Hepatitis A and Hepatitis E viruses are common causes of Hepatitis leading to Jaundice.

How do people get Hepatitis A or E?

People can get infection if they eat food or drink water with virus in it. The most common way for the hepatitis A virus to be spread is when an infected person does not wash their hands after using the bathroom and then touches food.

The majority of people who acquire the illness have had personal contact with an infected person. Poor hygiene and lack of adequate sanitation are often the causes of infection.

Hepatitis E virus is spread by focally contaminated water. Person-to-person transmission is uncommon. Rarely Hepatitis E virus can be transmitted by blood transfusion.

What are the symptoms?

Hepatitis can cause flu-like illness initially. Initial symptoms may be non- specific.

At first, symptoms usually include:

* Feeling tired

* Nausea or vomiting

* Having no appetite

* Sometimes Fever higher than 100 °F

* Pain on the right side of the abdomen

Later on, symptoms usually include:

* Dark-colored urine

* Light-colored bowel movements

* Jaundice, when the skin or white part of the eye turns yellow

* Itchy skin

Hepatitis E symptoms are relatively severe compared with Hepatitis A.

Majority of patients will recover fully. Rarely, hepatitis A and E can cause liver failure that can lead to death (0.5 to 3%).

What are the tests to diagnose Hepatitis A or E?

Usually a blood test to look for liver function test and Hepatitis A and E antibodies are done. Stool testing can be done (rarely used).

Sometimes Ultrasound of abdomen may be necessary.

What are the complications?

Most people feel better within two to three months of becoming infected with hepatitis A or E virus, and almost everyone completely recovers within few months. About 10 -15 percent of people infected will have prolonged or relapsing symptoms during the first six to nine months after being infected.

The most serious complication of hepatitis virus infection is liver failure which may lead to death. This occurs rarely, but is more likely in adults with chronic liver infections such as hepatitis B or C and those who have alcoholic liver disease.

Hepatic failure is also more likely in those who are pregnant and in those who are malnourished.

Unlike with other forms of hepatitis, people with hepatitis A or E do not develop chronic liver disease as a result of their infection.

What is the treatment?

The treatment of Hepatitis A and E virus is supportive treatments at home, including rest. Patients do not need any antibiotics. The amount of time needed to recover depends upon the individual; in general, the person should not return to work or school until the fever and jaundice have resolved and the appetite has returned.

During the recovery period, it is important to avoid drinking alcohol, which can injure the liver.

Less commonly, people infected with hepatitis A or E virus require treatment in a hospital to monitor the liver function, manage complications such as dehydration, bleeding and provide adequate nutrition.

Is there a vaccination?

Vaccines are available to prevent infection with hepatitis A virus. Vaccines for Hepatitis E are in development.

Hepatitis A vaccination can protect nearly 100 percent of people who receive two doses for a lifetime. The second dose is usually given six to twelve months after the first. The initial dose usually provides adequate short-term protection, and the subsequent doses provide long-term protection.

The most common side effect of the vaccine is brief redness or discomfort at the injection site.

Immune globulin — Immune globulin is an injection that provides temporary protection against hepatitis A and reduces the risk of infection by more than 90 percent. However, the hepatitis A vaccine is preferred to immune globulin in most cases because it provides long-lasting protection.

Immune globulin is given in a single injection shortly before travel to an endemic area. A single dose provides protection for about three months.

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