General characteristics

Hepatitis A virus (HAV) is classified with the enterovirus group of the Picornaviridae family. Many other picornaviruses cause human disease, including polioviruses, coxsackieviruses, echoviruses, and rhinoviruses (cold viruses).

The term hepatitis A (HA) or type A viral hepatitis has replaced all previous designations: infectious hepatitis, epidemic hepatitis, epidemic jaundice, catarrhal jaundice, infectious icterus, Botkins disease, and MS-1 hepatitis.

Disease symptoms

Hepatitis A is usually a mild illness characterized by sudden onset of fever, malaise, nausea, anorexia, and abdominal discomfort, followed in several days by jaundice. The infectious dose is unknown but presumably is 10-100 virus particles.

The incubation period for hepatitis A, which varies from 10 to 50 days (mean 30 days), is dependent upon the number of infectious particles consumed. Infection with very few particles results in longer incubation periods. The period of communicability extends from early in the incubation period to about a week after the development of jaundice. The greatest danger of spreading the disease to others occurs during the middle of the incubation period, well before the first presentation of symptoms.

Many infections with HAV do not result in clinical disease, especially in children. When disease does occur, it is usually mild and recovery is complete in 1-2 weeks.

Occasionaly, the symptoms are severe and convalescence can take several months. Patients suffer from feeling chronically tired during convalescence, and their inability to work can cause financial loss. Less than 0.4% of the reported cases are fatal. These rare deaths usually occur in the elderly.

Diagnosis

Hepatitis A is diagnosed by finding IgM-class anti-HAV in serum collected during the acute or early convalescent phase of disease. Commercial kits are available.

Associated foods

HAV is excreted in faeces of infected people and can produce clinical disease when susceptible individuals consume contaminated water or foods.

Cold cuts and sandwiches, fruits and fruit juices, milk and milk products, vegetables, salads, shellfish, and iced drinks are commonly implicated in outbreaks. Water, shellfish, and salads are the most frequent sources. Contamination of foods by infected workers in food processing plants and restaurants is common.

Prevention

The disease can be prevented by proper hygiene and thorough heating (over 80°C) of the foods.

Risk populations

All people who ingest the virus and are immunologically unprotected are susceptible to infection. Disease however, is more common in adults than in children.