Hepatitis A- Clinical Features Incubation period Average 30 days Range 15-50 days Jaundice by 6yrs,<10% age group 6-14yrs,40%-50% >14yrs,70%-80% Complications Fulminant hepatitis Cholestatic hepatitis Relapsing hepatitis Chronic sequelae None
◼ Incubation period: Average 30 days Range 15-50 days ◼ Jaundice by <6 yrs, <10% age group: 6-14 yrs, 40%-50% >14 yrs, 70%-80% ◼ Complications: Fulminant hepatitis Cholestatic hepatitis Relapsing hepatitis ◼ Chronic sequelae: None Hepatitis A - Clinical Features
Hepatitis A Infection Typical Serological Course Symptoms Alt Titre Total anti HAV IgM anti-HAV Fecal HAWV 0 1 6 12 24 Months after exposure
Fecal HAV Symptoms 0 1 2 3 4 5 6 12 24 Hepatitis A Infection Total antiHAV Titre ALT IgM anti-HAV Months after exposure Typical Serological Course
Hepatitis a virus Transmission Close personal contact (e.g., household contact, sex contact, child day care centers) Contaminated food. water (e.g, infected food handlers, raw shellfish Blood exposure (rare) (e.g, injecting drug use, transfusion)
◼ Close personal contact (e.g., household contact, sex contact, child day care centers) ◼ Contaminated food, water (e.g., infected food handlers, raw shellfish) ◼ Blood exposure (rare) (e.g., injecting drug use, transfusion) Hepatitis A Virus Transmission
Sources of Hav infection 40 198393 30 可 Pr9na」 20 c9门 Day care enter 10 Foreign travell Druguse 0 Outbreak 19831984198519861987198819891990199119921993 Year Source: CDC, Viral Hepatitis Surveillance Program
Sources of HAV Infection 1983-93 Percentage of Cases Source: CDC, Viral Hepatitis Surveillance Program Year Personal contact Day care center Foreign travel Outbreak Drug use 40 30 20 10 0 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993
Concentration of hav in various Body Fluids Feces Serum Saliva Urine 10 102 10 10 10 1010 Infectious Doses per ml Source: Viral Hepatitis and Liver Disease 1984: 9-22 J Infect dis1989:160:887-890
Concentration of HAV in Various Body Fluids Source: Viral Hepatitis and Liver Disease 1984;9-22 J Infect Dis 1989;160:887-890 Feces Serum Saliva Urine 100 102 104 106 108 1010 Infectious Doses per ml