ISOLATION OF HAV PATIENT

What is hepatitis A?

Hepatitis A is a virus that can infect the liver. In most cases, the infection goes away on its own and doesn't lead to long-term liver problems. Rarely, it can be more serious.

Other viruses (hepatitis B and hepatitis C) also can cause hepatitis. Hepatitis A is the most common type.

How is hepatitis A spread?

The hepatitis A virus is found in the stool of an infected person. It is spread when a person eats food or drinks water that has come in contact with infected stool.

Sometimes a group of people who eat at the same restaurant can get hepatitis A. This can happen when an employee with hepatitis A doesn't wash his or her hands well after using the bathroom and then prepares food.

The disease can also spread in day care centers. Children, especially those in diapers, may get stool on their hands and then touch objects that other children put into their mouths. And workers can spread the virus if they don't wash their hands well after changing a diaper.

Some things can raise your risk of getting hepatitis A, such as eating raw oysters or undercooked clams. If you're traveling in a country where hepatitis A is common, you can lower your chances of getting the disease by avoiding uncooked foods and untreated tap water.

You may also be at risk if you live with or have sex with someone who has hepatitis A.

What are the symptoms?

After you have been exposed to the virus, it can take from 2 to 7 weeks before you see any signs of it. Symptoms usually last for about 2 months but may last longer.

Common symptoms are:

• Feeling very tired.
• Feeling sick to your stomach and not feeling hungry.
• Losing weight without trying.
• Pain on the right side of the belly, under the rib cage (where your liver is).
• A fever.
• Sore muscles.
• Yellow skin (jaundice), dark urine, and clay-colored stools.

All forms of hepatitis have similar symptoms. Only a blood test can tell if you have hepatitis A or another form of the disease.

Call your doctor if you have reason to think that you have hepatitis A or have been exposed to it. (For example, did you recently eat in a restaurant where a server was found to have hepatitis A? Has there been an outbreak at your child's day care? Does someone in your house have hepatitis A?)

How is hepatitis A diagnosed?

Your doctor will ask questions about your symptoms and where you have eaten or traveled. You may have blood tests if your doctor thinks you have the virus. These tests can tell if your liver is inflamed and whether you have antibodies to the hepatitis A virus. These antibodies prove that you have been exposed to the virus.

How is it treated?

Hepatitis A goes away on its own in most cases. Most people get well within a few months. While you have hepatitis:

• Slow down. Cut back on daily activities until all of your energy returns. As you start to feel better, take your time in getting back to your regular routine. If you try to do it too fast, you may get sick again.
• Drink plenty of water to avoid dehydration. Fruit juices and broth are other good choices, if you can tolerate them.
• Eat a healthy mix of foods. Even though food may not appeal to you, it is important for you to get good nutrition.
• Don't drink alcohol or use illegal drugs. They can make liver problems worse.
• Make sure your doctor knows all the medicines you are taking, includingherbal products. Don't start or change any medicines without talking to your doctor first.

If hepatitis A causes more serious illness, you may need to stay in the hospital to prevent problems while your liver heals.

Be sure to take steps to avoid spreading the virus to others.

• Tell the people you live with or have sex with that you have hepatitis A. They should ask their doctor whether they need a dose of the vaccine or a shot of immunoglobulin (IG).
• Wash your hands with soap and water right after you use the bathroom or change a diaper and before you prepare food.
• Don't have sexual contact with anyone while you're infected.

You can only get the hepatitis A virus once. After that, your body builds up a defense against it.

What can you do to prevent hepatitis A?

• Get vaccinated against hepatitis A(What is a PDF document?) if yourtravel plans, job, health, or lifestyle puts you at risk.
• Make sure your children get vaccinated. The U.S. Centers for Disease Control and Prevention recommends the vaccine for all children starting at age 1 year. It's also important for children adopted from other countries to get the vaccine.
• Talk to your doctor if you've been around someone who you know has hepatitis A. The hepatitis A vaccine or an injection of immunoglobulin (IG) within 2 weeks of exposure may prevent you from getting sick.¹
• Practice good hygiene habits.
  • Wash your hands well after using the toilet, after changing a diaper, and before you prepare or eat food.
  • Wash dishes in hot, soapy water or in a dishwasher.
  • Discourage children from putting objects in their mouths.
  • Don't eat or drink anything that you think may have been prepared in unclean conditions.
• Don't eat raw or undercooked shellfish.
• If you plan to travel to a part of the world where sanitation is poor or where hepatitis A is a known problem:
• Ask your doctor about getting the hepatitis A vaccine, a shot of immunoglobulin (IG), or the combination hepatitis A and B vaccine.
• Always drink bottled water or boil water before drinking it. Avoid drinks with ice cubes.
• Don't eat raw foods, such as unpeeled fruits or vegetables.
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What happens if I miss a dose (Havrix, Vaqta)?

Contact your doctor if you will miss a hepatitis A vaccine dose or if you get behind schedule. The next dose should be given as soon as possible. There is no need to start over.

Be sure to receive all recommended doses of this vaccine. If you do not receive the full seriesof vaccines, you may not be fully protected against the disease.

What happens if I overdose (Havrix, Vaqta)?

An overdose of hepatitis A vaccine is unlikely to occur.

What should I avoid before or after getting this vaccine (Havrix, Vaqta)?

There are no restrictions on food, beverages, or activity before or after receiving this vaccine, unless your doctor has told you otherwise.

What other drugs will affect hepatitis A vaccine (Havrix, Vaqta)?

Before receiving this vaccine, tell the doctor about all other vaccines you have recently received.

Also tell the doctor if you have recently received drugs or treatments that can weaken theimmune system, including:

• an oral, nasal, inhaled, or injectable steroid medicine;
• medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders, such as azathioprine (Imuran), efalizumab (Raptiva), etanercept(Enbrel), leflunomide (Arava), and others; or
• medicines to treat or prevent organ transplant rejection, such as basiliximab(Simulect), cyclosporine (Sandimmune, Neoral, Gengraf), muromonab-CD3(Orthoclone), mycophenolate mofetil (CellCept), sirolimus (Rapamune), ortacrolimus (Prograf).

If you are using any of these medications, you may not be able to receive the vaccine, or may need to wait until the other treatments are finished.

There may be other drugs that can affect this vaccine. Tell your doctor about all the prescription and over-the-counter medications you have received. This includesvitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist may have information about this vaccine written for health professionals that you may read. You may also find additional information from your local health department or the Centers for Disease Control and Prevention.

claimyourhealth.net

What should I discuss with my healthcare provider before receiving this vaccine (Havrix, Vaqta)?

Hepatitis A vaccine will not protect you against infection with hepatitis B, C, and E, or other viruses that affect the liver. It may also not protect you from hepatitis A if you are already infected with the virus, even if you do not yet show symptoms.

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any vaccine containing hepatitis A, or if you have received cancer chemotherapy or radiation treatment in the past 3 months.

Before receiving this vaccine, tell your doctor if you have:

• a bleeding or blood clotting disorder such as hemophilia or easy bruising;
• a history of seizures;
• a neurologic disorder or disease affecting the brain;
• an allergy to latex rubber;
• a weak immune system caused by disease, bone marrow transplant, or by using certain medicines or receiving cancer treatments; or
• if you are taking a blood thinner such aswarfarin (Coumadin).

You can still receive a vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

Before receiving the hepatitis A vaccine, tell your doctor if you are pregnant.

It is not known if hepatitis A vaccine passes into breast milk or if it could harm anursing baby. Tell your doctor if you are breast-feeding a baby.

How is this vaccine given (Havrix, Vaqta)?

This vaccine is given as an injection (shot) into a muscle. You will receive this injection in a doctor's office or other clinic setting.

You will most likely receive 2 separate injections of the hepatitis A vaccine at 6 months apart, depending on your exposure or risk of infection.

To prevent hepatitis A while traveling, you should receive this vaccine at least 2 weeks before your trip. Your 

healthcare

 provider will determine the best dosing schedule for your situation.

Your doctor may recommend treating fever and pain with an aspirin-free pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, and others) when the shot is given and for the next 24 hours. Follow the label directions or your doctor's instructions about how much of this medicine to take.

It is especially important to prevent fever from occurring if you have a seizuredisorder such as epilepsy.

Hepatitis A Treatment

There are no specific medicines to cure infection with hepatitis A. Most people require no treatment except to relieve symptoms. However, if symptoms become severe ordehydration develops, the person should seek medical care emergently.

There is a vaccine for hepatitis A (see below, vaccine and prevention). If a person has been exposed to someone who is infected with HAV, a treatment called immune serum globulin is available and may prevent them from becoming infected. Immune serum globulin is more likely to be effective when given within 2 weeks of exposure.

Hepatitis A (HAV, Hep A): Hepatitis A virus (HAV, Hep A) refers to liver inflammation caused by infection with the hepatitis A virus. Causes of HAV is generally from person to person via contaminated water, blood, stool, or direct contact. Symptoms of hepatitis A virus include nausea, vomiting, diarrhea, fever, rash, fatigue, jaundice, abdominal pain, and pale or gray-colored stools. Treatment for hepatitis A virus is focused on relieving symptoms. There is a vaccine to prevent hepatitis A virus.

What is hepatitis A vaccine (Havrix, Vaqta)?

Hepatitis is a serious disease caused by a virus. Hepatitis A is spread through contact with the stool (bowel movements) of a person infected with the hepatitis A virus. This usually occurs by eating food or drinking water that has become contaminated as a result of handling by an infected person.

Hepatitis causes inflammation of the liver, vomiting, and jaundice (yellowing of the skin or eyes). Hepatitis can lead to liver cancer, cirrhosis, or death.

The hepatitis A adult vaccine is used to help prevent this disease in adults. The vaccine works by exposing you to a small amount of the virus, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

Vaccination with hepatitis A adult vaccine is recommended for all adults who travel in certain areas of the world where hepatitis A is a common disease.

Other risk factors for hepatitis include: being a homosexual male; having chronic liver disease; using intravenous (IV) drugs; receiving treatment for hemophilia or other bleeding disorders; working in a research laboratory or around animals (especially monkeys) where you may be exposed to the hepatitis A virus; or being in an area where there has been an outbreak of hepatitis A.

Like any vaccine, the hepatitis A vaccine may not provide protection from disease in every person.

What are the possible side effects of hepatitis A vaccine (Havrix, Vaqta)?

You should not receive a booster vaccine if you have ever had a life-threateningallergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shots caused any side effects.

Becoming infected with hepatitis A is much more dangerous to your health than receiving the vaccine to protect against it. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.

Call your doctor at once if you have any of these serious side effects:

• high fever;
• fast or uneven heartbeats; or
• behavior changes.

Less serious side effects include:

• low fever;
• headache;
• dizziness, tired feeling;
• nausea, vomiting, stomach pain, diarrhea, loss of appetite;
• joint pain;
• sore throat; or
• swelling, redness, or a hard lump where the shot was given.

This is not a 

complete

 list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

What is the most important information I should know about hepatitis A vaccine (Havrix, Vaqta)?

Hepatitis A vaccine will not protect you against infection with hepatitis B, C, and E, or other viruses that affect the liver. It may also not protect you from hepatitis A if you are already infected with the virus, even if you do not yet show symptoms.

You will most likely receive 2 separate injections of the hepatitis A vaccine at 6 months apart, depending on your exposure or risk of infection. Children should receive their first hepatitis A vaccine between 12 months and 23 months of age.

Your individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by the health department of the state you live in.

Vaccination with hepatitis A adult vaccine is recommended for all adults who travel in certain areas of the world where hepatitis A is a common disease.

Other risk factors for hepatitis include: being a homosexual male; having chronicliver disease; using intravenous (IV) drugs; receiving treatment for hemophilia or other bleeding disorders; working in a research laboratory or around animals (especially monkeys) where you may be exposed to the hepatitis A virus; or being in an area where there has been an outbreak of hepatitis A.

Be sure you receive all recommended doses of this vaccine. If you do not receive the full series of vaccines, you may not be fully protected against the disease.

You can still receive a vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shots caused any side effects.

Becoming infected with hepatitis A is much more dangerous to your health than receiving the vaccine to protect against it. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.

Hepatitis A Diagnosis

The health care practitioner

 will ask questions about the illness and patient will be asked about his or her symptoms, and about any possible exposures to other people diagnosed with hepatitis, especially the type of hepatitis (type A, B, C, or others).

If the health care practitioner determines that the patient may be at risk for contracting hepatitis, then it is likely that the patient undergo blood tests.

• The blood will be tested to determine how well the liver is functioning.
• A test will be ordered to detect antibody to hepatitis A. The results of this test will also determine if the patient has been recently exposed to HAV.
• Blood probably will be tested for the hepatitis B and hepatitis C viruses, and others. For example, if a patient has had a large amount of vomiting or has not been able to take in liquids, the bloodelectrolytes may be out of balance. Blood chemistry may be tested to checkelectrolytes.

• Hepatitis A Vaccine and Prevention

  If a person has hepatitis A, strict personal hygiene and hand washing help prevent transmission of HAV to others. There are ways to help reduce or prevent HAV infection.
  • Wash hands thoroughly every time after use of the bathroom, before touching or preparing food, and before touching others. Wash hands with soap and warm water, and then dry the hands thoroughly (with paper or air so the drying towel in not reused by anyone).
  • Contaminated surfaces should be cleaned with household bleach to kill the virus.
  • Heat food or water to 185 F or 85 C to kill the hepatitis A virus.
  If people are not infected with HAV, they can reduce the chance of becoming infected by the following methods:
  • Wash hands carefully with soap and warm water several times a day, including every time the bathroom is used, every time a diaper is changed, and before preparing food.
  • Do not eat raw or undercooked seafood or shellfish such as oysters from areas of questionable sanitation (just about everywhere, including developed countries).
  • Individuals traveling to developing countries should not drink untreated water or beverages with ice in them. Fruits and vegetables should not be eaten unless cooked or peeled.
  In addition to the above methods, there are vaccines that work to prevent infection with HAV, but are not substitutes for good hygiene and careful food and drinkconsumption..
  • The vaccines, Havrix and VAQTA, contain no live virus and are very safe. No serious adverse effects have been reported. Some people have some soreness at the injection site for a few days. There is a combined vaccine available for both hepatitis A and B termed Twinrix for patients over age 18.
  • The vaccines are given in a series of two shots. The second is given 6-18 months after the first. The shots can be given at the same time as other vaccines.
  • Protection from HAV starts about 2-4 weeks after the first shot. The second dose is necessary to ensure long-term (years or lifetime) protection.
  • The vaccines are thought to protect from infection for at least 20 years.
  • The vaccines must be given before exposure to the virus. They do not work after exposure and infection.
  Not everyone needs to have the hepatitis A vaccines. However, the CDC recommends HAV vaccine for the following groups:
  • All children older than one year are recommended to get the vaccine, especially children who live in communities where the number of HAVinfections is unusually high or where there are periodic outbreaks of hepatitis A. The vaccines are not recommended for children younger than one year old.
  • People who are likely to be exposed to HAV at work. The only group of workers shown to be at higher risk than the general population is people who work in research laboratories where HAV is stored and handled. Routine vaccination is not usually recommended for health care workers, food service workers, daycare personnel, and sewage and waste-water workers.
  • People traveling to developing countries (preferably given at least 4 weeks before travel); travel is a major source of hepatitis A in people who live in developed countries.
  • Men who have sex with men
  • People who use illegal drugs. This group of individuals have had higher-than-average rates of HAV infection.
  • People who are likely to become seriously ill if they are infected with HAV. This includes people with impaired immune systems or chronic liver disease.
  • People with blood-clotting disorders who receive clotting factors
  If a person has never had hepatitis A and is exposed to the virus, call a primary health care practitioner immediately. There is a treatment that may prevent individuals from becoming infected. It is called immune serum globulin (Gammastan, Gammar-P) and is composed of antibodies that help destroy the virus.
  • Immune serum globulin is a preparation of antibodies that can fight the virus in the body.
  • It is given as a one-time shot (injection).
  • It must be given within 2 weeks after exposure for maximum protection.
  • Immune serum globulin can be safely given to children younger than 2 years.
  • Immune serum globulin can be given during pregnancy and breastfeeding.
  • Immune serum globulin can provide short-term protection against infection if given before exposure. This protection lasts no longer than 3 months. If the person is likely to be exposed immediately to HAV (for example emergency travel to an endemic area in Africa) both the immune serum globulin and HAV vaccine can be given at the same time.
  If a person has had hepatitis A confirmed by a blood 
  test
  , they almost never get it again. People should continue to practice preventive measures, however, to prevent transmission of other infections.

Hepatitis A Vaccine and Prevention

If a person has hepatitis A, strict personal hygiene and hand washing help prevent transmission of HAV to others. There are ways to help reduce or prevent HAV infection.

• Wash hands thoroughly every time after use of the bathroom, before touching or preparing food, and before touching others. Wash hands with soap and warm water, and then dry the hands thoroughly (with paper or air so the drying towel in not reused by anyone).
• Contaminated surfaces should be cleaned with household bleach to kill the virus.
• Heat food or water to 185 F or 85 C to kill the hepatitis A virus.

If people are not infected with HAV, they can reduce the chance of becoming infected by the following methods:

• Wash hands carefully with soap and warm water several times a day, including every time the bathroom is used, every time a diaper is changed, and before preparing food.
• Do not eat raw or undercooked seafood or shellfish such as oysters from areas of questionable sanitation (just about everywhere, including developed countries).
• Individuals traveling to developing countries should not drink untreated water or beverages with ice in them. Fruits and vegetables should not be eaten unless cooked or peeled.

In addition to the above methods, there are vaccines that work to prevent infection with HAV, but are not substitutes for good hygiene and careful food and drinkconsumption..

• The vaccines, Havrix and VAQTA, contain no live virus and are very safe. No serious adverse effects have been reported. Some people have some soreness at the injection site for a few days. There is a combined vaccine available for both hepatitis A and B termed Twinrix for patients over age 18.
• The vaccines are given in a series of two shots. The second is given 6-18 months after the first. The shots can be given at the same time as other vaccines.
• Protection from HAV starts about 2-4 weeks after the first shot. The second dose is necessary to ensure long-term (years or lifetime) protection.
• The vaccines are thought to protect from infection for at least 20 years.
• The vaccines must be given before exposure to the virus. They do not work after exposure and infection.

Not everyone needs to have the hepatitis A vaccines. However, the CDC recommends HAV vaccine for the following groups:

• All children older than one year are recommended to get the vaccine, especially children who live in communities where the number of HAVinfections is unusually high or where there are periodic outbreaks of hepatitis A. The vaccines are not recommended for children younger than one year old.
• People who are likely to be exposed to HAV at work. The only group of workers shown to be at higher risk than the general population is people who work in research laboratories where HAV is stored and handled. Routine vaccination is not usually recommended for health care workers, food service workers, daycare personnel, and sewage and waste-water workers.
• People traveling to developing countries (preferably given at least 4 weeks before travel); travel is a major source of hepatitis A in people who live in developed countries.
• Men who have sex with men
• People who use illegal drugs. This group of individuals have had higher-than-average rates of HAV infection.
• People who are likely to become seriously ill if they are infected with HAV. This includes people with impaired immune systems or chronic liver disease.
• People with blood-clotting disorders who receive clotting factors

If a person has never had hepatitis A and is exposed to the virus, call a primary health care practitioner immediately. There is a treatment that may prevent individuals from becoming infected. It is called immune serum globulin (Gammastan, Gammar-P) and is composed of antibodies that help destroy the virus.

• Immune serum globulin is a preparation of antibodies that can fight the virus in the body.
• It is given as a one-time shot (injection).
• It must be given within 2 weeks after exposure for maximum protection.
• Immune serum globulin can be safely given to children younger than 2 years.
• Immune serum globulin can be given during pregnancy and breastfeeding.
• Immune serum globulin can provide short-term protection against infection if given before exposure. This protection lasts no longer than 3 months. If the person is likely to be exposed immediately to HAV (for example emergency travel to an endemic area in Africa) both the immune serum globulin and HAV vaccine can be given at the same time.

If a person has had hepatitis A confirmed by a blood 

test

, they almost never get it again. People should continue to practice preventive measures, however, to prevent transmission of other infections.

Hepatitis A Prognosis

Hepatitis A symptoms are usually mild and resolve on their own; most patients fully recover in 3 to 6 months.

• Rarely will patients develop complications such as relapsing hepatitis or liver failure.
• With relapsing hepatitis, symptoms improve, but then return
• Death from hepatitis A is rare.
• The elderly, the very young, and people with advanced chronic liver diseases such as from hepatitis C are at greatest risk for complications such as liver failure or fulminant hepatitis (rapid developing and life-threatening liver failure) from hepatitis.
• The cause of hepatitis A is hepatitis A virus(HAV) that is transmitted person to person by contaminated foods, water or other drinks (including ice), blood, stool, and direct contact. The virus is a Picornavirus that contains single-stranded RNA as its genome covered by a protein shell. The virus enters through theepithelium in the mouth or gut and migrates to the liver over a period of about two to six weeks. Symptoms (jaundice and other symptoms, see below) then begin to develop as the virus replicates in the liver cells(hepatocytes and Kupffer cells, also termed liver macrophages). HAV reproduces itself by utilizing the liver cell's ribosomes for viral replication; however this interferes with normal liver cell function. If large numbers of liver cells are infected with HAV, the person will develop symptoms. The viruses are secreted into the GI tract by the bile fluid made in the liver. The majority of people infected recover with no lasting damage to the liver.
  Hepatitis A Virus (HAV) Courtesy of the CDC