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Hepatitis A (infectious disease)
December 6, 2012
Hepatitis A (the second name — an infectious disease) is an intestinal infection which often occurs at children. At its development there is general intoxication of an organism, but the liver of the person generally is surprised. As a rule, hepatitis A develops not at one child, and at the whole group of children who closely contact among themselves. Most often the disease affects children aged from three till seven years. However adults also have hepatitis A. In a percentage ratio more than 60% of cases of an illness are the share of children. The disease very seldom occurs at babies who are reliably protected by maternal antibodies.
Hepatitis A virus
Hepatitis A – an acute infectious illness which develops under the influence of a virus.
The virus of hepatitis A differs in resistance to a number of substances — to acids, ether, chlorine. At the same time he shows sensitivity to formalin, and at boiling perishes in 5 minutes.
The virus is allocated from a human body together with excrements, and, infectious the person is since the termination of an incubation interval and throughout the preicteric period. In Calais the person with already developed jaundice the virus is not found. The virus is implemented into an organism through mucous membranes of a digestive tract.
At a viral hepatitis And duration of an incubation interval can fluctuate and make from 7 to 50 days considerably. But generally it makes from 15 to 30 days.
Reproduction of virus particles happens in cytoplasm of cells of a liver. After they leave liver cells, at once get to bilious canals and then together with bile appear in intestines.
Hepatocytes (liver cell) are injured owing to an inflammation which develops in a liver. In turn, inflammatory process is an effect of attack of immune system of an organism on the liver cells affected with a virus. As a result, the infected hepatocytes perish, the infectious disease is shown and functioning of a liver is broken.
As there is infection
The source of an infection is the person infected with a virus. With its excrements billions of viruses in environment are allocated. If the person uses water or products which were infected with a hepatitis A virus, then the virus gets into intestines of the person, and then together with a blood-groove it moves to a liver and is implemented into hepatocytes.
Thus, a way of transfer of a virus of hepatitis A — fecal and oral. Very often infection with an illness happens in the countries to hot climate on different continents.
Hepatitis is also called "an illness of dirty hands". In civilized countries in view of normal work of public health and municipal services, and also thanks to observance of rules of hygiene by the population people have hepatitis seldom. Therefore, antibodies to this disease are developed at very small number of people. Contacting to the carrier of a virus, the person at which antibodies are absent, risk to catch. Therefore during trips to the countries of Asia and Africa infection cases occur at our fellow citizens rather often.
The healthy person can have contact with the patient, without risking to catch. At the same time it is more important to follow all rules of hygiene accurately. But it is the best of all to isolate children from patients with hepatitis A.
To define a risk degree of infection with a disease for the purpose of the solution of a question of expediency of vaccination it is possible to conduct a special blood analysis at which is defined whether is in an antibody human body to a hepatitis A virus. If they are found, then it designates that the person has an immunity to a virus, and the inoculation is not necessary. Repeatedly people have practically no hepatitis A. In the absence of antibodies the risk of infection exists, so, the inoculation is necessary.
Before probable infection or after it within two weeks the person can enter immunoglobulin which during this period will protect from infection or from development of an illness in an organism.
Hepatitis A symptoms
The infectious disease throughout an incubation interval gradually begins to be shown by some characteristic signs. Fever, and also dispepsichesky manifestations can disturb the person (vomiting, nausea, weight in a stomach and the right hypochondrium). At the child can in it is the first few days insignificant increase body temperature. Besides, symptoms of an infectious disease are shown by weakness and darkening of urine. Later at the patient jaundice develops – characteristic yellow color is found by scleras, skin, and the kcal at the same time becomes colourless. Yellowness is shown on a body very quickly, practically for one night. Such state keeps for three-six weeks. And, after display of jaundice of the patient begins to feel a little better. On average the illness proceeds about 40 days. At this time adequate treatment is carried out it. But different factors, for example, age, the correct approach to therapy, existence of other diseases of chronic character can influence duration of the period of an illness.
Approximately at 15% of people who are affected by a hepatitis virus the illness passes into a chronic form and can proceed till 9 months. In most cases at hepatitis A typical symptoms are shown, and the patient completely recovers if recommendations of the doctor, and also the corresponding diet are observed.
Most hard children who were not one year old yet, adult patients, and also people of advanced age have hepatitis A. Children of preschool age have a viral hepatitis And passes in easier form while at adult patients symptoms of hepatitis A are shown is expressed, with severe intoxication. The illness can last about three months, despite the undertaken treatment.
It is necessary to consider also the fact that all hepatitises having any origin are shown by similar symptoms. Therefore it is very important to see timely a doctor and to pass comprehensive inspection.
Hepatitis A and pregnancy
If the woman plans pregnancy, the hepatitis A inoculation as the illness can provoke complications of pregnancy and even premature births is necessary for it. If vaccination was not carried out, then the pregnant woman has to know about how the infectious disease as prevention in this case is very important point is transferred accurately.
Classification of hepatitis A
There is a division of hepatitis A on several types by different criteria. Depending on displays of a disease the typical option (the patient has a jaundice) and atypical option is allocated (jaundice is not observed). If the last option takes place, then sometimes the illness passes imperceptibly as the child in this case suffers only from shortly frustration of a chair.
Estimating disease of Botkin at the child, doctors allocate an easy form (the majority of cases), medium-weight a form (about 30% of cases), a severe form (seldom, approximately in 1-3% of cases).
Diagnosis of hepatitis A
To diagnose hepatitis A for the patient, the doctor needs to study the epidemiological anamnesis of the patient carefully. In this case it is about what countries were visited by the person, than he ate whether at it contacts with patients, etc. Besides, it was obligatory analyses – the general and biochemical blood analysis, the analysis on markers of a viral hepatitis, the general analysis of urine, a koagulogramm are carried out.
The main criterion of diagnosis of an acute form of an infectious disease is allocation from blood of the person of antibodies to hepatitis A. They can be revealed in blood only during the acute period of a disease.
Treatment of hepatitis A
If hepatitis A is diagnosed for the person, then specific therapy does not practice as the patient recovers without treatment. In modern medicine of effort of specialists concentrate on reducing the content of harmful substances in a human body and to remove them. Such substances begin to appear in a human body when the liver is injured, and its main functions are broken. Therefore, the patient enters dezitoksikatsionny solutions, and also glucose. Reception of vitamins and drugs-gepatoprotektorov is shown them (these medicines protect liver cells). At an infectious disease there is no need for carrying out antiviral therapy. If doctors deal with a hard case of a disease, then the principle of treatment does not change, but volumes of the appointed drugs increase.
In process treatment it is important to adhere to a certain dietary food allowance. The food has to be caloric and balanced. It is necessary to enter into a daily diet of a squirrel in the form of low-fat meat and fish, eggs, low-fat cheese. Carbohydrates need to be used in the form of porridges, potatoes, bread, sugar. Fats need to be chosen a plant origin, and also to periodically use butter. Besides, it is important to child to eat many vegetables, fruit, to drink juice. At the same time it is forbidden to enter into a diet refractory fats, fat meat, fish, sausage, spicy food, bean, chocolate, smoked products, etc.
Good rest and condition of emotional and physical rest is not less important. Children who have an illness easily need to limit a physical activity. But if the child constantly feels bad, then he should adhere to a bed rest.
After recovery children without fail stay under dispensary observation. If after two surveys disturbances in a state of health are not found in the child, then it is struck off the register.
At hepatitis A the forecast is favorable, the person has a complete recovery of functions of a liver. In rare instances the liver remains increased, but it does not influence its functions.
Prevention of hepatitis A
The main measure of prevention is vaccination from an infectious disease. Modern vaccines are highly effective and have a high immunogenicity. It is necessary to enter a vaccine twice, at the same time the interval makes of half a year till one year. After introduction of a vaccine of people it is protected from infection with a virus till 10 flyings.
Inoculations do to the children who reached three-year age and also adults who never had hepatitis A. It is also important to carry out vaccination of those people, the risk of infection at whom is increased.
Several categories of persons which need to make vaccination against hepatitis A are defined. First of all, it is members of the family of the patient with hepatitis A and people, it is close to him contacting. The persons which had sexual contacts with patients have to receive inoculations. Also to vaccination it is necessary for those who live in regions where many cases are fixed; the people who are going to visit the countries where hepatitis A is widespread; homosexuals; those who use drugs.
Also employees of infectious departments of hospitals, all personnel of child care facilities, the employees of spheres of water supply and public catering, people suffering from chronic diseases of a liver have to receive hepatitis inoculations.
If in a family someone got sick with an infectious disease, it is recommended to inspect all family members regarding existence of antibodies to hepatitis A. Besides, as prevention of an illness all should follow the simplest rules of hygiene: to wash hands as often as possible, at the same time always to use soap. Very important from the earliest age to accustom children to observance of rules of prevention.
Section: Infectious diseases