Hepatitis A – USA

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King County (USA, Washington) has seen a surge in hepatitis A cases with 71 confirmed, while the yearly average is 5-16 cases. The total for Washington State is at 160, while the number last year was 20 cases for the same period.

In King County, for 2020, 18 onsets were recorded in January, 19 in February, and a jump to 28 in March.

Hepatitis A is an infectious disease of the liver caused by a virus. Many people have few or no symptoms, especially in the young. The time between infection and symptoms, in those who develop them, is between two and six weeks.

When symptoms occur, they typically last eight weeks and may include nausea, vomiting, diarrhea, jaundice, fever, and abdominal pain.

Hepatitis A virus thrives in poorly sanitized environments and transmits through contact with infected people and surfaces. It is usually spread by eating food or drinking water contaminated with infected feces. Shellfish which have not been sufficiently cooked are a relatively common source. Furthermore, it can transmit through sexual intercourse.

Anyone who has not gotten a vaccine is at risk. 

Photo: Hepatovirus A micrograph, colorized.

In the USA, it mostly affects the homeless and people who use street drugs, but also inmates, international travelers, people with chronic liver disease, or clotting disorders, and caregivers assisting hepatitis patients. A risk of wider secondary spread exists during outbreaks, mediated by food handling.

Globally, symptomatic hepatitis A infections are believed to occur in around 1.4 million people a year. Acute hepatitis A resulted in 11.200 deaths in 2015.

Developed countries have low circulating levels of the virus, while developing countries have higher levels of circulation. Most adolescents and adults in developing countries have already had the disease, thus are immune. Adults in mid-level countries may be at risk of disease with the potential of being exposed. In developed countries the disease poses a significant risk, due to low immunity levels in the community.

No specific treatment for hepatitis A is known. Recovery from symptoms following infection may take several weeks or months. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhea.

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