| Disease/Syndrome |
Hepatitis A |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Moderate |
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| Synonyms |
Infectious hepatitis |
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| Biomedical References |
Search PubMed |
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| Comments |
Many cases are mild and without jaundice. The AST/ALT liver enzymes are in the range of 400 to several thousand U/L. Chronic infections do not occur, but 15% of cases may be prolonged or relapsing, lasting as long as a year. IgM antibodies are diagnostic and are detectable for up to 6 months after onset of the illness. Common sources of outbreaks include infected food handlers and contaminated water, mollusks, strawberries, and lettuce. Humans are the primary reservoirs, rarely primates. Case-fatality is less than 1% in most populations. Transmission may occur by sexual contact (fecal-oral). [CCDM, p. 247-53; 5MCC; Current Consult, p. 870] Injection drug users are at higher risk, and transmission by transfusion has been reported. Virus is excreted in the stool for 1-2 weeks before and 1 week after onset of the illness. Jaundice occurs rarely in children 4 years old and younger, in about 10% of children aged 4-6, and in 40-70% of patients over the age of 15. When jaundice appears, it usually resolves within 2 weeks. Bradycardia may be present during the icteric phase. Some patients develop a vasculitis affecting the skin of the buttocks and legs. Other complications are pancreatitis, renal failure, mononeuritis multiplex, and Guillain-Barre syndrome. [PPID, p. 1429-30] Other common symptoms are loss of appetite, dark urine, and light-colored stools. Symptoms occurring in less than 30% of patients include headache, myalgia, arthralgia, diarrhea, and constipation. About 0.14 % of hospitalized patients develop fulminant hepatitis with bleeding diathesis (GI bleeding) and coma. [ID, p. 761] PREVENTION: Preventive measures in daycare centers include thorough hand washing after every diaper change. [CCDM]; "Nosocomial hepatitis A occurs infrequently, and transmission to personnel usually occurs when the source patient has unrecognized hepatitis and is fecally incontinent or has diarrhea. . . . Serologic surveys among health care personnel have not shown greater prevalence of HAV infection than in control populations; therefore, routine administration of vaccine in health care personnel is not recommended. . . . Immune globulin given within 2 weeks after an HAV exposure is more than 85% effective in preventing HAV infection and may be advisable in some outbreak situations. Restriction from patient care areas or food handling is indicated for personnel with HAV infection. They may return to regular duties 1 week after onset of illness." [Guidelines for Infection Control in Health Care Personnel. CDC. 1998] |
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| Latency/Incubation |
2-7 weeks; average 1 month; |
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| Diagnostic |
IgM antibodies (anti-HAV) become detectable 5-10 days after exposure and remain positive for 3-6 months. Paired sera (4-fold rise); [CCDM; Lexi-ID, p. 156] |
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| ICD-9 Code |
070.1 |
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| Available Vaccine |
Yes |
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| Scope |
Global; "Hepatitis A is one of the most common vaccine-preventable infection acquired during travel." [CDC Travel, p. 155] |
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| Reference Link |
CDC - Hepatitis A |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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