Wellbeing / 08 May, 2020

Hepatitis A explained

Dr Lau Pik Onn

What is Hepatitis A?

Hepatitis A is an inflammation of the liver caused by infection with the Hepatitis A virus (HAV), which can cause mild to severe illness. The liver may become enlarged, inflamed and tender during this infection.

In Singapore, the majority of reported Hepatitis A cases were from consuming contaminated food such as raw or partially cooked cockles. From 1989 to 2009, a total of 2 955 cases of acute Hepatitis A were reported.1 Overall, 36% were classified as imported (acquired abroad). The rate was highest between ages 25 to 34.1

WHO states that there are 1.4 million cases of Hepatitis A around the world each year, with 400 000 of these cases within South-East Asia.2,3

How is Hepatitis A spread?

The Hepatitis A virus is excreted within your faeces and transmitted through contaminated food and water. Hepatitis A is usually spread via the faecal oral route.

Ways that you can get Hepatitis A include:

  • Drinking contaminated water and other fluids (including ice)
  • Eating raw or undercooked shellfish, such as clams, cockles, mussels
  • Eating vegetables, fruits or other foods prepared by infected food handlers
  • Sexual contact/drug use with infected persons

What are the signs and symptoms of Hepatitis A?

Signs and symptoms include:

Jaundice

(yellowing of whites of eyes and skin)

Fatigue

Fever and muscle aches

Loss of appetite

Nausea and vomiting, diarrhoea

Abdominal discomfort or pain

(especially on upper right side beneath your lower ribs)

Pale coloured stools

Dark urine

These symptoms are generally relatively mild and go away in a few weeks. However, in certain cases Hepatitis A infection may result in severe illness that can last several months.

How is Hepatitis A diagnosed?

Since symptoms of Hepatitis A are non-specific, the virus is diagnosed through a blood test to detect the presence of the Hepatitis A virus in your body. This will show whether you have been exposed recently to HAV. At Icon Health Screening, we test for Hepatitis A in all of our screening packages to give you peace of mind. For further information on our comprehensive screening options, click here.

How is Hepatitis A treated?

In most cases, the liver heals itself within six months with has no lasting damage.

The focus of treatment is to relieve Hepatitis A symptoms and keep you comfortable. This will involve bed rest, managing nausea, drinking plenty of fluids, avoiding alcohol and using medication with care.

Can Hepatitis A infection be prevented?

The best way to prevent Hepatitis A infection is to get vaccinated.

Hepatitis A vaccination involves two injections, six months apart. If you receive a combined Hepatitis A and B vaccination, this involves three doses over six months.

Other tips to reduce your risk of Hepatitis A include:

  • Good hygiene (always wash hands with soap and water after using the toilet and before preparing any food and drinks)
  • Avoid sharing eating utensils, drinking glasses, toothbrushes and other personal items

When travelling overseas:

  • Avoid eating raw fruits, vegetables and raw shellfish
  • Drink bottled water or boil water before drinking, and avoid drinks with ice
  • Brush your teeth with bottled water
  • Avoid eating at unhygienic locations

Complications

Most patients recover fully from Hepatitis A with a life-long immunity. There are usually no long-term problems or complications, and it does not become chronic.

However, in rare cases, some patients with the infection may suffer a sudden loss of liver function leading to liver failure, especially in older adults or patients with existing chronic liver disease. Screening for hepatitis as part of your regular health check at Icon is important to avoid these long-term complications.

References

For a full list of references, click here.
  1. Lee, HC. 2011, ‘Changing Epidemiological Patterns of Hepatitis A Infection in Singapore’, Annals Academy of Medicine Singapore, vol. 40, no. 10, pp. 439-47
  2. World Health Organisation. (2015). Hepatitis A. Retrieved on 22 April 2020 from https://www.who.int/immunization/diseases/hepatitisA/en/
  3. World Health Organisation. (2011). Viral Hepatitis in the WHO South-East Asia Region. Retrieved on 22 April 2020 from http://hepcasia.com/wp-content/uploads/2015/03/who_searo_viral-hepatitis-report.pdf
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