Spring is the season of high incidence of viral hepatitis. We have learned include viral hepatitis A, B, C, D, hepatitis E, respectively A, B, C, D, hepatitis E virus. In addition to research does not rule out there that are not clear and unknown hepatitis virus.
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Spring is the season of high incidence of viral hepatitis. We have already learned include viral hepatitis A, B, C, D and E hepatitis, by A, B, C and D, hepatitis E virus. In addition there are still no studies does not rule out a clear and unknown hepatitis virus.
Today we focus on the hepatitis A and hepatitis E infection.
1, hepatitis A and hepatitis E disease characteristics
China is high incidence of viral hepatitis, hepatitis A prevalence as high as 80% of the population, is infected with hepatitis caused by hepatitis A virus antibodies in persons (anti-HAV positive) accounted for 80% of the population. We may wonder, with so high? This is because hepatitis A infection who are far more than latent infection in patients with acute hepatitis.
Also known as subclinical latent infection is pathogen invades the human body, the body produces a specific immune response, pathogens can be removed, but does not cause or caused only very minor tissue damage, so no clinical symptoms and signs, or even no biochemical Check the change only be found by immunological tests, such as letters from readers mentioned the situation, China's Hepatitis A and Hepatitis E virus infection were prevalent with latent infection. HEV infection rate of about 17% of the population.
We know, B, C, hepatitis D patients with multiple clinical manifestations of chronic infection, and A, compared with acute hepatitis E infection, generally do not become chronic. A and hepatitis E virus carrier state has not, it is also different from, B, C, D hepatitis.
Latent infection the virus to carry and how different? Carriers not immune response onset and no rejection, can not clear the pathogen, but the discharge of pathogens from the body (ie latency to carry, rather than the dominant recovery after infection carry), So contagious, as the source of infection.
A and hepatitis E infection source is infected with hepatitis and hidden, while B, C, hepatitis D source of infection including the virus.
A and hepatitis E through the gastrointestinal tract by fecal - oral transmission. Is usually referred to the general public "in the outside eating infected", is different from B, C, hepatitis D is through blood and body fluid other than the way other gastrointestinal spread.
A and hepatitis E virus enters the body orally, by the intestine into the bloodstream, causing a brief viremia, after re-entering the liver cells, and in which the copy, a small amount of virus into the blood, most of the bile into the intestine and then excreted with the feces.
Or latent infection in patients with faecal contamination of drinking water, food, vegetables, appliances, toys, etc., can cause A and hepatitis E epidemic. In particular, water, food contamination outbreak may occur.
By the end of 1987 to March 1988, the Shanghai people eat contaminated cooked Blood Clam without causing the largest one since the founding of the pandemic of hepatitis, 4 months, 31 million disease. 1986 to 1988, the southern region of Xinjiang in China due to faecal pollution of water sources, has two hepatitis E outbreak occurred, there were 119,000 cases, up to 18 months duration.
Susceptible population is hepatitis A hepatitis A antibody negative. As the universal human susceptibility to hepatitis A virus, so most of our people were infected at an early age, mainly to latent infection, dominant hepatitis patients also more common in children and adolescents. The dominant hepatitis E infection primarily for adults.
2, hepatitis A and hepatitis E in which the clinical manifestations
The incubation period of hepatitis A is about 4 weeks, HEV was 6 weeks. Are acute onset, jaundice and jaundice-free distinction. In fact not much higher than the incidence of jaundice jaundice, or about 50% of the total cases to 90%. As no jaundice symptoms are mild jaundice, onset is also slower and recovery faster and often overlooked, so it is more common hepatitis jaundice.
A, clinical manifestations of hepatitis E is similar to early may have chills, fever, fatigue, loss of appetite, nausea, vomiting, tired of oil food, abdominal distension, diarrhea, liver pain, dark urine and other symptoms, easily misdiagnosed as respiratory tract infection or gastroenteritis.
By the way, these symptoms of acute hepatitis found in chronic active hepatitis, but in general a little light in the non-active or even asymptomatic. Often asymptomatic patients with chronic hepatitis alone on their own that "nothing", refuses to be examined, is wrong.
Because symptoms of acute hepatitis, it is more timely medical treatment. Patients until the time of the skin, sclera ("supercilious jen") appears yellow dye, the general heat withdrawal, relieve symptoms. But the urine can be further deepened, due to bile salt stimulation may have itchy skin. Some patients may appear gray short stool. At this time patients may have hepatosplenomegaly, tenderness and other signs of liver area. Ultrasound also change accordingly. Check liver function tests, alanine aminotransferase (ALT) significantly increased, ALT is the function of liver cells in most commonly used biochemical indicators.
The total clinical course of hepatitis A 2 to 4 months, severe hepatitis is rare, but infants suffering from hepatitis often heavier, can develop acute severe hepatitis. Hepatitis E and hepatitis A symptoms compared to slightly heavier and longer course of disease, particularly the extent and duration of jaundice is often more significant than that of hepatitis. The elderly more common in acute hepatitis to hepatitis E and jaundice and more; late pregnant women suffer from hepatitis E when severe illness, postpartum hemorrhage more common, vulnerable to liver failure and mortality can be as high as 30% or more; chronic hepatitis B infection in patients with overlap E When liver disease is also heavier, high mortality. But most of the good prognosis of hepatitis E, the general course of no more than 6 months.
Hepatitis A and hepatitis E diagnosis is relatively straightforward, based on epidemiological history, exposure history and symptoms, signs and laboratory diagnosis can be made. Etiology of viral hepatitis by checking to distinguish which type of infection; rely mainly on clinical immunology, infectious hepatitis A or hepatitis E virus, the early body will produce anti-HAVIgM respectively, or anti HEVIgM antibodies, which are recent signs of infection , acute phase and disappeared. Hepatitis A antibodies in the recovery period the production of anti HAVIgG it sustainable for years or for life, the protection of antibody, usually no longer infectious HAV. The hepatitis E IgG antibodies in the acute stage to reach high levels of recovery decreased significantly, more than 6 to 12 months away, unprotected sex.
Third, hepatitis A and hepatitis E in the prevention and treatment
The clinical course of hepatitis and HEV generally good, mostly self-limiting is not special treatment, a period of time can also be self-healing, full recovery. But the extra attention to special populations.
Acute phase should be isolated, symptoms and patients and jaundice, liver function changes significantly should bed rest, recovery activities can gradually increase the amount of normal liver function 1 to resume work after 3 months.
Diet should be light and easily digestible food selection, appropriate vitamin supplements, protein intake should be sufficient. Can also be added as appropriate, through intravenous glucose and other nutrients.
Drug treatment aimed at elimination of symptoms and liver function, not too much should not increase the burden of the liver, usually without antiviral drugs. The treatment of severe hepatitis patients was more complex.
A, is the prevention of hepatitis E from control Source of infection, cut off the transmission and protection of the vulnerable populations of several aspects. Isolation of infected patients on treatment, environmental sanitation and hygiene, enhance manure and water management, good food hygiene and tableware disinfection, do not drink unboiled water, do not eat undercooked seafood, meat and eggs foods, to prevent " start with the mouth. " Attention to exercise and strengthen resistance to disease.
The most effective preventive measure is still the vaccination, anti-HAVIgG negative, can be inoculated with hepatitis A vaccine, mainly for infants, children and other high risk groups of infants less than 6 months without vaccination, carried from their mother's antibodies. Immunity after vaccination for at least 5 years. Hepatitis E is no vaccine.
We can see a kind of infectious diseases is one of the standard of living, health habits and level of education and other factors closely related. Therefore, a fundamental control of infectious diseases but also on overall national strength.
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