Hepatitis A in primary care: working in partnership for diagnosis, management, and prevention of outbreaks

Ntouva, Antiopi; Sibal, Bharat; Balogun, Koye; Mandal, Sema; Harding, Nick

doi:10.3399/bjgp19x705965

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Hepatitis A particles may also be detected in bile, blood, and the liver by nucleic acid hybridization assay or polymerase chain reaction. The investigations of seroprevalence, along with the exploration of national-level interventions for better sanitation and vaccination for high-risk groups, are assuming public health importance (26).…”

Section: Discussionmentioning

confidence: 99%

Common-Source Outbreak of Hepatitis A in an Indian Himalayan Mountain Camp

et al. 2021

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Background: Hepatitis A is an emerging public health problem worldwide, with alerts issued in developed countries, although it remains under-reported, under-diagnosed, and under-investigated in the developing world. Prolonged epidemics can occur due to person-to-person transmission. The ongoing outbreak of hepatitis A reported in the United States is one of its largest-ever outbreaks of the disease. A public health emergency for hepatitis A was declared in Florida, with over 2000 cases across several regions of The United States, in the year 2019. Methods: The outbreak investigation was carried out on 30 travelers in an Indian Himalayan mountain camp. Clinical features were correlated with laboratory parameters for establishing diagnosis by standard case definition. Line listing and epidemic curve were plotted to corroborate outbreak variables. Clinicodemographic, clinical, laboratory, and outbreak variables were descriptively analyzed. Results: Most of the 30 patients with hepatitis A were young male patients within the age range of 20 - 30 years. The most common clinical features among the case-patients were anorexia and vomiting. The epidemic curve revealed a peak of 15 case-patients from June 22 to July 5, 2019. Liver function tests showed mild derangement in all the case-patients. All the patients required hospitalization, with a mean duration of hospital stay reported as 11.86 ± 2.53 days. All the patients fully recovered with no fatalities. Conclusions: Hepatitis A outbreaks can occur through the consumption of untreated mountain stream/river water due to upstream contamination with human/animal excrements. Strengthening surveillance systems, traveler education, vaccination, and intersectoral coordination for safe water supply remains a necessary public health measure.

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Section: Discussionmentioning

confidence: 99%

Common-Source Outbreak of Hepatitis A in an Indian Himalayan Mountain Camp

et al. 2021

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“…Although there have been no reports of fecal-oral transmission of SARS-CoV-2, safe water management and sanitation service with good hygiene practice will provide co-benefits in also preventing other infectious diseases such as hepatitis A infection, hence basic hygiene practice should always be enforced during the COVID-19 pandemic (WHO., 2020). Proper and hand hygiene practice is one of the most pivotal methods to prevent both COVID-19 and HAV infection (WHO., 2020; Xiao et al, 2020;Ntouva et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 with acute hepatitis A virus co-infection in a fully-vaccinated individual: a case report

Siregar

Putradasa²,

Nisaul³

et al. 2021

Trends Infect Global Health

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In a developing country with varying degree of public hygiene and sanitation, prevalent infectious diseases such as hepatitis A (HAV) could add to the burden of infection during coronavirus disease 2019 (COVID-19) pandemic and complicate its gastrointestinal and hepatic manifestation. Here we present a case COVID-19 with acute hepatitis A virus co-infection in a young female with fever, joint pain, non-productive cough, loss of smell, abdominal discomfort, darkened urine, and pale loose stool before admission. The significant finding was slightly icteric sclera, hepatomegaly with tenderness in the epigastrium and right upper quadrant, increase in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, C-reactive protein and, D-dimer. A naso-oropharyngeal swab examination for SARS-CoV-2 infection was positive, and IgM anti-HAV was reactive with a total anti-HAV titer 60 mIU/mL. Subsequently, she was hospitalized for 14 days, successfully recovered; her symptoms resolved and her level of liver enzymes back to normal, and she was discharged for self-isolation at home. RT-PCR for SARS-CoV-2 infection came back negative 7 days later. In light of the pandemic, physicians need to raise suspicion of co-infection of COVID-19 with other hepatitis viruses in cases with gastrointestinal and hepatic manifestation. A marked increase in liver enzyme may warrant further testing for hepatitis viruses where such infection should be suspected.

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“…Estas pruebas deben solicitarse siempre a personas expuestas a situaciones de riesgo de esta infección. 44,45 La presencia de anticuerpos IgG anti-VHA indica una inmunidad duradera. 46 La mayoría de las personas infectadas por el VHB son asintomáticas y se diagnostican en la fase crónica de la enfermedad.…”

Section: Diagnósticounclassified

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: hepatites virais

Duarte

Pezzuto

Barros

et al. 2021

Epidemiol. Serv. Saúde

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Resumo Este artigo aborda as hepatites virais, tema tratado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis e, mais precisamente, nos Protocolos Clínicos e Diretrizes Terapêuticas para Hepatite B e para Hepatite C e Coinfecções, publicados pelo Ministério da Saúde do Brasil. Além do espectro ampliado de acometimento da saúde, os vírus das hepatites A, B e C também apresentam diferentes formas de transmissão, seja parenteral, sexual, vertical ou oral. Entre as estratégias sugeridas para o controle das hepatites virais, além das medidas comportamentais, estão o diagnóstico ampliado, a vacinação precoce contra os vírus da hepatite A e hepatite B e o acesso aos recursos terapêuticos disponíveis. Considerando a transmissão vertical dos vírus da hepatite B e hepatite C, a triagem das gestantes portadoras crônicas desses vírus é uma importante estratégia de saúde perinatal, indicando com precisão quem pode se beneficiar das intervenções profiláticas disponíveis.

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Hepatitis A in primary care: working in partnership for diagnosis, management, and prevention of outbreaks

Cited by 5 publications

References 5 publications

Common-Source Outbreak of Hepatitis A in an Indian Himalayan Mountain Camp

Common-Source Outbreak of Hepatitis A in an Indian Himalayan Mountain Camp

COVID-19 with acute hepatitis A virus co-infection in a fully-vaccinated individual: a case report

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: hepatites virais

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