Hepatitis

Hepatitis

You've probably heard warnings about hepatitis, a category of viral infections that can cause serious liver damage and even lead to death. Hepatitis literally means inflammation of the liver (hepa = liver; it is = inflammation).

If you're having trouble keeping up with the alphabet soup of the different types of the virus you're not alone. There are six main types: A, B, C, D, E and G. For the most part, however, you need to concern yourself only with hepatitis A virus, hepatitis B virus and hepatitis C virus-referred to as HAV, HBV and HCV respectively.

The hepatitis viruses all cause acute inflammation of the liver, while some infections related to hepatitis B and C may become chronic. Although many hepatitis infections do not cause symptoms, in those that do, the leading symptoms are:

• jaundice (yellowing of the skin and eyes)
• fatigue, malaise
• abdominal pain
• appetite loss
• nausea
• diarrhea
• vomiting

The good news is that vaccines against hepatitis A and hepatitis B have been introduced in the last 20 years. The U.S. Centers for Disease Control and Prevention (CDC) recommends that all children under 18 be vaccinated against hepatitis B (HBV), and that those at risk for either infection get the appropriate vaccination.

Hepatitis A

Hepatitis A, or HAV, causes about one third of all cases of acute hepatitis in the U.S., During epidemic years, the number of reported cases reached 35,000. In the late 1990s, hepatitis A vaccine was more widely used and the number of cases reached historic lows. However, health officials believe it is underreported because people often have no symptoms. HAV infection causes temporary symptoms and is not associated with chronic liver disease. Once you have had HAV you cannot get it again, although about 15 percent of people infected with the virus have prolonged or relapsing symptoms over a six to nine month period, according to the CDC.

HAV receives attention usually because of community outbreaks that result from person-to-person transmission, primarily through daycares and contact with contaminated food or water. In fact, the FDA recently (Nov. 2003) issued a warning advising the public that several recent hepatitis A outbreaks have been associated with eating raw or undercooked green onions (scallions) and offered the following advice to consumers:

• Cook green onions thoroughly. This minimizes the risk of illness by reducing or eliminating the virus. Cook in a casserole or sauté in a skillet.
• Check food purchased at restaurants and delicatessens and ask whether menu items contain raw or lightly cooked green onions. Consumers who wish to avoid food that contains raw or lightly cooked green onions should specifically request that raw or lightly cooked green onions not be added to their food. Foods such as freshly prepared salsa and green salads often contain raw green onions.

For most women, the biggest risk factors are sexual or household contact with an infected person, or travel to countries where hepatitis A is common. You cannot get the infection through casual contact.

For hepatitis A, vaccination is recommended for the following persons:

• Children two years of age and older
• Travelers to areas with increased rates of hepatitis A (view map, see below for link)
• Men who have sex with men
• Injecting and non-injecting drug users
• Persons with clotting-factor disorders (e.g., hemophilia)
• Persons with chronic liver disease