Hepatitis A - The Common Jaundice

 By: Gaurav Gupta
Most of us are aware of and have probably been vaccinated against hepatitis B. Given the fact that so many of us are protected from hepatitis B, have you ever wondered why we still have so many cases of jaundice especially in the months of summers and monsoons?

The reason is jaundice due to poor food, water and sanitation, meaning hepatitis A and hepatitis E virus.

The most important thing to realize that taking hepatitis B vaccination will not protect you against these forms of jaundice since they are caused by a different virus.

Hepatitis means inflammation (swelling) of the liver. While there are many infections that can cause this, in India the commonest cause in children and one of the most common causes in adults is Hepatitis A. If symptoms are present, they usually occur abruptly and may include:
- fever,
- tiredness,
- loss of appetite,
- nausea,
- abdominal discomfort,
- dark urine, and
- jaundice (yellowing of the skin and eyes).

Symptoms usually last less than 2 months; a few persons are ill for as long as 6 months. The average incubation period (i.e., time taken from transmission from one person to the other) for hepatitis A is 28 days (range: 15-50 days).

The diagnosis can be made with a blood test (IgM Hepatitis A antibody- cost approx. Rs. 600/-), since the symptoms of all types of hepatitis are the same. Other tests like the liver function tests are useful in finding out the extent of the disease.

Treatment is essentially supportive, and with adequate rest and minimum use of anti-fever and anti - vomiting medicines a patient should generally recover within 15- 30 days. However 15 % of patients (mostly adults) may have a prolonged course of illness lasting even as long as 6-9 months!

Prevention rests on maintaining a good personal hygiene. Always wash your hands after using the bathroom, changing a diaper, or before preparing or eating food. Avoid outside food and water especially food that is undercooked/ uncooked (like salad etc.). Since proper food and water in India is still a pipe-dream, a more feasible way is to take the Hepatitis A vaccine. This is a very safe and highly effective vaccine (more than 90 % effective) with no major side-effects. It can be given to anyone above 1 year of age. Two doses are needed for life long protection and these need to be given 6 months apart. The vaccine is effective a month after the first dose is given.

Dr. Gaurav Gupta is a practicing pediatrician in Chandigarh, India. Other than being a member of the American and the Indian Academy of Pediatrics, he is also published many papers and written in various medical journals. He writes a bimonthly column is in Indian Pediatrics, official journal of the Indian Academy of Pediatrics. He writes a medical blog, and contributes regularly to local newspapers and magazines while also answering online question about common parenting questions and kids health's.
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