Saturday, December 22, 2012

Email 170: Concerned About Hepatitis A


Hi Pozziepinoy!

I happened to read your blog when I first found out that I'm positive last June 2012. Your blog is very helpful for all of us pusits (pozzies). Actually, I have several questions for you that I need to know. 


Just very recently, one of teammates was diagnosed with Hepatitis A (I'm not sure). And I have contact with her since she's my teammate. Sometimes, we are only one seat apart. My worries are, firstly, will I get easily infected with her? But she told us that it is not airborne. Secondly, Is she still allowed to go to work as her condition might affect the rest of us on the floor. Another one, I don't have hepa vaccination until now. Do I need to have a vaccination so that I can be prevented with hepa as well? 

The moment I knew that she has hepa, I panicked and didn't know what to do. Good thing she is brave to disclose her status, but on my part I cannot and would not disclose it. My concern is really because of my condition, I know that I am very prone to infection like that. 

Please help me!

Thank you,

@blue_poz
Pozitive




POZZIEPINOY’S RESPONSE

Hi Pozitive.

Thank you for your email. Thank you for reading the blog. I hope you are finding answers to your questions here.

Regarding your concern, let us discuss what Hepatitis A first so the readers can understand where we are coming from.
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What is Hepatitis A?


Hepatitis A is a condition characterized by inflammation of the liver. Symptoms of this viral infection are not always present, but can include jaundice, dark urine, and stomach pain. Since the virus cannot be killed, treatment consists of relieving symptoms while the body fights the infection. 


The cause of hepatitis A is an infection with the hepatitis A virus. This is a single-stranded RNA virus from the family Picornaviridae and genus hepatovirus. The virus only infects humans.


How is it Transmitted?


Hepatitis A is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person infected with hepatitis A (even though it may look clean). The virus is shed in the feces of infected people, and this type of transmission is known as fecal-oral transmission.

Common ways that hepatitis A transmission occurs include:

  • Household contact with an infected person.
  • Sexual contact with an infected person (more common in promiscuous homosexual men).
  • Eating or drinking contaminated food or water. Cold cuts and sandwiches, fruits and fruit juices, milk and milk products, vegetables, salads, shellfish, and iced drinks are commonly implicated in outbreaks. Contamination of foods by infected workers in food processing plants and restaurants is also common.
  • Sharing eating utensils that are contaminated.
  • Touching contaminated surfaces and then placing your hands near or in the mouth.  
Hepatitis A transmission is common throughout the developing world, where infections most frequently occur during early childhood, and usually have mild symptoms or none at all. This is because transmission of the virus is enhanced by poor personal hygiene and overcrowding.

In developed countries, hepatitis A transmission is less common, but community-wide outbreaks still occur in some areas of the United States. These outbreaks are common in institutions, crowded house projects, prisons, and in military forces in adverse situations.

Casual contact, as in the usual office, factory, or school setting, does not spread the hepatitis A virus.


Symptoms

Many people with hepatitis A will not have any symptoms. This is especially true in children. If people do have symptoms, they may start abruptly and include the following:

  • Yellowing of the skin or eyes (also known as jaundice)
  • Feeling very tired
  • Stomach pain (abdominal pain)
  • Not feeling very hungry
  • Dark urine
  • Nausea
  • Diarrhea
  • Muscle pain
  • Joint pain
  • Low-grade fever.  

Preventing Hepatitis A


1. Handwashing
The following tips can help reduce your risk of spreading or catching the virus:
  • Always wash your hands thoroughly after using the restroom and when you come in contact with an infected person's blood, stools, or other bodily fluid.
  • Avoid unclean food and water.
The virus may spread more rapidly through day care centers and other places where people are in close contact. Thorough hand washing before and after each diaper change, before serving food, and after using the restroom may help prevent such outbreaks.
2. If You Are Exposed
If you have recently been exposed to hepatitis A and have not had hepatitis A before, or you have not received the hepatitis A vaccine series, ask your health care provider about receiving the hepatitis A immune globulin shot.
Common reasons why you may need to receive this shot include:
  • You live with someone who has hepatitis A.
  • You recently had sexual contact with someone who has hepatitis A.
  • You recently shared illegal drugs, either injected or non-injected, with someone who has hepatitis A.
  • You have had close, personal contact over a period of time with someone who has hepatitis A.
  • You have eaten in a restaurant where food or food handlers were found to be infected or contaminated with hepatitis A.
You will likely get the hepatitis A vaccine at the same time as the immune globulin shot.
3. Vaccines
Vaccines that protect against hepatitis A infection are available. Hepatitis A vaccination is recommended for all children older than age 1.
The vaccine begins to protect 4 weeks after receiving the first dose. A 6- to 12-month booster is required for long-term protection.
Other people who are at higher risk for hepatitis A and should receive the vaccine include:
  • People who use recreational, injectable drugs
  • People who work with the hepatitis A virus in a laboratory or with primates that may be infected with the virus
  • People who have chronic liver disease
  • People who receive clotting factor concentrate to treat hemophilia or other clotting disorders
  • Military personnel
  • Men who have sex with other men
  • Employees of child day care centers
  • People who care for patients living in long-term nursing homes and other facilities
4. Travelers
Travelers should take the following precautions:
  • Avoid dairy products.
  • Avoid raw or undercooked meat and fish.
  • Beware of sliced fruit that may have been washed in contaminated water. Travelers should peel all fresh fruits and vegetables themselves.
  • Do not buy food from street vendors.
  • Use only carbonated bottled water for brushing teeth and drinking. (Remember that ice cubes can carry infection.)
  • If no water is available, boiling water is the best method for eliminating hepatitis A. Bringing the water to a full boil for at least 1 minute generally makes it safe to drink.
  • Heated food should be hot to the touch and eaten right away.
People who work or travel in areas where hepatitis A is common should be vaccinated. These areas include Africa, Asia (except Japan), the Mediterranean, Eastern Europe, the Middle East, Central and South America, Mexico, and parts of the Caribbean.
If you are traveling to these areas in fewer than 4 weeks after your first shot, you may not be fully protected by the vaccine, You can also get a preventive dose of immunoglobulin (IG).

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Going back to your questions, the best way to handle your situation is by protecting yourself. Always wash your hands or use hand sanitizers. Also talk to your HIV doctor about your concern and ask if he or she will recommend for hepatitis A vaccination for you. I can't just say that you need it because I don't know your past medical history so only your HIV doctor can prescribe it for you.

With regards to your teammate who has Hepatitis A, I talked to an HR Manager of a company and she said that no matter what the company can't tell your teammate not to come to work because of hepatitis A, unless her doctor will tell her that she can't come to work. 

Consider that any infection can infect us because of our weakened immune system and we have to do everything to protect us from getting them. We can't control what other people has but we can control how we can protect ourselves. 

I hope I was able to answer your concerns. Feel free to email me again if you have other questions.




Stay healthy,
Pozziepinoy




"WE ARE ALL IN THIS TOGETHER.
NO PLHIV is alone with his or her struggle with HIV!"

-Pozziepinoy-


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http://hepatitis.emedtv.com
http://www.nlm.nih.gov

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