What is the issue with hepatitis A?

Although typically a mild virus, hepatitis A can also kill.

  • How can a virus that usually causes a mild inflammation of the liver, actually kill someone?
  • The answer is not as straightforward as we think, but the solutions certainly are.
    • To answer the why hepatitis A kills, we have to look at
      1. who is most vulnerable and
      2. how exposure as well as transmission happens, which leads us to
      3. prevention.

What does research tell us about vulnerability and severity?

  • In countries such as the United States,
    • where we typically see low incidence of hepatitis A and low vaccination coverage against it,
      • we eventually shift to low levels of virus in the community as well as
        • an increase in vulnerable individuals.
    • It is only a matter of time before this leads to flare ups in older individuals.
  • At increased risk of severe disease due to hepatitis A are
    • individuals 55 and older, and
    • those who are already infected with any of the other hepatitis viruses
      • such as hepatitis B, C, or E,
        • as well as with HIV.
  • At the severe end of infection, the liver fails, necessitating a life-saving liver transplantation.

In 2017, Florida accounted for the highest number of new HIV diagnoses in the country.

  • 4 of the 10 metropolitan areas with highest rates of new HIV infection per 100,000 are all in Florida:
    • Miami (at # 1),
    • Fort Lauderdale (# 2),
    • Orlando (# 6), and
    • Jacksonville (#9).
  • One in seven HIV infected individuals are not even aware of their HIV infected status.
  • On the basis of HIV prevalence data,
    • men who have sex with men and
    • active injection drug users
      • are at very high risk for new HIV infection
        • – also risk factors for hepatitis A.

While vulnerability to hepatitis A may follow a wave pattern in the community, we cannot afford to just wait to ride the wave.

  • Instead, we have to do what we must,
    • to avoid being at the severe end of this viral infection.

How do we protect those at higher risk of severe hepatitis A?

Hepatitis A viruses are found in feces of infected individuals.

How does the virus make its way from feces to surfaces such as elevator push buttons or self-serve spoons, or hands we shake?

Simply put, DIRTY HANDS –

  • those that are unwashed
    • or not adequately washed
      • after a bowel movement
        • or after changing diapers.

At increased risk of hepatitis A is

  • anyone who is at increased risk of exposure to fecal matter,
    • whether it is within the United States
      • or when traveling to countries where
        • hepatitis A is seen as an endemic
          • that means it is always there and can flare up every once in a while.

Eating raw or undercooked shellfish from waters contaminated with the feces of those infected with hepatitis A virus, can be a risk factor for infection.

  • As we get older, we may indulge in gastronomic pleasures more often than in our younger days, because we have more time and/or more money.
    • Raw or undercooked shellfish may put us at risk of hepatitis A and a list of other pathogens.
    • Increased potential for exposure is not good, considering the inreased risk of severe infection in people over 55 years oaf age.
  • It is always good to ensure that the source is reputable or that the shellfish have been cooked adequately.

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