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Hepatitis A
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Rebecca Pierce-Williams, Neil Silverman, Steven K. Herrine, Danielle Tholey
Hepatitis A is usually transmitted through fecal-oral contact with infected persons or contaminated food and/or water. Most cases in the United States are directly transmitted through person-to-person or sexual contacts during outbreaks. The average incubation period is 28 (15–50) days, with peak infectivity 2 weeks prior to an abrupt symptom onset [9, 10]. HAV infection can be symptomatic (adults) but also asymptomatic (mostly children <6 years of age). The vast majority of cases are self-limited (1–2 weeks), though severe cases can last months [11]. Relapse can occur (up to 20% of cases), though the symptoms are often milder, and the average duration is 4.7 weeks, with reported durations up to 4 months [12]. Anti-HAV IgM usually appears 5–10 days before symptoms present, and can persist for 3–12 months [10].
Immunomodulatory Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Following the success of the national hepatitis B vaccination program in Taiwan, administration of hepatitis B vaccination was recommended for all infants and children up to the age of 18 by the WHO and the US Centre for Disease Control and Prevention (CDC) in 2009. In the UK, it is now routinely given as part of the NHS vaccination schedule to babies aged 8, 12, and 16 weeks. In particular, individuals considered to be at an increased risk of hepatitis B include infants born to those who inject drugs, those who change sexual partners frequently, health care workers with occupations putting them at risk of contact with blood or bodily fluids, such as nurses and doctors, and those travelling to high-risk countries. Once vaccinated, the individual is protected for life.
Infectious Diseases
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
The clinical presentation of acute hepatitis may depend on the underlying cause. Generally, patients with hepatitis experience non-specific symptoms (fatigue, nausea, vomiting) followed by development of a fever, jaundice, RUQ discomfort and hepatomegaly. Chronic hepatitis presents with similar symptoms or symptoms of cirrhosis and liver failure (see Section 3.4).
Simple and feasible detection of hepatitis a virus using reverse transcription multienzyme isothermal rapid amplification and lateral flow dipsticks without standard PCR laboratory
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2023
Mao-ling Sun, Yang Zhong, Xiao-na Li, Jun Yao, Yu-qing Pan
HAV infection is a global public health problem. Around the world, 1.5 million people are infected with HAV each year, and the number of undiagnosed infections may reach tens of millions [11]. In China, hepatitis A outbreaks are a public health crisis, causing great panic and a huge shock to the economy. In 1988, 1.5 million people in Shanghai were infected by HAV transmitted by Scapharca subcrenata, with more than 300,000 presenting with symptoms [6]. In that year, the cost of free treatment for hepatitis patients far exceeded the health expenditure of Shanghai [12]. Because Hepatitis A often spreads through contaminated food and water, it can infect many people in a short time (a cluster outbreak) [13]. Therefore, a rapid, accurate, and economical diagnostic test for HAV is urgently needed to control hepatitis A epidemics, especially in resource-limited settings [14].
Chapter 9: Pediatric tuberculosis
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022
Rachel Dwilow, Charles Hui, Fatima Kakkar, Ian Kitai
Treatment support should be available to those prescribed intermittent regimens or where adherence issues are a concern, given the commonly encountered practical difficulties, including (but not limited to) spitting out medicines, parental anxiety and taste issues with liquid suspension or crushed tablets. Routine baseline lab investigations are not required in otherwise healthy children who do not have any underlying conditions predisposing them to hepatotoxicity. Regular follow-up visits, either by public health staff or clinicians, should focus both on adherence to treatment and adverse event monitoring. Questions should focus on the early warning signs of drug-induced hepatitis: persistent nausea, vomiting, fatigue, anorexia or abdominal pain. Jaundice and scleral icterus are late signs of severe liver injury. If any of these symptoms are observed by the caregivers, they should be told to stop treatment immediately and report this to their health care team, followed by prompt assessment for hepatotoxicity.
Hepatitis A epidemiology in Latin American countries: a 2020 view from a systematic literature review
Published in Expert Review of Vaccines, 2020
Anar Andani, Tessa M. van Elten, Eveline M. Bunge, Cinzia Marano, Fernanda Salgado, Kathryn H. Jacobsen
The national prevention and control strategy for viral hepatitis may include the introduction of hepatitis A vaccination for infants (ideally in a national immunization program to ensure high coverage rates), as per WHO recommendations [4]. With the wealth of data on the effectiveness of hepatitis A vaccines, including long-term data from countries such as Israel and the USA [15], an increasing number of countries are establishing pediatric HAV national immunization programs. In Latin America, the hepatitis A vaccine has now been introduced in nine countries, most recently Honduras in January 2020 [86]. However, there are challenges to implementing vaccination against hepatitis A, including competing priorities for new national vaccine introductions [6]. Another perceived challenge is the cost to governments. Although health economic models have established the cost-effectiveness of this intervention in middle-income countries [87], the cost of outbreaks and treatment of cases (in general, as well as during an outbreak) are not well documented in most Latin American countries. It is important to consider the vaccine’s long-term (>10 years) cost-effectiveness, taking both direct and indirect costs into consideration, in addition to monitoring the success of immunization programs in preventing disease in the target population and inducing herd protection. National hepatitis A surveillance programs are particularly important in the context of anticipated increases in global trade, including food supplies, and international travel and migration [2].