Everyone wants to be healthy. However, sadly, none of us can ever avoid illness. And the man who once proclaimed himself the “king of nature” becomes completely defenseless against the smallest living creatures on our planet - various bacteria and viruses.
One of their many, dangerous to humans, is the causative agent of a disease such as Hepatitis A. "What is this disease?" - you ask. In common people, it is known as Botkin's disease, or jaundice. This article will discuss this disease, in particular, what the pathogen virus looks like, how you can get infected, what signs and symptoms should make you alert and consult a doctor, and, most important, how to deal with it successfully.
General information about the disease. What is hepatitis A virus?
As mentioned in the introduction, the causative agent of jaundice is enterovirus, that is, a virus with an acid-resistant membrane that is not exposed to the destructive environment of the stomach. He does not have any difficulty together, for example, with unwashed vegetables, fruits or contaminated water, to pass the protective acidic environment located in the stomach and end up in the intestines, which causes the disease of the carrier of the virus. For those who have a weak idea (or none at all) about a disease such as hepatitis A, what it is and how it is transmitted, we report: this pathogen has a powerful immunity to the aquatic environment, which often provokes its transmission through the liquid. There is good news: the virus has a very high immunogenicity, which contributes to the formation of persistent lifelong immunity after a disease.
Prevalence
Statistics impartially indicate that, although some do not even know what hepatitis A is, what kind of disease it is, this is the most common infection among those that pose a danger to human health. In countries with a warm climate and poor sanitary conditions, the incidence of type A hepatitis is very high. According to official figures, in Central Asian countries, almost 100% of the child population is ill with this infection. In Eastern European countries, the level of jaundice infection is 1: 400, that is, for example, 250 out of 100,000 people get sick there annually.
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, which include your favorite places for recreation and tourism. These are African countries, including Tunisia and Egypt, Asian states and islands, among which there are Turkey and India, popular among Russians, as well as 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, without even leaving the borders of our homeland, you can easily catch hepatitis A. How is it transmitted in this case? The causative agents of infection can be on the surface of vegetables and fruits. Therefore, before you eat them, without fail, properly wash them under running water and dry them. This will give a small, but a guarantee that you will not get sick by eating an apple or tomato. If you have a weakness for seafood, then when buying them fresh or frozen, remember: before you get to your table, they must undergo a heat treatment in which all bacteria and viruses on their surface will die.
The main source of hepatitis A is a person who has caught this virus and has become ill with jaundice. Together with its feces, a huge number of viruses are released into the environment, which account for billions.
If a person does not follow generally accepted hygiene rules, consumes infected water and food (especially thermally poorly processed seafood), the virus can penetrate the intestines, and then, after being absorbed into the bloodstream, it enters the liver and penetrates the hepatocytes - it cells.
The reproduction of virus particles occurs in the cytoplasm of liver cells, leaving them and falling into the bile ducts, they, together with bile, enter the intestines of the patient.
The inflammatory processes that began in the liver, leading to damage and even destruction of hepatocytes - its cells, are immunological in nature. T-lymphocytes, cells of the human immune system, attack liver cells that are infected by the virus, recognizing them. As a result of this, infected hepatocytes die, the normal functioning of the liver is disrupted, and hepatitis A develops. How this disease is transmitted, we said earlier.
Chance of infection
In developing countries, where the level of both economic and social development is low, jaundice is primarily a childhood infection. Most of the children in such countries have been ill with it by the age of 10 years and are acquiring persistent lifelong immunity to this disease.
According to epidemiological studies, the manifest forms in which jaundice, it is hepatitis A, symptoms typically appear, are now much less common. A more common phenomenon was the course of the infection in the so-called anicteric form, in which it is impossible to diagnose the disease.
Residents of developed countries call jaundice nothing more than "dirty hands disease." The probability of infection is extremely low, which is facilitated by the high-quality work of housing and communal services and a 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 risk of infection very high.
Even those who do not know about a disease such as hepatitis A, what it is and how it is transmitted, are not immune to infection if they travel to relax and work in the warm countries of Africa and Asia, without observing generally accepted hygiene rules.
If you need to find out the likelihood and degree of risk of getting sick, and also decide on the introduction of a vaccine, you should donate blood for an analysis that identifies antibodies to 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 getting jaundice. To avoid this, you need to be vaccinated.
Who is at risk?
Epidemiologists distinguish several groups of people who are highly likely to be diagnosed with hepatitis A. What does this give? If you consider yourself to be one of the following groups, we strongly recommend that you take an analysis for the presence of antibodies to the virus and, if necessary, get vaccinated. This list includes:
- household members and family members of a person infected with hepatitis A virus;
- persons who entered into an intimate relationship with patients;
- people (especially children) who live in places where hepatitis A is common;
- persons who are sent to countries with a high incidence rate;
- men who engage in homosexual intimate relationships.
When the house is sick. Answers to Common Questions
People who do not fully understand the specifics of an infection such as hepatitis A, what the disease is and how it is transmitted, sometimes there are questions that need to be answered in the framework of this article. These questions are especially acute when one of the family members becomes ill with jaundice.
First of all, the majority is concerned with the question: is it possible not to become infected by contact with an infected person? Of course, yes, if you adhere to generally accepted rules of hygiene. But it should be remembered that it is better to limit the contacts of children with the patient to a minimum, and ideally, to stop until complete recovery.
The second important question concerns the possibility of infection with 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 a person will inevitably become ill.
In order to quickly protect against a possible infection or to prevent the development of an ailment in case of infection, a person is given 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 treatment methods, but also as a prophylaxis of hepatitis A. If you have already been ill with it, then the probability of re-transferring it is negligible.
As mentioned earlier, to detect antibodies in the blood is capable of analysis for the presence of immunoglobulin G (anti-HAV IgG). Their presence indicates infection or vaccination of a person. It is recommended that all family members with an infected person be examined for the presence of immunoglobulin in the blood, and vaccinated if necessary.
And, of course, one should not forget about the basic rules of hygiene: wash hands with soap after going to the toilet, after caring for young children, before cooking and eating.
The consequences of infection and the duration of the disease
If hepatitis A virus enters the blood of a person who has not been vaccinated, he will inevitably get jaundice. However, it is quite difficult to determine the exact time of infection if it is not an epidemic caused, for example, by an accident in sewer networks.
The incubation period lasts about a month from the date of the alleged infection, after which hepatitis A begins to appear. Symptoms by which it can be recognized by a layman: fever, dyspepsia (disturbance of the normal functioning of the stomach), discoloration of the skin.
After the appearance of jaundice, there is an improvement in the general condition and well-being of the patient. 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 encountered an infection like hepatitis A. What is it? The photo clearly demonstrates what the skin of a sick person looks like in comparison with skin not infected with jaundice.
Many people are concerned about the danger of the disease to certain individuals. The most difficult cases of hepatitis are children up to 1 year old, the elderly and adults. 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: this is the age of the patient, the state of his immunity, concomitant chronic diseases (their presence or absence). The strict implementation of the recommendations and appointments that will be given by the doctor plays a very important role. In 15% of the entire population, a chronic form of hepatitis is noted, which can last from 6 to 9 months.
The possibility of death and self-treatment
An interesting question is about the possibility of a fatal outcome in a disease. Many people think that this is impossible, thinking: “Fatal and hepatitis A? What is it? Jaundice? What danger can it bear? ” Indeed, a fatal outcome in this disease is a rarity, 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 is accompanied by acute liver failure.
Statistics show that hepatitis A is fatal in 0.1% of the child population, 0.3% is death from infection in adolescents and adults under the age of 40, and already 2.1% in those over 40.
Often, patients and their relatives ask about the possibility of independent recovery of the patient without treatment. In most cases, everything happens just like that, because modern methods of treatment 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 impaired normal functioning of the liver. In this case, the fight against the infection itself lies with the patient's immune system.
Signs and symptoms of the disease, time of their appearance, analyzes
As already mentioned above, the first signs by which it is possible to suspect the presence of a virus in the human body appear in about 30 days, but this period can vary from 15 to 50 days.
The first signs that should alert you are a deterioration in overall health, an increase in body temperature, and significant changes in the color of urine. Sometimes after visiting the toilet, people do not understand what happened to its color, and they are surprised, not yet suspecting hepatitis A in themselves, what it is. The photo of the color of urine, presented below, is a vivid example of how it looks in a sick person. As you can see, it resembles tightly brewed black tea and foams very much.
In the presence of these signs, it is urgent to contact a specialist. Remember that only a qualified doctor can determine if the patient actually has hepatitis A. What is it? The symptoms in this case speak for themselves: the fever accompanied by dyspeptic syndrome (nausea, a feeling of heaviness in the right hypochondrium and stomach, vomiting), weakness, darkening of urine, which we spoke 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 is manifested in a similar manner.
In order to detect a patient's hepatitis virus in the blood, 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 illness), with an improvement in the patient's condition, their blood content becomes lower.
Diagnosis process
The first item in this procedure is to find out the epidemiological history, which will either confirm or refute hepatitis A. What does this mean? The doctor finds out what places the person has visited lately, what food and water he has consumed, whether there have been contacts with a sick jaundice.
After that, the doctor carefully examines the patient in daylight, noting:
- general well-being and condition of the patient, possible signs of intoxication;
- the presence of digestive disorders - dyspepsia;
- the presence of increased body temperature - fever, sweat, chills;
- the presence of jaundice of the skin, tongue, eyes.
This is how the skin of a person diagnosed with hepatitis A looks like, which this photo, presented below, clearly demonstrates.
In addition to all of the above, the doctor assesses the condition of all internal organs and systems of the patient in accordance with generally accepted diagnostic methods, notes the color of urine and feces of the patient. On palpation (palpation) of the abdomen, an enlarged liver can be detected.
After that, the results of the analyzes are studied, which include:
- KLA - general blood count;
- LHC - biochemical blood test;
- kaogulogram - a blood test for its coagulability;
- OAM - general urine analysis.
If antibodies to hepatitis A (anti-HAV IgM) are detected in the blood, which is accompanied by pronounced changes in liver samples, 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 him - this is the main question that worries everyone who came across him. If the disease proceeds in a mild or moderate form, then the body is able to cope with the infection that has got inside it on its own. 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 performed. If the disease is severe, then much attention is paid, along with detoxification, and symptomatic therapy.
The above methods are the most modern today.Together, these two therapies help to reduce intoxication, which occurs as a result of liver damage, dilution of blood with toxins and the removal of harmful substances, eliminating the symptoms of the disease. All this leads to an improvement in the general condition and well-being of the patient.
During relapse, you should adhere to diet No. 5 according to Pevzner. 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. Also shown is the consumption of a large amount of fluid and compliance with 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 a disease such 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 are the same for a patient of any age, consultation of a local pediatrician who will examine the child and prescribe those drugs that will help to successfully fight the disease and not cause even more harm to health is strongly recommended.
After recovery, doctors, as a rule, give the most favorable prognoses, since the normal functioning of the liver is restored in full.
Protection against the disease: vaccination and its effectiveness
Earlier we talked about a virus that causes a disease such as hepatitis A, what kind of infection it is, how it is transmitted and how to treat it. It's time to talk about how to prevent it.
To date, vaccination is the most effective method of preventing infection, and several fairly effective vaccines have been created that protect against jaundice at the proper level.
Such a vaccine is nothing more than killed hepatitis viruses with high immunogenicity. It is administered twice, and the interval between the first and second vaccination is from 6 to 12 months.
Most people after the first dose of the vaccine has been delivered, approximately 14 days later, antibodies appear that are ready to fight the virus. This method is by far the most effective and, perhaps, the only prevention of hepatitis A.
The vaccine introduced stimulates the production of a large number of antibodies, which provides reliable protection against infection for both children and adults. The vaccine lasts from 6 to 10 years.
Who is vaccinated for?
Vaccination against jaundice must be given to people who have not previously had type A hepatitis - adults and children, as well as those who are at increased risk of infection.
Among them:
- tourists and military personnel who are sent to areas with a high incidence of hepatitis A;
- honey. infectious disease staff
- persons working in kindergartens;
- employees of public catering and water supply places.
Regulatory documents provide for the vaccination of children living in areas where there is a high incidence rate. They begin to receive a vaccine starting at the age of 3 years. Mandatory to be vaccinated and patients suffering from chronic liver diseases.
I would like to believe that all of the above will help those who already had the misfortune to get sick, cope with the infection, and those who have so far passed this misfortune, make the right decision and protect themselves from it in a timely manner. Be healthy!