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HEPATITIS
INTRODUCTION
Hepatitis A
● Hepatitis A (formerly known as "infectious" hepatitis or epidemic
jaundice) is an acute infectious disease caused by Hepatitis A virus
(HAV).
● The disease is heralded by non-specific symptoms such as fever,
chills, headache, fatigue, generalized weakness and aches and pains,
followed by anorexia, nausea, vomiting, dark urine and jaundice.
● The disease is benign with complete recovery in several weeks.
● One stable serotype only• 4 genotypes
● Globally, there are an estimated 1.4 million cases of hepatitis A every
year
● Hepatitis A infection does not cause chronic liver disease and is rarely
fatal, but it can cause debilitating symptoms and fulminant hepatitis
(acute liver failure)
TRANSMISSION
• Primarily –faecal -oral route Waterborne outbreaks
(infrequent) are usually associated with sewage-contaminated
or inadequately treated water.
• Close physical contact with an infectious person not casual
contact among people.
• Hep A is in the poop of someone with hep A.
• If they haven't washed their hands after using the toilet, tiny
bits of poop can get on things they touch. Hep A spreads from:
EPIDEMIOLOGY TIME
Number of hepatitis cases reported, number tested, and number confirmed for hepatitis A and hepatitis E* - India,
2011-2013
EPIDEMIOLOGY
PLACE
This is a
map of
India
showing
the number
of reported
hepatitis
outbreaks
(N = 291),
by state
during
2011-2013.
EPIDEMIOLOGY Person
Age-specificprevalence (all centers).Abbreviation: HAV, hepatitisA virus.
RISK FACTORS
• Poor sanitation
• Lack of safe water
• Injecting drugs
• Living in a household with an infected person
• Being a sexual partner of someone with acute
hepatitis A infection
• Travelling to areas of high endemicity without being
immunized
SIGN. AND SYMPTOMS
• Hepatitis A infection has four clinical phases, although these do not occur in all patients.
• First stage An incubation period of 15 to 50 days (mean 28 to 30 days).
• Asymptomatic Infected person may be actively shedding the virus in the stool.
• Second stage Several days to weeks that may precede the onset of jaundice .
• Prodromal period is characterized by nonspecific symptoms
• Gastrointestinal symptoms such as anorexia, nausea, vomiting, abdominal pain, fatigue,
malaise, and fever .
• Myalgia, arthralgia, cough, pharyngitis, constipation, diarrhea, pruritus, and urticaria. Dark urine
caused by elevated bilirubin levels usually occurs prior the onset of jaundice.
• Third stage Characteristic yellowing of the skin and eyes of jaundice appear•
• Most symptoms subside Clinical signs such as hepatomegaly and hepatic tenderness are found in
about half of patients There is no treatment for HAV infection.
• Jaundice usually resolves within a few weeks
• Final stage Convalescent period during which the patient recovers.
PREVENTION
• Primary
• High risk individual includes person-
• travelling to high/intermediate endemic area,-
• Drug users - Homosexual because of oral-anal contact- with chronic liver disease (have
increased morbidity & mortality).-
• Food handlers and person exposed to raw sewage are not at high risk..
• Secondary
• W.H.O. position on Hepatitis A vaccine- Vaccination should be part of comprehensive plan for
prevention and control of Hepatitis A.
• If indicated on basis of age-specific incidence and consideration of cost-effectiveness, can be
integrated with national immunization schedule for children above 1 year age.
• Tertiary
• W.H.O. position on Hepatitis A vaccine- In high endemicity area, natural immunity is acquired so
large scale vaccination programme not recommended.- In intermediate endemicity large scale
vaccination programme are cost-effective.- In low endemicity vaccination of high risk group
should be considered.
THANK YOU

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Hepatitis epidemiology person, place, time graph

  • 2. INTRODUCTION Hepatitis A ● Hepatitis A (formerly known as "infectious" hepatitis or epidemic jaundice) is an acute infectious disease caused by Hepatitis A virus (HAV). ● The disease is heralded by non-specific symptoms such as fever, chills, headache, fatigue, generalized weakness and aches and pains, followed by anorexia, nausea, vomiting, dark urine and jaundice. ● The disease is benign with complete recovery in several weeks. ● One stable serotype only• 4 genotypes ● Globally, there are an estimated 1.4 million cases of hepatitis A every year ● Hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure)
  • 3. TRANSMISSION • Primarily –faecal -oral route Waterborne outbreaks (infrequent) are usually associated with sewage-contaminated or inadequately treated water. • Close physical contact with an infectious person not casual contact among people. • Hep A is in the poop of someone with hep A. • If they haven't washed their hands after using the toilet, tiny bits of poop can get on things they touch. Hep A spreads from:
  • 4. EPIDEMIOLOGY TIME Number of hepatitis cases reported, number tested, and number confirmed for hepatitis A and hepatitis E* - India, 2011-2013
  • 5. EPIDEMIOLOGY PLACE This is a map of India showing the number of reported hepatitis outbreaks (N = 291), by state during 2011-2013.
  • 6. EPIDEMIOLOGY Person Age-specificprevalence (all centers).Abbreviation: HAV, hepatitisA virus.
  • 7. RISK FACTORS • Poor sanitation • Lack of safe water • Injecting drugs • Living in a household with an infected person • Being a sexual partner of someone with acute hepatitis A infection • Travelling to areas of high endemicity without being immunized
  • 8. SIGN. AND SYMPTOMS • Hepatitis A infection has four clinical phases, although these do not occur in all patients. • First stage An incubation period of 15 to 50 days (mean 28 to 30 days). • Asymptomatic Infected person may be actively shedding the virus in the stool. • Second stage Several days to weeks that may precede the onset of jaundice . • Prodromal period is characterized by nonspecific symptoms • Gastrointestinal symptoms such as anorexia, nausea, vomiting, abdominal pain, fatigue, malaise, and fever . • Myalgia, arthralgia, cough, pharyngitis, constipation, diarrhea, pruritus, and urticaria. Dark urine caused by elevated bilirubin levels usually occurs prior the onset of jaundice. • Third stage Characteristic yellowing of the skin and eyes of jaundice appear• • Most symptoms subside Clinical signs such as hepatomegaly and hepatic tenderness are found in about half of patients There is no treatment for HAV infection. • Jaundice usually resolves within a few weeks • Final stage Convalescent period during which the patient recovers.
  • 9. PREVENTION • Primary • High risk individual includes person- • travelling to high/intermediate endemic area,- • Drug users - Homosexual because of oral-anal contact- with chronic liver disease (have increased morbidity & mortality).- • Food handlers and person exposed to raw sewage are not at high risk.. • Secondary • W.H.O. position on Hepatitis A vaccine- Vaccination should be part of comprehensive plan for prevention and control of Hepatitis A. • If indicated on basis of age-specific incidence and consideration of cost-effectiveness, can be integrated with national immunization schedule for children above 1 year age. • Tertiary • W.H.O. position on Hepatitis A vaccine- In high endemicity area, natural immunity is acquired so large scale vaccination programme not recommended.- In intermediate endemicity large scale vaccination programme are cost-effective.- In low endemicity vaccination of high risk group should be considered.