least 20 years or possibly for life after 2 doses)
How effective is pre-exposure prophylaxis?
Pre-exposure immunization is at least 90 – 97% effective and recommended for individuals 6 months of age and older at increased risk of infection:
Travellers to HAV-endemic countries
Individuals with chronic liver disease or clotting disorders
Men who have sex with men (MSM)
Injectable and non-injectable illicit drug users
Living in communities with hepatitis A outbreaks
Household or close contacts of children adopted from HAV-endemic countries
Military personnel and humanitarian relief workers
Workers involved in research that may have exposure of hepatitis A virus
Zoo-keepers, veterinarians and researchers who handle non-human primates
How and when is post-exposure prophylaxis for Hep A done?
Post-exposure prophylaxis may consist of administration of HAV vaccine +/- immune globulin for those at high risk. Protective efficacy of vaccine used within 1 week of exposure is approximately 80%. Consider the following to receive post-exposure prophylaxis:
Household and close contacts of people infected with HAV
Contacts in group child care centres and kindergartens
Co-workers and clients of infected food handlers
