Every thing you want to know about Hepatitis Hepatitis A (Infectious Hepatitis/Catarrhal jaundice) and Hepatitis B (Serum Hepatitis)

Hepatitis

Hepatitis A (Infectious Hepatitis/Catarrhal jaundice)

- liver disease caused by the hepatitis A virus.

- inflammation of the liver that is not really very severe & runs an acute course.

- starts within 2 – 6 weeks after contact with the virus, lasts no longer than 2 months.

Period of Communicability

The infected patient is capable of transmitting the organism a week before and a week after the appearance of symptoms.

Mode of Transmission

Ingestion of contaminated drinking water or ice, uncooked fruits and vegetables.

Through oral-fecal pathway.

By infected food handlers. Clinical Manifestations Clinical Manifestations

Flu-like illness with chills and high fever

Diarrhea, fatigue, and abdominal pain

Loss of appetite

Nausea, diarrhea, and fever

Jaundice and dark-colored urine

The infection in young children is often mild and asymptomatic

Diagnostic Procedure

1. HAV and HBV – complement fixation rate

2. Liver function test – to determine the presence and extent of liver damage and to check the progress of the liver

3. Bile examination in stool and urine

4. SGOT – serum glutamic oxaloacetic transaminaseSGPT – serum glutamic pyruvic transaminaseALT – serum alanine transaminase

5.  IgM level

Treatment Modalities

1. There is no specific treatment, although bed rest is essential.

2. Diet must be high in carbohydrate, low in fat, and low in protein.

3. Patient must take vitamin B complex.

4. Isoprinosine (methisoprenol) – enhance the cell-mediated immunity of the T-lymphocytes.

Nursing Management

1. The patient must be isolated (enteric isolation).

2. Patient should be encouraged to rest during acute or symptomatic phase.

3. Improve nutritional status.

4. Utilize appropriate measures to minimize spread of the disease.

5. Observe the patient for melena and check stool for the presence of blood.

6. Provide optimum skin and oral care.

7. Increase in ability to carry out activities:

a. encourage the patient to limit activity when fatigued

b. assist the client in planning periods of rest and activity

c. encourage gradual resumption of activities and mild exercise during recovery

Prevention and Control

1. Hands should be washed thoroughly every after use of toilet.

2. Travelers should avoid water and ice if unsure of their purity.

3. Food handlers should carefully be screened.

4. Safe preparation and serving of food must be practiced.

5. The public should be educated on the mode of transmission.

Hepatitis B (Serum Hepatitis)

-inflammation of the liver caused by hepatitis B virus.

- More serious than Hepatitis A due to the possibility of severe complications such as massive damage and hepatocarcinoma of the liver.

Incubation Period Incubation Period-50 to 189 days or 2 to 5 months

Period of Communicability:

The patient is capable of transmitting the virus during the latter part of the incubation period and during the acute phase.

The virus may persist in the blood for many years.

Mode of Transmission

Direct contact via infected body fluids.

Through contaminated needles and syringes.

Through infected blood or body fluids introduced at birth

Through sexual contact

HBV transmission does not occur:

By fecal-oral route

By food-borne or water-borne transmission

By arthropod (mosquito) transmission

Clinical Manifestations

·         Prodromal Period

a.       Fever, malaise, and anorexia

b.      Nausea, vomiting, abdominal discomfort, fever, and chills

c.       Jaundice, dark urine, and pale stools

d.      Recovery is indicated by a decline of fever and improved appetite

*Fulminant Hepatitis – fatal & manifested by ascitis and bleeding

Diagnostic Procedures

1. Compliment Fixation test

2. Radio-immunoassay-hemaglutinin test

3. Liver function test

4. Bile examination in blood and urine

5. Blood count

6. Serum transaminase – SGOT, SGPT, ALT

7. HbsAg

Prevention

·         Blood donors must be screened to exclude carriers.

·         Caution must be observed in giving care to patients with known HBV.

·         Hands and other skin areas must be washed immediately and thoroughly after contact with body fluids.

·         Avoid injury with sharp objects or instruments.

·         Use disposable needles and syringes only once and discard properly.

·         Avoid sharing of toothbrush, razor, and other instruments that may be contaminated with blood.

·         Observe “safe sex”.

·         Have adequate rest, sleep, and exercise, and eat nutritious food.

·         Hep B vaccine is recommended for pre-exposure.

·         Hepatitis Immune Globulin (HBIg) should be administered within 72 hours to those exposed directly to hep B virus either by ingestion, by prick or by inoculation.