Hepatitis A is an infection of liver formerly known as “Infective” hepatitis or epidemic jaundice, caused by hepatitis A virus. Although mortally is less (0.1%) patients may be incapacitated for many weeks.
Incidence & Prevalence: Exact incidence difficult to calculate due to high proportion of asymptomatic case4s however according to W.H.O. it is 10-50 persons per 1,00,000 population per year.
Agent: Hepatitis A virus is an enterovirus, which multiplies only in hepatocytes. Faecal shedding of virus is at its highest during the later part of incubation period & early acute phase of illness. The virus is inactivated by ultraviolet rays, by boiling for 5 minutes & autoclaving. It withstands heating & routine chlorination. However, it is destroyed in water by super chlorination (1 to 1.5 ppm chlorine levels).
Host: more frequent among children, but affects all ages if infected. Both sexes susceptible. Immunity after attack probably lasts for life.
Environmental: Associated with heavy rainfall. Poor sanitation & overcrowding favors the spread.
Mode of transmission: Major route is faeco oral transmission (direct from person to person or indirectly from contamination of water, food or milk. rarely can be transmitted from parenteral route (blood & products or skin contamination & sexual route).
Incubation period: 15-45 days
Clinical features: Nonspecific symptoms like fever, chills, headache, fatigue, generalized weakness followed by anorexia, nausea, vomiting, dark urine & jaundice. Many cases are subclinical or asymptomatic.
Diagnosis: demonstration of HAV particles or antigens in the faeces. Demonstration of a rise in anti HAV titre. Detection of ig M antibody to HAV.
Prevention & containment:
- Primary: i) Personal & environmental sanitation. ii) Vaccines:- 4 inactivated vaccines currently available, are given parenterally, in 2 doses, 6-8 months apart. iii) Human immunoglobulin:- is given to susceptible population traveling to highly endemic area and to the close personal contacts of cases. It is also given to susceptible persons during an out break in institutions.
- Secondary: Control of reservoir: it is difficult because of faecal shedding of the absence of specific treatment, notification, disinfection of faeces & fomites, health education are the measures advised.
Homeopathy prevention steps for Hepatitis A :
- Promoting personal hygiene: Education of people, about hand washing, before eating & after toilet. Advise boiled water for drinking purpose especially during epidemics.
- Promoting community hygiene: Education about sanitary disposal of excreta, which will prevent contamination of food, water or milk.
- Ensuring purification of water supply. 1 mg/liter of free residual chlorine can cause destruction of virus 30 minutes at ph value of 8.5 or less.
- Collection of water, food & milk samples in the area to confirm the epidemic.