Hepatitis….Do You Know Your ABC’s
By Karen Wilkinson, RN, NHA, CLNC – CareerSmartCareerSmart® Learning Contributor
Hepatitis….Do You Know Your ABC’s?
Hepatitis has recently been in the headlines…and not for the best of reasons. The California Department of Public Health reported a large hepatitis A outbreak in California in 2017, with 686 cases and 21 deaths, primarily in San Diego, Santa Cruz and Los Angeles counties. But California is not alone. According to the Centers for Disease Control, outbreaks have also occurred in Michigan and Utah as well, accounting for an additional 782 cases and 22 deaths, as of the beginning of 2018. These outbreaks have several similarities. They are primarily occurring among the homeless, those who use drugs (both injectable and non-injectable), and their direct contacts. CDC is recommending hepatitis A vaccination for at risk persons, as well as post-exposure prophylaxis for those unvaccinated persons with exposure to the virus. Despite the availability of hepatitis A vaccine, and the focus of public health experts, hepatitis A remains an ongoing threat.
Hepatitis is a viral infection which causes liver inflammation and potential liver damage. There is a literal alphabet of hepatitis viruses, but five main types cause the majority of infections: A, B, C, D, and E. Typically, people sickened with hepatitis A (HAV) and hepatitis E (HEV) have an acute infection which usually gets better after a few weeks, with or without treatment. HAV and HEV are usually spread through oral-fecal contact, typically through drinking water or food contaminated by an infected person’s stool, or through close contact with someone infected, including sexual contact. It only takes a microscopic amount of contaminated fecal material to spread the infection. Symptoms of acute infection may include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, gray-colored stools, joint pain and jaundice.
Hepatitis B (HBV), C (HCV) and D (HDV) can cause chronic and acute infections. HBV results from contact with infected blood, semen, or other body fluids, typically through sexual contact, birth to a mother with HBV, from needlesticks, or from sharing of needles or syringes contaminated by the virus. The acute phase of HBV rarely results in death and most people recover without liver damage. Those chronically infected with HBV, however, run a 15-25% risk of developing chronic liver disease, such as cirrhosis, liver failure or liver cancer. The CDC estimates that between 850,000 – 2.2 million people live with chronic HBV infection. Even more startling, the CDC estimates there are 2.7 – 3.9 million people living with chronic hepatitis C infection. Common routes of transmission include contact with blood of an infected person, former injection drug use, long-term hemodialysis, birth to a mother with HCV, sexual contact with an HCV-infected person, through tattoos or body piercings, or as a recipient of blood or blood products prior to 1992, or clotting factor prior to 1987. There is no vaccine available, however a simple blood test will screen for HCV, and early diagnosis and treatment can help prevent liver damage. Lastly, HDV occurs only in conjunction with HBV – either at the same time, or after HBV is already established. HDV is spread through injection drug use and unprotected sexual contact and is relatively uncommon in the United States.
Now you know your hepatitis ABC’s and D and E. For more information on hepatitis, visit the Centers for Disease Control and Prevention at: https://www.cdc.gov/hepatitis/index.htm
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6 Centers for Disease Control and Prevention. (2016). The ABCs of Hepatitis. Retrieved January 09, 2018 from https://www.cdc.gov/hepatitis/resources/professionals/pdfs/abctable.pdf
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Hepatitis (Viral). Retrieved January 09, 2018 from https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis