,

How is hepatitis A transmitted?

  1. Characteristics of the pathogen
  2. Ways of transmission
  3. Waterway
  4. Food path
  5. Contact path
  6. Parenteral route
  7. Sexual way
  8. Other transmission routes
  9. Risk groups
  10. Vaccination

Hepatitis A (or Botkin's disease) is a liver disease of a viral nature, in which there is inflammation of its tissue and necrosis of hepatocyte cells. This pathology belongs to the intestinal group of infections, which is different from most other viral lesions of the liver, therefore, how hepatitis A is transmitted has its own characteristics.

Characteristics of the pathogen

Hepatitis A virus is highly resistant to adverse effects. In the environment, it can remain viable for weeks at room temperature, for months - in the refrigerating chamber, and for years - when freezing to -20 ° C. Boiling kills him only after 5 minutes. Many ways of inactivating infections used in food production can also be transmitted by the virus without damage.

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Ways of transmission

The high survival rate of the pathogen in the environment determines its main transmission paths - water and alimentary (food). The general mechanism of infection is called fecal-oral.

Waterway

The virus is excreted in large quantities along with the feces of a person with hepatitis. With inadequate disinfection of discharges, it, along with wastewater, can get into fresh or salty water bodies.

Drinking unboiled and non-chlorinated water is one of the main ways to get a virus. This can happen in countries and regions with an undeveloped or missing sewage system and central water supply. It should be noted that local residents in such areas often suffer hepatitis A in childhood and, by about 10 years of age, have a persistent lifelong immunity to the reintroduction of the pathogen.

Another type of infection is through raw vegetables and fruits that have been previously washed with water containing a live virus.

Food path

Once in the water, the virus can accumulate in the bodies of river and sea inhabitants - mollusks and fish. Many bivalves, mussels, oysters and other soft-bodied in the process of obtaining food filter large amounts of water, thereby concentrating the virus in their bodies. In the same way, the gills and intestines of fish are infected. If seafood is consumed raw or not thermally processed, there is a chance of being infected with the hepatitis A virus.

If an infected person is associated with cooking (a cook or a housewife) and poorly complies with the rules of personal hygiene, there is a high likelihood of infection from eating foods created by him. Especially dangerous are cold appetizers, salads, dishes made from products previously thawed by thawing at room temperature.

The peculiarity of the course of hepatitis A lies in the fact that in the initial period, an infected person may have little or no pain, while becoming the source of infection. In addition, there are erased and anicteric forms of the disease, making it difficult for its timely diagnosis and isolation of the patient.

Contact path

Infection is possible by close contact with a sick person while violating hygienic rules. This most often occurs during the care of patients at infectious departments (or at home), as well as in nursing homes, close communication in kindergartens and schools, labor or army collectives. The danger increases if there is a need to change diapers (with incontinence in a patient's urine and feces). Possibilities of infection are, first of all, the staff of clinics or family members in contact with the patient, in the second turn, other people who have daily or casual communication with him.

Parenteral route

Transmission of the virus through the blood is theoretically possible in the case of blood transfusion from a donor infected with hepatitis A and in the prodromal period (when there are only harbingers of the disease). The risk increases if drugs (for example, blood plasma) are prepared and frozen from the patient’s blood.

Previously, this pathway had epidemiological significance and sometimes led to the infection of patients with hemophilia who received blood coagulation factor from frozen plasma. At present, when repeated and multi-stage control of donor blood is used, the probability of infection with the hepatitis A virus is not seriously considered parenterally.

The possibility of infection by drug addicts when using a common syringe has not been finally clarified. The rare cases described are most likely variants of contact infection (through dirty hands).

Sexual way

With normal heterosexual sexual intercourse, the hepatitis A virus is not transmitted because it is not found in semen or in vaginal secretions. However, sexual intercourse increases the likelihood of the usual fecal-oral transmission of the pathogen (especially homosexual acts between men). Is hepatitis A transmitted through kiss? There is information about a low concentration of the virus in saliva, but this mode of transmission has not been confirmed. In any case, you should not kiss a person with hepatitis until his recovery.

Other transmission routes

There are isolated reports of infection of a newborn with a sick mother, although, most likely, this is not about intrauterine infection, but about transmission of the virus after birth by the usual contact way.

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Risk groups

The following populations are most susceptible to possible infection with the hepatitis A virus:

  • living in areas with a high prevalence of the virus;
  • heading to regions that are epidemically unfavorable for hepatitis A (countries in Africa, Central and Southeast Asia, some regions of Latin America);
  • medical staff of infectious diseases clinics;
  • family members in which there is a patient with hepatitis;
  • persons who have close contact with the patient (including sexual contact);
  • men practicing same-sex relationships;
  • people who use drugs (in any form).

Everyone at risk is recommended to be tested for hepatitis A and to actively immunize by administering a vaccine.

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Vaccination

The vaccine is inactivated pathogen particles that have retained their immune properties. The drug is administered twice (with an interval of up to 1 year). The protective level of antibodies occurs several days after vaccination and lasts up to 10 years.

Although the disease caused by the virus is relatively benign, usually leads to complete recovery and almost does not form chronic forms, there may be complications such as liver failure, which makes treat the pathology seriously. Given the way hepatitis A is transmitted, in the prevention of infection, compliance with basic hygienic standards, heat treatment of food and the use of proven drinking water are crucial.

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