The virus easily spreads by stool of infected people and it usually affects social groups with imperfect hygienic standards (“disease of dirty hands”). It can also transmit by contaminated food. For example, there was a great epidemic of hepatitis A in former Czechoslovakia in Europe in 1979, when tens of thousands of people got infected from contaminated frozen strawberries from Poland.
First symptoms usually occur in four weeks after the infection. The virus itself does not cause much harm and the majority of troubles are caused by our own immune response that damages the liver tissue. The disease has typically relatively mild manifestation including fatigue, fever, loss of appetite, nausea, vomiting and diarrhea. Hepatitis A is also frequently accompanied with jaundice, i.e. yellow discoloration of eyes, skin and mucous membranes.
It is important to ask the patient about his or her symptoms and known occurrence of hepatitis A in patient’s close vicinity. Blood tests show elevated liver tests marking the damage of liver tissue and special serological examination can find serum antibodies against hepatitis A virus, which confirms the diagnosis.
The prognosis is excellent. Hepatitis A does not cause chronic liver inflammation or liver cirrhosis and in a short period of time it leads to full recovery. There are reported cases of hepatitis A associated with acute liver failure, but these are extremely rare.
There exists a vaccine, but in the majority of countries, it is not a part of mandatory program. It may be preventively administered to medical personnel or to travelers to areas with lower levels of hygiene.
The patient is usually hospitalized in isolation ward to prevent further spread of infection to other individuals. During the acute infection, it is advisable not to drink alcohol and to eat diet with only a low amount of fats. As a support, the doctors may prescribe drugs that protect the liver tissue (hepatoprotectives), but their effect is somehow questionable.