Hepatitis A

Pathogen

The Hepatitis A virus; incubation period is 2 to 6 weeks.

Transmission

The transmission occurs from person to person or via contaminated food and water. The prophylactic phrase therefore remains: "cook it, peel it or leave it". If you plan on traveling in Southern countries you should be careful with all food that has not been sufficiently cooked (salad buffets!) and you should not drink open water (be careful with the ice, too).

Clinical picture

The course of the disease frequently is asymptomatic. In children only 10% of the infected experience symptoms, for the six to 14-year-olds approx. 50% and for adolescents and adults approx. 70%.  

1. Prodromal stage:
Duration 2-7 days
Flu-like symptoms: Sub febrile temperatures, fatigue (DD: flu infection!!)
Gastrointestinal problems: Lack of appetite, nausea, pain in the right side of the stomach, diarrhea and joint pain

2. Hepatic organ manifestation
Duration 4-8 weeks
Yellow coloring (in 2/3 of the cases no visible signs of turning yellow)
Urine turns brown and stool becomes colorless  
Frequently enlarged liver with sensitivity to pressure

Infectiousness

2 weeks before and after onset of the disease (excretion of the pathogen in the stool)

Course of the disease

Healing after 4-6 weeks, no chronification, no virus carrier.

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Therapy

Causal therapy not known, therefore only symptomatic measures: bed rest (better for the liver), if bed rest interrupted too early increase of transaminasis

No alcohol
Interruption of intake of all medication that is not vital

- Cytostatica, immune suppressive medication, NSAR
- Estrogens
- Corticosteroids (prevent the body’s virus elimination, favor a chronic course, are usually stopped early and then can lead to an episode)

Complications

In 0.1% of the cases, hepatitis is violent and is accompanied by a high-grade icterus, ascites, hemorrhagic diathesis, liver coma.

Immunity

After the disease has been overcome, the patient has life-long.