What are the paths of infection with hepatitis and exist? Causes, symptoms and treatment of hepatitis and the main way of transmission of viral hepatitis A

Hepatitis A or Botkin's disease - acute viral liver disease, which causes damage to organ cells. It manifests itself with general intoxication and jaundice. Hepatitis A is transmitted by the fecal-oral way, so it is also called the "dirty hand disease."

Compared to other hepatitis (B, C, E), this disease is considered the most benign. In contrast, hepatitis A does not cause chronic lesions and has a low mortality rate - less than 0.4%. With the uncomplicated flow, the symptoms of the disease disappear in 2 weeks, while the liver functions are restored over a period of one and a half months.

Diseases are equally susceptible to men and women of all ages. Children from year to 10 years tolerate disease in light shape, and babies and elderly people in heavy. After the suffered disease, persistent immunity remains, so hepatitis A is sick once.

Incidence statistics Hepatitis A.According to WHO, the disease annually transfer 1.5 million people. In fact, the number of illness is more different. The fact is that 90% of children and 25% of adults suffer a hidden asymptomatic form of the disease.

Viral hepatitis A is distributed in developing countries with low sanitation ^ Egypt, Tunisia, India, the countries of Southeast Asia, South America and the Caribbean. It is worth remembering to tourists departing for rest in hot countries. In some states, the disease is so common that all children are overgamed to the ten-year-old age. The territory of the CIS refers to countries with an average risk of infection - 20-50 of those ill per 100 thousand population. Here the seasonal rise in incidence is celebrated in August - early September.

History. Hepatitis A is known since the time of antiquity called "Justice Disease". Large epidemics broke out during the war, when the masses of people turned out to be in the conditions of antisanitarian, so hepatitis was also called the "troop jaundice." Doctors linked the disease for a long time only with blocking of biliary tract. In 1888, Botkin put forward a hypothesis that the disease has an infectious nature, so subsequently it was named after him.
The hepatitis virus was detected only in the 70s of the twentieth century. At the same time, it was possible to create a vaccine that protects against infection.

Hepatitis A virus properties

Hepatitis A or HAV virus belongs to the Picornavirus family (from the Italian "small"). It really is different from other pathogens very small size - 27-30 nm.

Structure.The virus has a rounded spherical shape and is one chain of RNA enclosed in a protein shell - capsid.

HAV has 1 serotype (variety). Therefore, after a transferred disease in the blood, antibodies to it are preserved and the disease is no longer developing during re-infect.

Sustainability in the external environment. Despite the fact that the virus does not have a shell, it remains for quite a long time in the external environment:

• when drying on household item - up to 7 days;
• in a humid environment and on food products for 3-10 months;
• when warming up to 60 ° C withstands up to 12 hours;
• when freezing below - 20 ° C is saved for years.

Disposal with a boiling virus over 5 minutes or solutions of disinfectants: chlorine lime, potassium permanganate, chlorine T, formalin. Given the stability of the virus, disinfection in the premises where the patient was needed especially carefully.

HAV Life Cycle. With food, the virus falls on the mucous membrane of the mouth and intestines. From there he penetrates into the bloodstream and in the liver.

Since the virus falling into the body before the occasion of the disease, it takes from 7 days to 7 weeks. In most cases, the incubation period lasts 14-28 days.

Next, the virus penetrates inside the cells of the liver - hepatocytes. How he manages it still has not been established. There it comes out of the shell and embedded in the ribosome of cells. He rebuilds the work of these organelles in such a way that they create new copies of the virus - Virion. New bile viruses fall into the intestines and are outlined with the feces. The affected liver cells wear out and dying, and the virus moves to neighboring hepatocytes. This process continues while the body does not produce enough antibodies that destroy viruses.

The transmission mechanism is fecal-oral.

The sick person allocates a huge number of viruses with the creation of the environment. They can get into the water, for food, household items. If the pathogen falls into his mouth with a healthy susceptible to the infection to a person, hepatitis will develop.

Infected hepatitis A can be infected in such situations

• Swimming in polluted pools and water bodies. The virus enters mouth with fresh and sea water.
• Eating contaminated products. Often it is berries, for the fertilizer of which used human feces.
• Eating raw mollusks and mussels from contaminated reservoirs where the causative agent of the disease can continue.
• When using poorly purified water. Infected water is dangerous not only to drink, but also use it for washing hands and dishes.
• With a joint accommodation with a sick, infection occurs through household items (door handles, towels, toys).
• With sex with patients. This transmission path is especially common in the Homosexual environment.
• With intravenous drug administration, the non-sterile syringe. The virus circulates in the blood and through the needle is transmitted from one person to another.

Risk factors for hepatitis A

• non-compliance with personal hygiene rules
• stay in the places of large cluster of people: boarding rooms, barracks
• stay under conditions where there is no water supply and sewage: refugee camps, military camps of military personnel
• trips to areas with high levels of morbidity without preliminary vaccination
• accommodation with man, sick hepatitis A
• lack of access to safe drinking water

Symptom	Development mechanism	How externally or when diagnosing manifests itself
Prickful period lasts 3-7 days
Signs of general intoxication appear at the end of the incubation period	Liver cell decay products poison the patient's body, including the nervous system	Havigation, increased fatigue, lethargy, loss of appetite
Temperature increase. In the first days of illness in 50% of patients	The reaction of the immune system to the presence of blood virus	Chills, fever, temperature rise to 38-39
The jaundice period lasts 2-4 weeks
Jaundice appears on the 5-10th day since the beginning of the disease	A bile pigment is accumulated in the blood - bilirubin. This is a product of the decay of erythrocytes in the liver. Normally, the pigment binds to blood proteins. But when the function of the liver is broken, it can not "send" it in bile, and bilirubin returns to blood	First yellow the mucous membrane under the tongue and eye sclera, then the skin becomes yellow, saffron. This happens when the bilirubin concentration in the blood exceeds 200-400 mg / l With the advent of the jaundice, the temperature is normalized
Damage urine	In the surplus bilirubin and urobilin from the blood output through the kidneys with urine	Urine acquires dark beer color, foams
Decorating Cala	When hepatitis, the arrival of sterkobilo with bile in the intestines is reduced. This is a pigment from destroyed red blood cells, which stains cals	In the pre-sutual period of the feces decollected gradually - becomes spotted, then it becomes completely colorless
Pain in the right hypochondrium	Viruses affect liver cells and cause their death, edema develops. The liver increases in size and stretches the sensitive capsule	The feeling of rubbing, pain and severity in the right hypochondrium. The liver is enlarged, when tugs, the patient feels pain
Increased spleen	Associated with an immune response to infection and reinforced neutralization of toxins	When tugs, the spleen is increased
Dyspeptic phenomena	Digestive problems are associated with impaired liver function. Bile is stood in the gallbladder misses the intestines in sufficient quantities	Nausea, vomiting, gravity in the stomach, belching, bloating, constipation
Pain in muscles and joints	Pains are associated with accumulation of toxins caused by the death of virus and liver cells	Lomotation in body pain in muscles
Skin itch	Increasing the level of bile acids in the blood leads to their accumulation in the skin and allergic reaction.	Dry skin that is accompanied by itching
The period of recovery lasts from 1 week to six months
Symptoms gradually weaken, liver functions are restored.

Treatment of hepatitis A.

Hepatitis Treatment A Medications

Specific medication treatment of hepatitis A does not exist. Therapy is aimed at eliminating symptoms, removal of intoxication and speedy restoration of normal liver operation.

Group of drugs	Mechanism of therapeutic action	Representatives	How to apply
Vitamins	Reduce the permeability of vessels, reduce the edema of the liver tissue, increase the body's resistance to the virus	Askorutin, Askorutin, Undevit, Aevit	1 tablet 3 times a day
Hepatoprotectors	Accelerate the restoration and division of damaged liver cells. Supply structural elements necessary for the construction of cell shells of hepatocytes	Esssential, Carsil, Hepatofalc	1-2 capsules 3 times a day
Enterosorbents	To remove toxins from the intestine and eliminate the bloating	Smekt, polyfepan.	2 hours after each meal
Enzyme preparations In medium and heavy forms	Contribute to the splitting of proteins, fats and carbohydrates and early suction of food in the intestine	Creon, Mezim-Forte, Pancreatin, Festal, Enzystal, Panzinorm	During each meal of 1-2 tablets
Glucocorticoids With a sharp deterioration of the state	Anti-inflammatory anti-allergic effects, reduce the attack of immunity cells (lymphocytes and leukocytes) on damaged liver cells	Prednisolone, methylprednisolon	60 mg / day orally or 120 mg / day intramuscularly for 3 days
Immunomodulators	Improve the work of immunity. Stimulate the production of antibodies to combat hepatitis A virus	Timalin, Timogen	Introduced intramuscularly at 5-20 mg per day for 3-10 days
		T-activin	Enter subcutaneously 1 ml 0.01% solution for 5-14 days
Disinfect solutions	Bind toxins circulating in blood and contribute to their rapid excavation with urine	Gemodez, Geopolyglyukin	Intravenously drip 300-500 ml per day
Choleretic means	Eliminate bile stars in the liver, contribute to its cleansing and improving digestion	Sorbitol Magnesium Sulfat.	1 tsp dilute in a glass of warm boiled water and drink overnight

Currently, doctors try to abandon unnecessary drugs, assigning only the necessary minimum to eliminate symptoms.

Does hospitalization need for hepatitis ah?

When hepatitis, I need hospitalization into an infectious office in such cases:

• with complicated forms of hepatitis A
• with the joint occasion of the disease of Botkin and other hepatitis
• with alcohol liver damage
• elderly patients and children under the 1st year
• in weakened patients with severe concomitant diseases

Diet with hepatitis A

In the treatment of hepatitis A recommended diet 5. In the fight against infection, therapeutic nutrition plays a big role. It reduces the load on the liver and protects its cells. It is recommended to eat in small portions 4-6 times a day.

• dairy products: low-fat cottage cheese, kefir, yogurt, low-fat sour cream for refueling
• non-fat meat: beef, chicken, rabbit
• meat products: Steam beds, meatballs, meatballs, sausages and boiled sausages from beef
• non-fat fish: Sudak, Pike, Carp, Heck, Mintai
• vegetables: Potatoes, zucchini, cauliflower, cucumbers, beets, carrots, cabbage, tomatoes
• garniirs: Cruses (except legumes and pearl), pasta
• soups low-fat vegetables, milk with the addition of croup
• bread Yesterday, SUKHARI
• eggs: Omelet from proteins, 1 egg skeyka per day
• desserts: mousses, jelly, kislets, marshmallow, marmalade, grazing, protracted cookies, honey, homemade dried fruit jam
• fats:creamy oil 5-10 g, vegetable oils up to 30-40 g
• beverages: Tea black, herbal, compotes, juices, umbar, decoction of rosehip, coffee with milk, alkaline mineral waters, 5% glucose solution.
• preloading preparations To restore the electrolyte balance, reciprons are recommended, Human electrolyte, hydraulic forte.

Exclude from the diet:

• fried smoked dishes
• cannedize Fish, meat, vegetable
• meat of fatty varieties: Pork, goose, duck
• fat fish: sturgeon, bulls, spicy herring, caviar
• fat.: Saletz, Salo, Margarine
• bakery products Fresh bread and puff pastry
• fatty dairy products: whole milk, cream, bold cottage cheese, salted cheese
• soups on concentrated meat, fish broth, sour soup
• vegetables: radish, radish, sauerkraut, sorrel, onions, parsley, pickled vegetables, mushrooms
• desserts: ice cream, chocolate, products with cream, candy, sparkling
• beverages: Strong coffee, cocoa, carbonated drinks, alcohol

Diets must be followed during the disease and for 3-6 months after recovery. The limitation of fat and simple carbohydrates allows preventing fat degeneration of the liver. Lightweight dishes and fractional nutrition contribute to the best outflow of the bile and normalization of digestion.

It is very important to stick to the drinking mode. To remove toxins, it is necessary to use at least 2 liters of pure water without gas.

Is it possible to treat hepatitis and at home?

With the easiest course of the disease, hepatitis can be treated at home. For this you need several conditions:

• the patient passed the survey, passed the tests, and will regularly visit the doctor
• the disease occurs in a light uncomplicated form
• it is possible to isolate a patient in a separate room
• compliance with diet and semi-state regime

By the time of the appearance of jaundice, the patient becomes practically not dangerous for others. It can eat at one table with family, use a shared toilet and bathroom.

Restrictions. It is not desirable to attract a patient for cooking. All family members must strictly follow the rules of personal hygiene and thoroughly wash their hands after visiting the toilet.

Mode. Prickful period - bedding needed. The patient is experiencing strong weakness and excess energy costs can lead to an additional liver load. And in a horizontal position, the sick organ gets more blood, which contributes to a speedy recovery.

Justice period - The semi-noar mode is allowed. After the symptoms of the disease weakened, you can gradually increase activity. This contributes to the restoration of the physical and emotional state.

Complications are not characteristic of hepatitis A. The consequences arise only 2% of cases. In the risk group, people who disturb the diet, not respecting the appointment of a doctor who abuse alcohol suffering from the pathology of the liver.

The most common complications of hepatitis A

• Biliary dyskinesia - Violation of the motorbish of biliary tract, as a result of which the stagnation of bile arises. Symptoms: pain in the right hypochondrium, giving up the right shoulder, occurs after eating and physical exertion. Bind in the mouth, nausea, vomiting, unpleasant smell of mouth.
• Cholecystitis - Inflammation of the walls of the gallbladder, accompanied by stagnation of bile. Symptoms: sharp pain in the right hypochondrium, giving up the right side of the lower back and neck. Strengthen when moving, cough, changing body position. The right half of the abdominal wall is tense. Joy, skin itching, nausea, vomiting. In chronic fine-free cholecystitis after a meal there are stupid bastards in the right half of the abdomen.
• Chronic pancreatitis - chronic inflammation of the pancreas. Symptoms: Pain in the area of \u200b\u200bthe stomach and left hypochondrium, pains can be permanent or periodic, are given in the back, heart, often have a sinking character. The disease is accompanied by diarrhea, nausea and can cause diabetes mellitus.

Hepatitis A. Prevention

Hepatitis prevention A includes several directions.

1. Disinfection in hepatitis and hepatitis

   Disinfection is carried out in the apartment of the disease. Medical staff teaches family members how to handle items with which the patient contacted.

   • Bed linen and clothing boil in soap 2% solution (20g any washing powder per liter of water) 15 minutes, and then erased as usual.
   • Dishes after meals are boiled 15 minutes in 2% soda solution
   • Carpeted coatings are cleaned with a brush moistened in a 1% solution of chlorine.
   • The floors and other surfaces wash with hot 2% soap or soda solution. In the same way handle the door handles of the toilet and wash tank.
2. Hepatitis A vaccination

   Vaccination is aimed at reducing susceptibility to the virus.

   • Human immunoglobulin is normal.The drug is administered intravenously drip people living in the same apartment with sick. The drug contains ready-made donor antibodies against hepatitis A and other infections. Its use several times reduces the risk of getting sick.
   • Vaccine against hepatitis A - a mixture of neutralized cleaned viruses. In response to the introduction of vaccine, the body produces specific antibodies. Therefore, if infection occurs, the disease does not develop - antibodies quickly neutralize viruses.
   The vaccine is not included in the list of mandatory vaccinations due to its expensive value.
   • Travelers serving low hygiene countries
   • Servicemen, long time staying in the field
   • People in refugee camps and other places where it is impossible to comply with the rules of hygiene due to the lack of water supply and sewage
   • medical personnel
   • employees of food industry enterprises
3. Hygiene rules
   • thoroughly wash your hands after visiting the toilet
   • drink only boiled water
   • wash vegetables, fruits and greens
   • do not swim in the reservoirs in which the wastewater could get
   • carefully serving and deliver products when cooking
4. Activities for contact persons

   To prevent the spread of infection, the health workers are watching people who were in contact with the patient:

   • Quarantine in groups and children's teams for a period of 35 days from the moment of insulation of the last diseased disease
   • Observation of all contacting. Check whether there is no yellowness on the mucous membranes and the gluers, whether the liver is not increased. When influenate symptoms appear, they need to be isolated
   • Blood test for the presence of specific antibodies to hepatitis A virus (IgG)

Hepatitis A is considered a relatively benign disease, but requires a serious relationship and treatment. Otherwise, its consequences can be felt for months and years.

What types of hepatitis exist, what are their causes and consequences? Such a disease leads to a violation of the functions of the liver, and this is extremely negatively affected by health. Some forms are fatal. Treatment is completely dependent on which form is diagnosed. Therefore, with the slightest suspicions, it should immediately contact a specialist for a survey and subsequent treatment. Hepatitis is a disease, which cannot be categorically started, as it is dangerous for life.

What role does the liver perform?

The liver is one of the important organs of our body. It is responsible for performing the following functions:

1. The processing of proteins, fats, vitamins that are so necessary for any organism occurs.
2. The synthesis of proteins, including albumin, is due to the participation of the liver.
3. The bile that is necessary for digesting fat is produced by this body, although it is stored in the bustling bubble.
4. All toxic substances, poisons, drugs, nicotine, alcohol are output through the liver. She takes the bulk of himself, protecting the body from their negative influence.

Viral hepatitis

All viral hepatitis are caused by viruses. Those, in turn, are striking the liver, begin to actively develop, destroying the authority. Today, the types of hepatitis are denoted by Latin letters from A to D. The most common are 3 forms: A, B, C. They are distinguished by the complexity of the course of the disease, the path of infection is different.

Forms D and E are more rare. The first form is usually chronic, it develops against the background of hepatitis B. During diagnostics, a specialist can immediately detect both of these types. Hepatitis E is an acute form of the course of the disease, usually infection occurs when using contaminated water and food.

The origin of viruses that cause liver damage is at the moment it is definitely not clarified. Scientists have not fully decided on the disease development mechanism. Part of the researchers believe that after the penetration of the virus in the tissue, inflammation occurs, damage to individual sections. Other scientists believe that the virus is multiplied in the tissues of the liver, the cells are attached to the cells like enzymes and proteins. Reproduction and infection is carried out in various ways, most often with blood, other body fluids.

Nevivar hepatitis

Hepatitis classification includes a large group of non-liberal diseases:

1. An autoimmune is a rare chronic form, the cause of which is still definitely defined. Developed against the background of other autoimmune diseases or by itself, there is a violation of the work of the general immune system of the body.
2. The alcohol form today is found quite often. Approximately 20% of alcoholics and drinkers are diagnosed precisely this disease. The age of patients is 40-60 years old, severe liver, cirrhosis, violation of the body, are observed.
3. The fatty non-alcohol form is diagnosed approximately 10-24% of the population. The conditions for the occurrence of various, on signs of the disease is similar to, but arises for other reasons. Most often, the risk group covers patients with severe obesity, the disease progresses slowly, but in the absence of treatment leads to cirrhosis, the formation of tumors.
4. is a form that develops against the background of the adoption of various drugs, i.e. It is a complication. Today, many drugs that are appointed for treatment may cause the appearance of this disease, especially against the background of alcohol intake.
5. It is a consequence of damage to plant, chemical toxins, products of industry, poisonous fungi.

Hepatitis A and transmission paths

Hepatitis A is considered the easiest, it is not necessary for treatment as difficult as the rest. The virus is highlighted with the feces, the transmission paths are contaminated water and food. Between people, this form can only be transmitted if the food is prepared by unwashed hands. In order to prevent the prevention, the hands should be regularly, do not eat dirty vegetables and fruits, do not drink water in unfamiliar places.

Ways of infection with hepatitis A:

• unprotected oral-anal sexual contacts;
• water, food infected with a virus;
• dirty hands.

What are the symptoms in the presence of this form? Usually, signs are poorly manifested, they find it difficult to find them, it is necessary to contact the doctor. They manifest themselves about 2-6 weeks from the beginning of infection. Adults have fatigue, nausea, severe itching, yellowing of skin, squirrel eyes, fever. Such signs may be observed within 2 months.

Urine usually becomes too dark, and the chair is chalk, light gray.

With such signs, it is necessary to immediately apply for a survey, after which the doctor will appoint appropriate treatment. It is impossible to delay the treatment, as it can adversely can affect the general state of health.

Hepatitis B and ways to transfer

The virus is transmitted through the blood of infected, sperm, discharge from the vagina. Methods for infection can be as follows:

Hepatitis itself is classified on acute and chronic. The symptoms of the sharp shape are not very expressed, most of the sick do not even suspect which disease is observed. Most often, obvious signs are found on a period of 6 weeks or 6 months, they strongly resemble flu.

The patient may not give them due attention, as the rise in temperature, the loss of appetite, fatigue, nausea, pain in the joints, muscles are signs of many others, not such dangerous diseases. The doctor is usually treated in the case when the skin acquires a characteristic yellowish tint, and urine becomes dark.

According to symptoms, it resembles sharp, many patients it lasts not one decade, there are no symptoms. But the liver damage is available, which adversely affects the vital activity, on the forecasts of treatment.

Hepatitis C and risk zones

It is considered one of the most dangerous. This is a viral form, which is transmitted with blood from an infected person. Most of the sick is infected with hygiene objects (razor blades, toothbrushes), syringe needles. Kids can be infected through mother's milk, which is already infected with this form of the disease.

In the risk area there are such categories of patients:

1. Consumers of narcotic drugs and those who used to use similar substances. It is recommended to regularly undergo a survey to eliminate the presence of such a disease at the moment.
2. Patients who were transfused blood or undergoing bodies transplantation in the period until 1992.
3. People who were born in the period 1945-1964. It is the patients of middle age that are most susceptible to this disease, so specialists are recommended to undergo one-time testing for infection. Many do not pay on time to diagnose, do not pay attention to the beginnings of symptoms, considering them a sign of simple malaise.
4. Patients who until 1987 received special preparations for increasing blood clotting.
5. All patients having various liver diseases receiving drugs negatively affecting its general condition. Side effects can be observed in many drugs, to this should be treated carefully.
6. Medical workers often turn out to be defeated by such a form of hepatitis. They are recommended an annual inspection, which is carried out not only to identify signs of such pathology, but also to prevent other diseases.
7. Infected HIV.
8. Children whose mothers are infected with hepatitis C.
9. People who made piercing, tattoo to the instrumental method.

Hepatitis can take a different look, but when the slightest signs of such a disease should immediately apply to the doctor. Diseases can be viral and non-revructible, the paths of infection vary. Patients relating to the specified risk groups is recommended to regularly undergo a survey in order to begin treatment on time.

Viral hepatitis A or Botkin's disease carries a threat to health. Such pathology is manifested by weakness, malaise, yellowing of the skin and mucous membranes. When developing viral hepatitis Cal becomes light, and urine is dark. Under the term "hepatitis A" also understand RNA virus of the Picornavirid family. Most people get infected in the spring.

General information about the disease Viral hepatitis A

Pathology has a long incubation period. From the moment of infection until the symptoms are 35 - 50 days. The duration of the latent stage also depends on the state of immunity. Infection bursts are observed in spring. Hepatitis virus and more often overtakes people than animals. Botkin's disease is often diagnosed in children. This is due to the fact that they do not carefully wash their hands in the absence of adult control.

If a woman gave birth to a child, but never hurt hepatitis and was not vaccinated, a child could get in one of the possible ways to transmit the virus. If, on the contrary, the mother of Botkin got sideways or was vaccinated, the child will show resistance to hepatitis A. The duration of immunity will be 10-12 months. Hepatitis A is often diagnosed in children by age 5 - 16 years. In order to avoid illness, the child must comply with the simplest rules of hygiene.

Hepatitis A Latent Period, Risk Factors

In the incubation period, Botkin flows hidden and the patient does not recognize what is infected. Tourists who are in countries with high levels of morbidity are prone to hepatitis. Pathology is diagnosed in persons living in regions with underdeveloped water supply structure. In most patients, the acute form of hepatitis A is diagnosed, chronic is rarely detected.

If pathology in the hidden period, the patient is still the source of infection. On average, the latent period lasts 30 days. During this time, the body accumulates viruses. Those moving around the bloodstream. In the incubation period, the patient does not feel the symptoms, it feels good, but is contagious. People who have hepatitis and flows without jaundice, also sources of infection. After the skin and sclera are painted in yellow, the contagiousness of pathology is reduced.

Methods of transmission

Transmission paths of hepatitis A:

1. Through urine and nasal mucus.
2. Through hygiene objects. Botkin's diseases are subject to doctors who are forced to contact with infected. Children pick up the virus in kindergartens, school institutions, boarding schools.
3. When drinking fruits and vegetables. If a person does not carefully rinses such products, it risks to get infected. Botkin's pathogens can be on the surface of fruits and berries brought from the eastern countries.
4. With tactile contact with slugs, mollusks.
5. Through water. If the area is not developed infrastructure or poorly organized water supply, the probability of catching the virus is greater.
6. Aerial drip. Microorganisms are distributed during sneezing and cough. It is possible to get sick if the skin of the nasal selection of infected is flooded.
7. Through insects. There is an opinion that the infection spread flies, however, it is controversial.
8. When overflowing blood.
9. In the absence of sterility during drug administration. The source of hepatitis A infection can be previously used syringe.

Clinical picture

There are typical and nonypical hepatitis A. In the first case, symptoms are characteristic of this disease. Depending on the state of immunity, it proceeds hard or relatively easy. Atypical pathology is not manifested by symptoms. The skin has a normal color, other clinical signs are absent.

Symptoms of hepatitis in children

As noted, children are more prone to this disease. They regularly contact each other and forget to wash their hands. The child is infected if eating unwashed vegetables or fruits. Hepatitis A in children is accompanied by weakness, malaise, sweating. Temperature of the body reaches 37 degrees.

Dyspeptic disorders are detected in children:

• nausea;
• vomiting;
• diarrhea.

Urine becomes dark, cal - light. The skin yellows 7 days after infection. 55% of children are diagnosed with a light form of illness. Parents without medical education are not able to diagnose. However, if they detect such symptoms of the child, consult a doctor. Do not wait for the situation to be aggravated. We need to show the child with infectious background. The doctor will hold a comprehensive examination and will determine the severity of the clinical picture.

If the diagnosis is confirmed, the child is isolated from others. Treatment depends on the severity of the disease. Botkin periodically exacerbates and subsides. Pathology is manifested by moderate fever. Children also diagnoses intoxication. If the disease proceeds in a light form, the skin acquires the previous color in 30-50 days. With a favorable outcome of the disease, the liver function is restored. In order to avoid complications, among which the hepatic coma must be observed by the prescriptions of the doctor. Self-treatment is unacceptable.

Botkin Middle Severity

When identifying signs of illness, a child should be called ambulance. It is important to diagnose in the early stages. To confirm the pathology, not only instrumental, but also a physical examination involving the palpation of the abdomen and the right hypochondrium. When hepatitis, the liver is filled with blood. On the X-ray, it can be seen that the organ has a smooth surface and a dense structure. The spleen is also enlarged in size. The main sign of hepatitis A is the jaundice of the skin. It keeps 14 - 20 days. The liver parenchyma is restored for two years.

Severe manifestations of hepatitis A

The most dangerous consequences of Botkin - hepatic coma. If the child constantly tears and sweats, it is necessary to urgently cause an ambulance. Pathology occurring in severe form is accompanied by the intensity of reactions, apathy, dizziness, nasal bleeding. The sign of severe form may be skin rash. The surface of the skin becomes yellow on the seventh day. Urina acquires a shade of dark beer, the feces becomes discolored.

With severe disease, the temperature rises to 40 degrees. The parenchymal organ increased in sizes, its edges dull. If you put pressure on the stomach in the right hypochondrium, pain will appear. On the X-ray, it can be seen that the spleen is enlarged. During the auscultation of the heart, the doctor reveals a violation of heart abbreviations.

Atypical form

Pathology proceeds hidden, in this its danger. The child does not know that he is a source of infection, so freely communicates with peers. At this time, it spreads the virus. All who contact with infected can get sick. If the disease proceeds without jaundice symptoms, the gastrointestinal organs are affected slightly, but the body temperature rises. The skin and sclera do not become yellow. Watering in patient colorless.

To confirm the rude hepatitis A, it is necessary to carry out physical, instrumental, laboratory examination. The doctor explores the urine, blood and feces. If specific IGM is detected in the blood, hepatitis A. It is assumed by the main sign of the disease in the absence of the jaundice of the skin and the scler is an increase in the liver.

Description of subclinical pathology

This pathology is not manifested by characteristic symptoms, but the patient is still infected. Parents must observe the child's condition. With the clinical form of Botkin, diarrhea or constipation appears at the child. A sign of pathology is also meteorism (increased gas formation in the intestines).

Watering and calming change color, temperature periodically increases. To confirm the subclinical form of Botkin, you need to conduct a comprehensive examination. The doctor assigns diagnostics to determine the specific immunoglobulins to hepatitis A. The blood test helps determine the level of digestive enzymes.

Cholestatic hepatitis

The disease is manifested by a symptom complex. Some children are diagnosed with hepatitis, in which bile does not arrive in the duodenum. Pathology occurs if there is a mechanical obstacle in biliary ducts. Cholestatic hepatitis syndrome is associated with viral lesion of the liver. It includes the jaundice, the scool of the mucous membranes.

With such a disease, Kal becomes light, and the urine is dark. Syndrome is associated with impaired liver and kidney functions. The liver does not act as filter. In the X-ray, it can be seen that the parenchymal organ is increased in size. The symptom complex also includes itching the skin. The disease arises due to the fact that the disintegration products irritate the nervous endings.

Botkin's manifestations in pregnant women

If the woman picked up the virus in the first trimester, it does not ride a threat to the health of the future child. Scientists cannot establish whether the child can be infected during pregnancy or during lactation. The forecast of hepatitis A depends on the degree of severity. To confirm the diagnosis, pregnant must be examined at an infectious background and a gynecologist.

Infectiousists believe that Botkin's manifestations are reminded by ARVI. The patient also has chills, weakness, malaise. When hepatitis, pregnant woman changes urine and feces. Incompute treatment of Botkin leads to dangerous consequences. Finding the symptoms of the disease, the future mother should immediately consult a doctor.

Possible complications

The lesion of the liver parenchyma is dangerous. Lack of treatment can lead to a fatal outcome. Hepatitis and often applies to contact path. Pathology has remote consequences. A person who had he hepatitis A is forbidden to be a donor. If the patient complies with a diet and limits exercise, its body is restored for two years.

Non-compliance with the prescriptions of the doctor leads to cirrhosis, liver cancer. If the disease proceeded in light or medium form, the patient starts work two weeks after discharge. People who suffered hepatitis A should refuse to work, which implies contact with hazardous substances. Limit exercise. It is forbidden to engage in self-medication, take dubious folk remedies.

Diagnostic events

The diagnosis is not easy if the disease is manifested by characteristic symptoms. With atypical form, obvious clinical signs are missing, a more detailed examination is required. Anamsnese collection survey, feeling the abdomen and the area of \u200b\u200bthe right hypochondrium.

Laboratory diagnostics involves urine and blood research. The purpose of the specific laboratory diagnostics is to identify the causative agent of hepatitis A. To form a diagnosis, PCR is also required. Non-specific examination methods include a general blood test for the detection of leukocytes and the definition of biliary pigments in the urine, a biochemical blood test, which allows to identify the level of bilirubin.

Hepatitis A vaccination

In Russia, uses the following drugs:

• TwinRix;
• Vakta.

The vaccine is introduced in accordance with the instructions. The drug is stored, observing the optimal temperature mode. Medicines warning hepatitis A can give side effects:

• weakness and malaise;
• headache;
• increasing body temperature;
• allergic reaction;
• edema;
• changing urine color.

If the body showed allergies to the drug, the doctor cancels further introduction, after - establishes the exact cause of such a reaction. The vaccination has contraindications. It is not prescribed during the exacerbation of chronic diseases. Vaccine against hepatitis A is not recommended if the pathology is accompanied by an inflammatory process. To ensure passive prevention, the immunoglobulin should be used.

Methods of treatment of virus

Patients are interested in how to treat hepatitis A. If pathology proceeds in a light form, the doctor prescribes basic therapy. The patient must comply with the diet, take medicines that improve the intestinal microflora. Preparations are prescribed to restore liver functions. When choosing treatment tactics, the doctor takes into account the pathogenesis of the disease, as well as the characteristics of the patient.

With the easiest flow of Botkin, a medicinal diet is appointed. The first 7 days of the patient must comply with bed regime. Disabled physical exertion. The patient should not exceed the dosage of drugs. In the pathology of the average severity, diet and pharmacological means are appointed. Botkin may be accompanied by vomiting.

The symptom occurs because the decomposition products accumulate under blood. The danger of vomiting is that it can lead to the dehydration of the body. When identifying the disease, you need to call an ambulance. The severe form of the disease is dangerous in that it can lead to a hepatic coma. For a speedy recovery, the patient must comply with the diet and follow all the prescriptions of the doctor.

If the pathology proceeds in severe form, the doctor prescribes antitoxic drugs or corticosteroid hormones. Therapy is carried out in the separation of intensive therapy. A severely ill patient is prescribed corticosteroids hydrocortisone or prednisone. Drugs are shown at the edema of the brain.

Therapy implies the introduction of disintellation solutions. They reduce the level of glucose. In hemorrhagic lesion, gastrointestinal bleeding occurs. In this case, hemostatic drugs are introduced. With dehydration of the body, a decade-free mannitol solution is prescribed. The drug is administered by the intravenous method.

If hepatitis A hip a bacterial complication is required to carry out therapy with antibiotics. Patients are often wondering what the difference in hepatitis A, B, C. Diseases provoke viruses of different types, however, the ways of infection are the same. Hepatitis A on average lasts one month, other types of pathologies are characterized by a longer flow. Treatment is also different. For diagnosis, a comprehensive diagnosis is required.

The doctor discharges the patient when well-being improved. The skin should find a natural color, and the liver is normal sizes. The patient who has a liver disease is diagnosed, must comply with a diet. The doctor prescribes the diet table number 5. You must enable boiled, steam dishes in the menu. Such food reduces the load on the gastrointestinal organs, including the liver.

Diet table number 5 contribute to the purification of a parenchymal organ. If necessary, intravenous administration of glucose is prescribed. The diet also includes liquid porridges, potato mashed potatoes, kissel. If the patient has a hepatic coma, it consumes mixtures instead of liquid food.

Healthy foods

There are products, for all types of hepatitis, improving the work of a parenchymal organ:

1. A fish. As you know, the meat is hardly absorbed. Fish contains the same valuable components as this product. In case of liver disease, doctors recommend in the diet of Heck, trout or cod. Herring - fatty fish, but it bears more benefits for the liver than meat. Boil non-fat meat. You can make cutlets for a couple.
2. Milk, fermented milk products, eggs. To improve the functions of the parenchymal organ, you should drink milk, but this product is absorbed long. Milk should be solely to use, so it is better to use it separately from other products. Cheese is useful. This product should not be third-party additives and spices. It is recommended to drink kefir. It is rich in valuable acids. Kefir normalizes the GTS functions and improves metabolic processes. Eggs also use eggs to restore the liver. They must be welded screwed or sick. Raw not recommended.
3. Vegetables, fruits, dried fruits. Such food fills the lack of vitamins. To improve the functions of a parenchymal organ, there is a pumpkin. Useful porridge based on this berry. Recommended dishes with carrots, zucchi. All products must be environmentally friendly. In the pathologies of the liver, including hepatitis A, useful legumes. It is recommended to soak them in water, after being subjected to thermal processing. Food should be soft, well digestible. It is necessary to eat raisins, kuragu, dried plum, orange. Fruit salad can be charged with honey.
4. Porridge. They contain proteins, carbohydrates, amino acids. Oatmeal is rich in lecithin, which absorbs harmful components and derives them from the body.
5. Soups. When hepatitis A and other viral diseases, lean soups are recommended. The first dishes are better to use cooled. Periodically you need to prepare the rubbed soups. Such food improves metabolism and purifies the parenchymal organ from toxins.
6. Vegetable oil. The diet assumes a limitation of oily food. Vegetable oil is not contraindicated. To refill salads, you can use sunflower or olive. Recently, amarantic oil is popular. The product contributes to the restoration of mucous membranes. Amaranta oil warns heavy diseases.

Prevention measures

To prevent dangerous disease, you need to interrupt potential transmission paths. It is important to create a favorable social and domestic conditions. Botkin's disease progresses in regions with underdeveloped infrastructure.

The population needs high-quality drinking water, a modern sewer system. Parents should teach children to hygiene. You can not eat unwashed vegetables and fruits, especially if they are imported. Prevention also implies vaccination against hepatitis A virus, however, this procedure is advisory.

Hepatitis A, which is also called Botkin's disease - is a viral disease of the liver cells, manifested with jaundice and intoxication. Unlike other forms of hepatitis, hepatitis A does not contribute to the chronicization of the processes of damage to hepatic cells and is very rarely the cause of the death of people. You can conquer the symptoms of the disease in 2 weeks, and also take about one or two months to bring the structure and liver function after the disease.

There is no specific group of persons among the population, which would be susceptible to the disease above the rest, absolutely everything, in equal conditions are in the risk area of \u200b\u200bthe disease: children, men, women of various social status and age years. Moreover, in children aged from the age of 10, there is a particularly easy transfer of the symptoms of the disease, and the old men and the kids of the first year of life are sick in complicated form.

What it is?

Hepatitis A is a RNA virus, refers to the Picorovirid family, the family of enteroviruses. Its size is 27-30 nm. The virus has no shell. Typing was carried out in 1973. Further, four more human virus genotypes and three monkeys genotype are allocated.

It has been established that independently of genotypes, all viruses and type have similar antigenic, immunogenic and protest properties. That is, one serotype, the virus is determined by the same standard sets of reagents, preventing the same vaccines.

Views

The following forms of viral hepatitis A are known:

• jaundice;
• with erased jaundice;
• angry.

A subclinical (inapparantant) form is separated separately, which is diagnosed only on the basis of the results of laboratory tests.

The course of the disease can be acute, protracted, subacute and chronic (extremely rare). Acute infectious hepatitis for gravity of clinical manifestations can be light, moderate and heavy.

How is hepatitis A transmitted?

The source of infection is sick people at the stages of subclinical flow and initial manifestations of the disease, including with a rude form. After staining, the sclera and skin contagiousness is significantly reduced. In the third week of pathogenesis, a dangerous virus is allocated only in 5% of patients.

The period of contagious, taking into account the incubation period, lasts about a month, less often until one and a half months.

Proved sources of virus spread, in descending order:

1. Observed food. This transmission method has a large epidemic value. However, it is almost impossible to establish the type of hazardous food because of a long incubation period.
2. Direct contact with the patient. It is characteristic of people with undeveloped hygienic skills and people professionally with them in contact. This is where the transfer of the causative agent in preschool and school groups, boarding schools for people with disabilities.
3. Feling, urine, isolation from the nasopharynx. This method of transmission is called fecal-oral. The main proved transmission factors of the hepatitis virus A include direct contact of a healthy and patient. The virus can also be transmitted with food, water, air-droplet (some authors are excluded), with sexual contacts, with non-sterile intravenous administrations, through flies - mechanical carriers of the virus.

Meanwhile, products that are more often determined by the virus transmission factors:

1. Garden berries in fresh and ice cream (after thawing) form, especially if in beds, near berry plants, mollusks are found, slugs that can accumulate the virus if the ridges are watered with fertilizer from human feces.
2. Products are prepared without heat treatment or storage used (salads, winegirls, cold snacks, dried fruits and berries, especially from Kazakhstan and Central Asia);
3. Aerosol. It is hypothetically possible in children's teams when layering outbreaks of respiratory diseases in groups with reduced resistance. The virus is transmitted when coughing, sneezing with the removal of the nasopharynx of a sick person.
4. Water. It is characteristic of territories with underdeveloped communal infrastructure, poor water supply organization, sewage and wastewater. Significantly increase the risks of infection during accidents and natural disasters.
5. Parenteral. The transmission of the virus during blood transfusions, intravenous administration of solutions, especially in the situation, excluding sterility compliance (drug addict), is not excluded.
6. Transmissive (transmitting the virus through the flies). Researchers are not excluded the possibility of transferring infection through the flies, but the prevalence of this factor has not been studied.
7. Sexual. The literature indicates as a possible transmission factor in homosexuals, while the causal relationship of homosexuality and hepatitis A.

Stages of development

There are several options for the flow of hepatitis A. The disease may proceed with a typical clinical picture and asymptomatic. In the case of manifest (flowing with bright symptoms), several stages are distinguished for the development of the disease.

Incubation period	It lasts 35-55 days, while there are no symptoms.
Promotional period	Lasts 3 - 10 days. Manifested by symptoms of general intoxication: weakness, fast fatigue, lack of appetite, moderate fever. Often, patients develop dyspeptic manifestations in the form of nausea, vomiting, stool disorders, feelings of gravity in the right hypochondrium.
Justice period	It has a different degree of severity, it lasts 15 - 20 days. In easy cases, the visible mucous membranes are yellowed, the color of the skin changes with a pronounced jaundice. With the development of jaundice, most patients are improved well-being. Urine darkens, its color is compared with a dark beer or tea welding. In some patients, feces are discolored.
Period of recovery	It comes after the disappearance of the jaundice, it lasts 2-4 weeks. At this time, the normalization of liver functional indicators occurs, the liver itself decreases to normal size.

After the transfer of infection is formed persistent lifelong immunity. Is it possible to get hepatitis a re-? This is expelled, after transferring the disease, the body produces cells protecting against re-infection.

Symptoms of hepatitis A.

Viral hepatitis A usually begins acutely. The long period may proceed in different clinical versions: dyspepsive, feverish or asthenovegetative.

For feverish (flu-like) forms of the production period are characteristic:

• increasing body temperature;
• general weakness;
• head and muscular pain;
• ensure in the throat, dry cough;
• rhinitis.

In the dyspeptic variant of the wagely period of the manifestation of intoxication, weakly are expressed. Typically, patients make complaints of different digestive disorders (belching, bitch in the mouth, bloating), pain in the field of epigastria or right hypochondrium, defecation disorders (constipation, diarrhea or their alternation).

The asthenovogetative form of the production period in viral hepatitis is not specific. It is manifested by weakness, lethargy, adamicity and sleep disorders.

1. The transition of the disease in the jaggptious stage is characterized by improving the overall state, normalizing the body temperature against the background of the gradual development of jaundice. However, the severity of dyspeptic manifestations in the jaggptious period not only does not weaken, but, on the contrary, is amplified.
2. With a severe course of viral hepatitis, and in patients can develop hemorrhagic syndrome (spontaneous nasal bleeding, hemorrhage on the skin and mucous membranes, phetechial rash).

When palpation detect moderately painful, protruding from the hypochondrium liver. In about 30% of cases, an increase in the spleen is noted. As the jaundice is increasing, calf and darkening of urine occur. After some time, the urine acquires a saturated dark color, and the feces becomes light gray (a sharp chair).

The jaundice period is replaced by the reconvaluation stage. The gradual normalization of laboratory indicators and improving the general condition of patients occur. Lost the recovery period can until six months.

Diagnostics

The diagnosis of hepatitis A is based on clinical signs of the disease: an increase in liver, jaundice and other symptoms. The doctor takes into account epidemiological factors, that is, how they are infected with infection (the use of noncompted water, unknown cleanliness products, and so on).

Lab laboratory studies are crucial. Specific analyzes:

• polymerase chain reaction to identify viral genetic material;
• immuno-enzyme analysis to detect antibodies to an IGM causative agent.

If only IgG class antibodies are defined in the body - this indicates a previously transferred illness or immunite to it. The chronic form of the disease does not occur, but there are cases of healthy virosoncy.

Non-specific laboratory signs of the disease in women and other groups of patients are necessary to assess the severity of the infectious process and the effectiveness of the designated drugs:

• Alt and Ast;
• bilirubin and its fractions (straight, indirect);
• level of protein in serum, fibrinogen.

To clarify the size of the liver applied ultrasound.

Complications

Hepatitis and rarely gives complications, usually the disease ends with complete recovery. The hardest complication of Botkin's disease is hepatic insufficiency. After recovery from hepatitis, a persistent immunity is usually preserved and a re-illness is not possible. However, if the treatment is not completed, and complete recovery has not come, the appearance of a repeated wave of the disease is possible. This happens in 15% of the diseases of Botkin and can repeat repeatedly.

Hepatic insufficiency is a rare and potentially dangerous complication of hepatitis, in which the liver can stop functioning normally. The following groups of people are simply subject to her:

• people with a weakened immune system (as a result of a chronic disease, such as diabetes, or by the side effect of some treatment methods, such as chemotherapy).
• people with already existing liver disease, such as cirrhosis or hepatitis C (heavier type of hepatitis);

Some symptoms of hepatic insufficiency are similar to Hepatitis A symptoms and include jaundice, nausea and vomiting.

Treatment of hepatitis A.

Patients with a diagnosis of hepatitis A are subject to immediate hospitalization into an infectious office. The duration of insulation of patients at least four weeks.

During periods of development and rapidness of the disease, the bed regime is obligatory. The patient is assigned a diet consisting of easily digestible products enriched with vitamins. In hemorrhagic phenomena, the vikasol is prescribed intramuscularly, and the vitamin K. in the case of a protracted severe course of the disease, as well as the presence of itching, corticosteroids are prescribed (the most often prednisone), and the glucose solution is administered. In complicated cases, as well as the presence of concomitant diseases, antibiotics are prescribed (terrarsicin, penicillin, etc.). To improve bile outflow, repeated duodenal probing.

Treatment of patients with toxic dystrophy complex, including glutamic acid, corticosteroid hormones, neomycin, a small-faced diet with a large amount of liquid.

In most recorded cases, hepatitis A ends with complete recovery, and this applies to severe cases. However, patients are found in which this disease acquires a chronic flow characterized by periodic exacerbations with a violation of adequate liver functioning.

Chronic flow of hepatitis A can acquire due to late hospitalization, various violations of dietary and hygienic regimes, mental and physical overvoltage, consumption of alcoholic beverages, as well as in the case of the associated diseases (gastroenterocolite, flu, etc.). These forms for phenomena of hepatic insufficiency for patients can end with fatal outcome.

Vaccination

Fortunately, there is a vaccine that can reduce the sensitivity of people to hepatitis A virus, but it is not included in the mandatory vaccination calendar due to high cost. There are two types of preventive vaccines, it is:

• solution based on the neutralized virus-provocateur virus;
• immunoglobulin containing antibodies to hepatitis and other diseases (infections) derived from donor blood. It is injected with dropper people living on one area with sick, urgently the first days of the detection of the disease. This procedure significantly reduces the risk of their infection.

Immunoglobulin introduces the most at risk of infection to population groups:

• servicemen;
• refugees;
• medical workers;
• people working on the mass production of food;
• traveling through the countries of the third world, where many cases of disease are registered.

Diet

The basis for the treatment of all diseases of the digestion system is a balanced nutrition. Diet with hepatitis A begins during the development of the disease and continues after recovery for a few more months.

How do patients eat?

1. It is impossible to reduce the amount of proteins, fats and carbohydrates, their ratio should be correct. Only some hard-permeable animal fats are limited: beef, pork and barbells.
2. It is impossible to reduce calorie food, calories must correspond to the physiological norm.
3. You need to drink the optimal amount of fluid - 2-3 liters of water per day.
4. Five-volume nutrition with small portions is recommended for patients with hepatitis A.

Such a dietary regime needs to stick six months after recovery. We must not forget that all the harmful and sharp products are prohibited, so as not to create a load on the liver.

Prevention of disease

To warn or significantly reduce the risk of infection with hepatitis A using vaccination. The vaccine is a drug containing non-visual viruses, the introduction of which to the body causes the production of antibodies and the activation of immunity. For the formation of protection for several years enough to single vaccination.

To achieve longer immunity, for 20-25 years, the vaccine must be used twice 1-1.5 years.

It is such a question that occurs in a person of any age after contact with a sick person. How hepatitis A is transmitted, how great the chances are sick with this disease, what precautions should be observed - there are quite specific answers to all these issues. Observing simple and understandable rules, a person practically cannot get infected with this viral disease.

Features of the hepatitis A virus

From the properties of the pathogen, in this case of certain characteristics of the hepatitis A virus, the possible ways of transmitting infection directly depend directly. The virus multiplies predominantly in liver cells, to a lesser extent - in biliary tracts and cells of the epithelium of the digestive channel.

The hepatitis A virus is resistant to a number of external environment factors, namely to chlorine and disinfectants, low temperatures. Thus, this pathogen can penetrate the tap water and continually persist in it, and infection is transmitted despite the traditional chlorination of tap water.

Source infection

Hepatitu A refers to a group of anthroponous infections with a predominant fecal-oral transmission mechanism. This means that in any situation, the source of infection is a sick person. The selection of the virus is sufficiently long: it starts in incubation (hidden) period and ends sometimes even slightly later than the patient's clinical recovery. Thus, a person is a danger to others during the whole illness and even before the appearance of clinical symptoms.

During the viral hepatitis A, the following periods are distinguished:

• incubation (i.e. hidden) - its duration is 14-30 (up to 55) days, there are no symptoms of the disease, it is during this period that the likelihood of infected with a infected person is most high;
• a short-term long-term (prospital) period - only 6-7 (up to 10) days; Intensive selection of the virus continues;
• the period of explicit clinical manifestations (the period of the right) can be limited to 10-14 days, and can delay for a whole month and more if exacerbations or complications are developing; The selection of the virus continues, but less active;
• the selection of the virus in the reconvaluation period (recovery) varies significantly, so it is rather difficult to talk about any average duration in this period.

Another important detail: It is equally dangerous by a person with obviously yellow skin covers (the so-called manifest form of the disease) and without a significant change in the general condition (the so-called rude shape). In addition, with hepatitis, it often develops so-called hidden or abortion forms of the disease. The person does not feel the signs of the disease of his own body, while he distinguishes the causative agent of infection into the environment and infects other people.

From this point of view, for healthy people, the greatest danger represents a person with a rude illness. No anti-epidemic activities are conducted in this case, since such a state is rarely diagnosed. A man with a clear jaundice is subject to hospitalization and isolation, all the subjects surrounding it - disinfection.

What way hepatitis A

Modern medical books indicate the following possible ways of infection with hepatitis A:

• water;
• food;
• contact-household;
• parenteral.

All transmission methods suggest certain situations dangerous in terms of infection. In some cases, infection is likely to be in others - exactly the opposite.

For hepatitis, but not typical by air-drip and transmissible transmission. The air-drip transmission mechanism is infection when inhalation of air containing a droplet of mucus from the nasopharynx of the patient. Since the hepatitis virus does not multiply in the respiratory tract, infection only when communicating (without direct contact) is impossible with a sick person.

The transmissive transmission path is infection with the bite of a sick person with a live carrier (loss, tick, mosquito, mosquito). When hepatitis, this option is not described in modern medical literature.

Water transfer

Most often, hepatitis A is transmitted through a contaminated (contaminated virus) water. For the so-called "water outbreaks" typical: a rapid increase in the amount of diseased, the massability of the disease among those living in a certain area or zone. The implementation of the waterway transmission is possible in the following situations:

• drinking for a drink of non-filled water from any source (including from central water supply);
• the most dangerous (potentially contain a greater amount of virus) wells, artesian wells, water taps of the old building (there is a possibility of mixing sewage drain and tap water);
• use of water for washing dishes, vegetables and fruits without subsequent processing by disinfecting agents or high temperatures;
• in an existing focus, the virus can fall into the oral cavity in the process of cleaning the teeth and when performing other hygienic procedures.

Viral hepatitis A when implementing a water path of transmission can cover the whole settlements organized by children's closed and open-type children.

Food transfer path

Viral hepatitis A is often transmitted to the food, for the implementation of which the following situations are dangerous:

• use of one dishes with a sick person;
• consumption of some culinary products;
• the inclusion in the food diet is poorly washed and not subject to thermal processing of vegetables, fruits and other things.

Food transfer path is most typical for children's teams that feed in one catering establishment (for example, school canteen). Dissemination contribute to non-compliance with hygienic skills, lack of soap and so on.

Contact path transmission

Infecting surrounding sick man touches a variety of items through which the virus is transmitted to other people.

The contact path is implemented:

• with direct contact with the sick person;
• when using general items (toothbrush, towel);
• in the process of the game with common toys (solid and soft);
• failure to comply with the rules of hygienic processing of the toilet (both public and home).

All methods of infection with hepatitis A can be implemented both at home and in public territory. Visiting public catering enterprises of any class, general toilets increases the risk of infection.

Epidemiological features of hepatitis A

Hepatitis A transmitting "through dirty hands" has a number of patterns:

• the increase in morbidity is celebrated in the warm season;
• predominant patients under 35 years old;
• easy infection causes the possibility of the development of an epidemic flash;
• after the suffering disease, life immunity remains;
• careful compliance with hygienic rules makes it easy to control this infection.

Gepatitis A - the process is quite easy, but the rules for preventing this disease are also simple, understandable and accessible to a person of any age.

Materials on the topic

infectium.ru.

Hepatitis A, which is often called Botkin's disease or jaundice - one of the infectious diseases common throughout. People are sick of all ages, but more often children from 2 to 14 years old, men and women are infected equally often. According to statistics, more than 1.5 million people are ill in the world, however, doctors believe that this figure is strongly understated, since in childhood the disease very often proceeds absolutely asymptomatic.

Causes and mechanism of infection with hepatitis A

Through the oral cavity, the hepatitis A virus falls into the intestines, from where it is absorbed into the blood and is transferred to the liver.

The disease is caused by a virus. The mechanism of transmission of infection fecal-oral. The sick person with carte masses highlights a huge amount of pathogens into the environment, which can fall on the item (dishes, toys, door handles, buttons in the elevator, etc.). With the disordered objects, the causative agent of the disease is most often applied to the hands, and then into the oral cavity. That is why the outbursts of hepatitis A in the collectives are often recorded, especially children, and the disease in the people is called dirty hands.

The virus can fall into water and food when preparing an infected cook. It is possible to interfere with vegetables, fruits and berries on which wastewater and sewage can enter. Bathing in contaminated water bodies and drinking from unverified sources can also lead to infection.

The probability of transmitting the virus by a parenteral manner exists, but it occurs extremely rarely.

The virus is sufficiently stable in the external environment. In room temperature, it is saved on the item at room temperature during the week, and on food in a humid environment - several months.

From the oral cavity, the virus enters the intestine, from there to blood, and further into the liver, where the inflammatory process causes. The causative agent is multiplied in the cells of the liver - hepatocytes, provoking their death. This occurs until the body has the amount of antibodies sufficient to suppress its activity.

Symptoms of disease Botkin

During the disease, several stages are distinguished: the incubation period, the pretty, jellied and recovery period.

The incubation period of the disease lasts up to 60 days, all this time the patient highlights the causative agent of the disease into the environment and can infect others.

Promotional (Pricky) period

During this period, the patients appear the first complaints, its duration usually does not exceed 7 days. The symptoms of general intoxication of the body appear: fever, weakness, headache, small runny nose, sore throat. There may be bol in abdominal pain, nausea, vomiting, diarrhea or constipation. Sometimes the symptoms of intoxication and the temperature increase are not and the disorders of the digestion are coming to the fore.

In some cases, the long period is hidden and the disease immediately manifests the jaundice.

Ripping period (jaundice)

Patients may be disturbed pain or severity in the right hypochondrium, it is caused by an increase in liver and stretching its capsules, it is also possible to increase the spleen. Nausea, vomiting, meteorism and stool disorders can persist. Jaundice comes to the fore: skin cover, mucous membranes, the sclers acquire lemon yellow painting. As a rule, with the advent of this symptom, the body temperature is normalized. Attention is drawn to the darkening of urine (dark beer color) and lightening of carts.

The duration of jaundice on average is 2-4 weeks.

Reconvocation period (recovery)

The symptoms gradually pass, restore the function of the liver, however the yellowness of the skin and the scool can be maintained for quite a long time. Complete recovery occurs after 1-12 months.

Treatment of hepatitis A.

Entryosorbents, the most famous among which are activated carbon will be assigned to hepatitis.

Hospitalization in the infectious department is usually not required. Specific treatment of this disease does not exist, symptomatic means apply. In addition, the diet shown in the pathologies of the liver (Table No. 5 for Pessner) is required.

Groups of drugs used in the treatment of Botkin's disease:

1. Disinfectants: saline and 5% glucose solution, with the addition of ascorbic acid, REOPOLIGULUKIN.
2. Enterosorbents: Activated coal, enterosgel, smecta, polyfepan, polysorb, etc.
3. Hepatoprotectors: Phosphoglie, Essence Forte, Pro Parp, Heptral, hepaben.
4. Enzyme preparations: Mezim Forte, Creon, Panzinorm, Festal, Poletrath, Pancreatin.
5. Glacers are applied only if the patient has no gallstone disease: Allohol, Holenzim, Hofitol, Holys, Flamin, etc.
6. Vitamins: any multivitamin complexes, but especially useful for the health of the liver Vitamins of Group V.

Consequences and prevention

In the overwhelming majority of cases, this disease does not give complications and does not lead to any consequences for the body. As a result of the treatment and observance of the diet, the liver function is restored completely. A diet must be observed for at least six months after the disappearance of symptoms, several courses of treatment for hepatoprotectors and reception of vitamins can also be recommended.

Exceptions are possible only in 2% of cases, when patients did not comply with the diet, abandoned therapy, chronically abuse alcohol or had previously any liver disease.

Prevention of hepatitis A does not represent special difficulties and is primarily reduced to compliance with the rules of personal hygiene and food culture. It is necessary to thoroughly wash your hands with soap (to wash at least 20 seconds) after each visit to the toilet and before eating. It should only drink boiled water, fruits and vegetables before use need to be washed and desirable to use boiling water.

If the team was detected in the team, the focus is needed:

• wet room cleaning with disinfecting solutions;
• in kindergartens and schools, disinfection of furniture and toys, quarantine is declared for 35 days from the moment of registration of the latter case;
• the dishes that previously used the patient should be thoroughly washed and boiled for 15 minutes in soda solution, and during the disease he needs to highlight an individual set of dishes, which will also be carefully processed after each meal intake;
• bed and underwear before washing, you need to boil in the solution of washing powder (15 minutes).

Hepatitis A vaccination

To date, an effective vaccine has been developed to prevent this disease, but it is not included in the list of mandatory vaccinations in our country. In Russia, several vaccines are used:

• Havrix;
• Avaksim;
• Vakta;
• Gep-A-in-Vak;
• Hepatitis A. vaccine

• travelers and people who are forced to visit countries with a high level of antisanitarian (countries of Africa and Asia);
• people, for a long time stay away from full sources of clean water and sewage (servicemen on field exercises, refugee camps);
• food industry workers at enterprises, catering establishments, kitchens of public institutions;
• medical workers, especially contacting patients with biological fluids (Sanitary, laboratory technicians, nurses, surgeons, infectiousists).

To which doctor to turn

When the child appears, the symptoms of infection must be referred to as a pediatrician or infectious background. In the future, consultation of the nutritionist will be useful, since the proper nutrition helps the liver cells to recover faster.

Fragment of the transmission "On the most important" (TV channel "Russia 1"), the topic of release "Hepatit A":

Hepatitis A - symptoms of cause and treatment

myFamilyDoctor.ru.

Many have a question: what is a disease of dirty hands, or jaundice, or hepatitis A, as is transmitted, what is the treatment and how to prevent infection? There is nothing surprising and complex in the process of acquiring this disease, it is enough to simply eat food or drink water with this infection to start the mechanism of rapid infection. Hepatitis A gives serious complications that may end the patient's death.

Hepatitis A is an acute bacterial infection caused by the hepatitis A virus (VGA). It is responsible for the processes of inflammation and damage to hepatic cells.

On a global scale, about 1.2-1.4 million cases of the disease are registered in the year, 20% of patients require absolute hospitalization. Mortality is low and is 0.6-2.1%.

Source

How can I get hepatitis? In 95% of cases, infection occurs by consumption:

• products, for example, washed in infected water - vegetables, fruits, fish, seafood;
• water contaminated with infected faeces.

In rare cases, BGA infection can be transmitted:

• through unprotected sexual contact;
• with close contact with infected people (a person can be infected with hepatitis A for 7 days after the appearance of symptoms of the disease), with constant finding with the carrier of the virus;
• other transmission paths arising from violation of tissue integrity (through blood) are possible.

Hepatitis A is transmitted often from children to adults. In turn, in turn, infection is accompanied by severe symptoms. Young children have no yellow leather with disease. More than 40% of patients over the age of 40 require hospitalization. In 10-20% of patients after recovery, there is a relapse of the disease.

How is hepatitis and other ways transmitted? The categories of people most vulnerable to hepatitis A infection include the employees of the organization of the sewage system. In addition, people working in the field of health, in children's nursery, gardens and in the army are in the risk group. The likelihood of obtaining infection of viral origin rises during a visit to countries where this disease is still common. In particular, these are the countries of Eastern Europe, the region of the Mediterranean and Russia.

Manifestation of symptoms

The mechanism of transmission and manifestation of the virus in the human body lasts from 15 to 50 days (on average about 30 days). After this time, symptoms of the disease appear, although sometimes after transmission of hepatitis, the disease occurs asymptomatic. This can occur in 90% of children until the 5th year of life. If the virus is transmitted to adults, the symptoms of the disease are usually enhanced.

For 6-7 days before the advent of the full form of the disease, the first symptoms may occur: flu, nausea, diarrhea. Then appears the most characteristic and visible symptom of the disease - jaundice (determined by a yellow leather and eye proteins), which can be accompanied by an increase in the liver. This is because the body increases the production of yellow pigment - bilirubin. Jaundice disappears in about a month.

In addition, they appear:

• bad well-being and weakness;
• fever;
• lack of appetite;
• nausea and vomiting,
• pain in the abdomen, muscles and joints;
• itching skin;
• dark urine color.

The acute manifestations of the disease usually pass in a few days.

Vaccination as a protection against the virus

The only effective way to prevent hepatitis A is vaccination. After the complete cycle of vaccination in the body, antibodies are formed that can protect against the virus. Two doses of vaccine are needed to protect against hepatitis for the entire life, applied according to the scheme 6 - 12 months.

It should be known that in accordance with the existing vaccination program against hepatitis A, immunization is recommended:

• persons living in countries with high and medium detection of this disease;
• persons employed in the production and distribution of food products, in disposal of waste and liquid sewage, as well as during the repair and maintenance of devices intended for this purpose;
• children of preschool, school age and young people who did not hurt hepatitis A.

Diagnosis of disease and methods of treatment

In the case of suspicion of hepatitis, the blood test is performed on the hepatitis A. virus. If infection occurred, the elevated activity of the enzymes of alanine is observed in the blood plasma, an increase in bilirubin concentration is observed. The final diagnosis and clinic of hepatitis A is raised on the basis of the results of a serological study, which is carried out to determine the antibodies.

This disease passes independently, for a maximum of 6 months. There is no drug that is designed to eliminate the virus in the body. The patient recommends restriction of physical activity, proper nutrition and hydration. In the case of reinforced itching, the patient can be given a cholestyramine.

Complications caused by hepatitis A are very dangerous and can lead to death. These include cholestatic jaundice, bone marrow aplasia, acute anemia, hemolytic hepatitis.

In addition, relapses may arise (in 10-20% of cases). Infection (WAG) does not lead to the development of chronic hepatitis, cirrhosis and primary liver cancer.

Diet and infusion therapy

Suitable for adult diet should contain a daose dose of nutrients in 2000 kcal (70% of in-depth carbohydrates, 10-20% fat and 10% protein) with a gradual expansion in accordance with individual tolerability. You can return to normal nutrition after six months. In the case of symptoms: strong vomiting and dehydration of the body, feeding through a probe or parenteral administration. Alcohol is better excluded from the diet during the treatment period.

During the acute manifestation of the disease, it should be avoided by drugs metabulating in the liver or causing cholestasis.

Preventive measures should be followed:

• comply with the rules of hygiene during cooking;
• use dishes after heat treatment (boiled, baked, fried);
• avoid badly roasted meat, also crusty meat, do not buy food on street trays;
• drink only water in bottles or boiled water (especially during stay abroad);
• protect food from insects.

It is difficult to neutralize the source of infection in the period of activation of the virus. It is necessary to identify the disease at an early stage of the disease.

To curb the ways to spread infection, it is necessary to comply with the rules of hygiene in the production and preparation of food, as well as to use healthy, clean water.

Improving immunity it is necessary that the body oppose infection. Immunity strengthening is carried out using the Introductions of the Humma Gamma Globulin Children under 14 in the case of contact with patients with hepatitis A or preventive vaccinations against this virus.

OgePatite.ru.

Hepatitis A is a disease of the viral nature, in which the inflammatory process in the liver cells occurs and their subsequent necrosis occurs.

This type of hepatitis is the most common of all forms of this disease. This infection called Botkin's disease is widely known. Most often the folk name is jaundice.

The high resistance of the virus in the external environment has determined the increased susceptibility to it of the human body. Its cells are capable of several weeks to remain active at room temperature. The premises of the virus in the freezer extends its viability for several years.

He is so strong that even some methods of industrial inactivation takes. The most efficient processing for today is boiling food for more than 5 minutes.

If you get into the body, the virus is delivered through blood to the liver. There, binding to a special CD81 protein, it penetrates inside the hepatocyte cell. In its membrane, the synthesis of a virus RNA begins, which occurs until the cell perbs itself or will not be destroyed by the body's immune system, as infected.

After its decay, the synthesized viruses penetrate new cells. Begins the motion of liver cells at a huge speed. When the decay of hepatocytes in the blood, the level of bilirubin occurs, which is formed during the decay of the hemoglobin of erythrocytes. Normally, it is excreted in the urine, and when hepatitis is accumulated in the blood, causing the yellowing of the skin and the scool eyes.

Fig. The proportion of hepatitis A in the structure of the incidence of hepatitis.

The source of infection is a sick person. The most susceptible to the risk of infection of children from 3 to 7 years, visiting children's institutions, elderly and people with defective nutrition.

Basic ways of transmission of infection

Unlike other hepatitis, this form of infection is enterovirus, is transmitted by a fecal-oral way and has its own ways of infection.

The patient is infected in the case of infections in the reservoir with the discharge of a sick person. The increase in morbidity is observed in the fall and spring, in the period of rain and floods. In the way of increasing incidence, high-quality wastewater treatment should be.

In the regions with an undeveloped sewage system, many residents carry hepatitis and in childhood. If there are products were fastened with infected water - the risk of infection in the body also increases.

Source - insufficiently thermally treated seafood (fish, mollusks, mussels and others). The greatest number of virus cells is in filtering systems and water inhabitants. In the process of cooking, an infected person must be observed thorough hygiene. Especially when creating snacks, raw and dried products, salads.

Contact

This path is dangerous when communicating with patients only in case of violation of the rules of care of them at home, in hospitals, nursing homes, orphanages. It is especially large likely to get infected when changing diapers and other close contact with the urine and feces of the patient.

There is no reliable information about infection through saliva infected, however, studies have shown hepatitis and weak concentration in the salivary secret.

Infection of a person with ordinary sex contact does not occur. Hepatitis A is not detected in sperm, nor in vaginal discharge. However, with homosexual contacts in men and anal sexual acts, the probability of obtaining infection has repeatedly increases.

There are information about several cases of infection from mother to child. However, there is no evidence that the infection occurred as a result of the penetration of the virus through the placental barrier.

Parenteral (through blood)

It is possible when transfusion of donor blood, taken from the patient in the prodromal (pregenistic) period and preparation of intermediate products (for example, plasma) from such a blood. Modern multi-stage system of quality control of donor blood minimized the factor of infection with hepatitis A through hemotransphus.

Infection of patients addicts when using sterile syringes does not occur. In this case, the spread of infection is most often possible when non-compliance with personal hygiene rules (through dirty hands).

Hepatitis Aity Risk Groups

Based on the analysis of the duration of contact with the causative agent of hepatitis A, several categories of people belonging to the risk group are distinguished, namely:

• people living in areas with underdeveloped wastewater treatment system;
• persons from socially disadvantaged segments of the population;
• housing and utilities workers related to cleaning sewer systems;
• residents and tourists of Africa, Latin America, Central and Southeast Asia;
• family members of the patient with hepatitis and to a lesser extent a circle of his communication;
• medical personnel of infectious clinics, children's preschool institutions, shelters, boarding schools, nursing homes;
• drug addicts;
• homosexuals, people practicing anal sex contacts.

Symptoms of disease and periods of infectiousness

A distinctive feature of hepatitis A is its fairly easy course, the minimum risk of complications in compliance with all the recommendations of the doctor, a rare transition to a chronic form. The course of the disease consists of such stages:

• The incubation period lasts from 15 to 30 days. Proceeds asymptomatic.
• The barn period lasts 3-6 days. During this short period, it is observed:
  • increased temperature, lubrication in the body;
  • headache;
  • weakness, fatigue;
  • nausea and pain in the liver;
  • diarrhea or constipation, increased gas formation in the intestines.

Often at this stage hepatitis A can be confused with the current ORVI. However, this disease has a number of distinctive features.

Table of distinctive features

• The jaundice period lasts 1-2 weeks. Develops against the background of the loss of appetite and nausea. It is characterized by darkening of urine (more often than dark beer color), then yellowing the scool. During this period, the fire brightens, the yellowness of the skin is enhanced.
• The period of extinction of hepatitis A. begins with recovery of appetite, reduced nausea. Water becomes light, and feces dark. The amount of virus in the discharge decreases, the liver gradually acquires normal dimensions.

There is also a rude shape of the flow of hepatitis, it is three times more often common, while the skin and sclera are yellow not so much, only the morning urine darkens.

Special treatment of hepatitis is not. In compliance with the diet, bedding, the disease lasts less than two months. Sick hepatitis A is a source of infection at the end of incubation and during the entire pregenial period (about 10-14 days).

Knowing how hepatitis A is transmitted is to significantly reduce the number of infection factors.

Prevention during hepatitis A includes:

1. Early diagnosis of diseases in children's, social and medical institutions. Inspection of children in Dow at least once a week.
2. Control for infected and their maximum insulation and permanent laboratory survey.
3. Compliance with personal hygiene and general sanitary requirements in all institutions.
4. Refusal to watering garden plants with standing water.
5. Food processing with boiled water.
6. Treatment of toilet and dishes with hepatitis A.
7. The use of high-quality drinking water.
8. Vaccination by epidemic testimony of inactivated vaccine. There are circuits of double (with an interval of 1 year) and three-time introduction of the vaccine (after 1 month and 6 months after the previous vaccination). Russia is popular for Belgian Havrix 1440 adult and chavcrix 720 for children from two years old, Avaksim (France), Vakta (USA). Russian vaccine Gep-A-in-Vac is used for children from three years.

Despite the fact that the most likely factors of infection with hepatitis A (water, seafood, untreated food) are found everywhere, configuring themselves with elementary preventive measures and timely vaccination, you can successfully avoid infection.

Yakutina Svetlana

Expert project VsePropechen.ru.

VsePropechen.ru.