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Labels
- Age dependent Pharmacology
- Approach to the patient
- body action on drug
- Causes of diarrhea
- Common cold
- Comparison Between Type 1 and Type 2 Diabetes Mellitus
- CPR
- Diabetes Mellitus
- Diabetes Mellitus type 1
- diarrhea treatment
- drug absorption
- drug elimination
- drug excretion
- drug metabolism
- Epidemiology
- Epidimiology
- epiglottitis
- Fever.Fever Unknown Origin
- Hepatitis A
- Hepatitis a Transmission
- Hepatitis a Treatment
- High blood pressure
- Hypertension
- Infectious Diarrhea
- introduction to hypertension
- Laboratory studies
- Obesity
- Pathogenesis
- pharmacodynamic
- pharmacokinetics
- Prevalence ofThe public health cost of hypertension
- primary hypertension
- Some health complications associated with hypertension
- Sore Throat
- Symptoms
- Symptoms of diarrhea
- Total costs of hypertension
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Showing posts with label Hepatitis a Treatment. Show all posts
Hepatitis a
Hepatitis A is a liver disease caused by the hepatitis A virus. The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the faeces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation and poor personal hygiene.
Infectious agent
Hepatitis A virus (HAV) is the causative agent.
Symptoms
Illness due to hepatitis A typically causes acute fever, malaise, anorexia, nausea and abdominal discomfort. This is followed a few days later by dark urine and jaundice. Symptoms usually last several weeks although convalescence may sometimes be prolonged. Severe illness may rarely occur when hepatitis A infection complicates pre-existing liver disease. Infants and young children infected with HAV may have a mild
illness with few or no symptoms, with jaundice often being absent.
Method of diagnosis
A blood test indicating IgM anti-HAV antibodies confirms recent infection.These antibodies are present for two to
four months after infection. IgG antibodies alone are evidence of past
infection. In the acute stage of the illness, blood biochemistry shows elevated
transaminase levels indicating hepatocellular damage. The pattern of liver function tests may be non-specific
in later illness.
Incubation period
The incubation period is fifteen to fifty days, with an average of 28–30 days. Public health significance and occurrence Hepatitis A occurs worldwide. In developing countries most people are infected during childhood. With good sanitation and hygiene in the developed world, most people now reach adulthood without experiencing infection. There are about 70–200 cases per year in Victoria. Notifications have been declining nationally since the late 1990s. Infection is more common in travelers to endemic areas, injecting drug users, children in childcare and men who have sex with men. Common source outbreaks due to contaminated food are rare.
Reservoir
Humans.
Mode of transmission
Infection is transmitted by the faecal-oral route from person to person or via fomites. Infectious food handlers may
contaminate non-cooked foods such as salads. Infection can also occur through ingestion of contaminated food or water.Filter-feeding shellfish such as oysters raised in contaminated waters may harbour the virus.The precise timing and mode of transmission are often difficult to define.
Period of communicability
Cases are most infectious from the latter half of the incubation period until a few days after the onset of jaundice,corresponding to a peak in transaminase levels in cases without jaundice. Most
cases are not infectious after the first week of jaundice. Long term carriage or excretion of the virus does not occur.
Susceptibility and resistance
All non immune people are susceptible to infection. Immunity after infection is
probably lifelong. Control measures
Preventive measures
Education about good hygiene is important, particularly hand washing before handling food and eating and after
using the toilet. Inadequate sanitation and housing may contribute to endemic illness.Inactivated hepatitis A vaccines are available for use in persons two years of age and over. Protection begins within
14–21 days after the first dose. A second dose is required for long term protection.The vaccine is recommended for travellers to high risk areas, persons in high risk occupations such as childcare workers and emergency services personnel, injecting drug users and men who have sex with men.
Control of case
Treatment is generally supportive.Exclude from childcare, school or work for at least one week after the onset of
illness or jaundice and until they are well.Children must have a medical certificate
of recovery before returning to school or
child care.
Educate the patient and their family on the need for strict hygiene practices.
Infected persons should not prepare meals for others while infectious, nor share utensils, toothbrushes, towels and face washers.
Dispose of or thoroughly wash nappies of infants that have hepatitis A.
Control of contacts
Normal immunoglobulin (IG) 0.02 mL/kg body weight intramuscularly is recommended for:
• household and sexual contacts of the case
• staff and children in close contact with a case in a childcare centre.
IG is not recommended for usual office, school or factory contacts. IG must be given within seven to ten days of
exposure to be effective. IG is rarely given to persons exposed to a potential common source of hepatitis A such as food or water because cases related to such a source are usually recognised too long after the exposure for IG to be effective. Timely administration of IG will prevent or modify clinical illness for approximately six weeks after the dose. However, people exposed and infected before the administration of IG may still experience a mild infection, and may have the potential to infect others if strict personal hygiene is not maintained. Surveillance of contacts in a household or workplace should be maintained. Live vaccines such as Measles Mumps Rubella (MMR) should not be administered for three months after a dose of IG, and may also be ineffective if given in the 14 days prior to IG. Reschedule such routine vaccinations. When the case is a food handler:
• consider serological testing of coworkers to determine whether they have been infected or are susceptible
• place uninfected susceptible coworkers under surveillance and give them IG prophylaxis. These persons remain at a risk of developing mild illness modified by IG but can generally continue to work provided good personal hygiene and food handling practices are maintained
• undertake surveillance for hepatitis A in patrons by seeking a history of exposure to the food premises from
cases notified over the next two to three months
• carefully consider the role of the infected food handler. If transmission to patrons appears likely, consider urgent
follow-up of exposed patrons to offer them IG prophylaxis.Note that when the index case is a patron, it is usually
too late to offer IG prophylaxis to other diners, although personal contacts of the patron case should be offered IG
according to the usual protocol.When the case is a health care worker,the role of the case should be assessed
and consideration given to the provision of IG prophylaxis for co-workers and patients in their direct care whilst
infectious. Surveillance of contacts in the health care facility should be maintained.
Control of environment
A source of infection should always be sought. For apparently sporadic cases,consider contact with another known case and recent travel to an area where the disease is endemic. Acquisition of infection from young children, particularly those in childcare should be considered. Special attention should be given to toilet hygiene in schools and childcare centres. Ensure that soap and water are available and are used regularly to wash
hands.Food premises, health care facilities or child care centres where a case has worked whilst potentially infective should be requested to carry out a clean up in accordance with the Department’s Guidelines for the investigation of gastrointestinal illness.
Infectious agent
Hepatitis A virus (HAV) is the causative agent.
Symptoms
Illness due to hepatitis A typically causes acute fever, malaise, anorexia, nausea and abdominal discomfort. This is followed a few days later by dark urine and jaundice. Symptoms usually last several weeks although convalescence may sometimes be prolonged. Severe illness may rarely occur when hepatitis A infection complicates pre-existing liver disease. Infants and young children infected with HAV may have a mild
illness with few or no symptoms, with jaundice often being absent.
Method of diagnosis
A blood test indicating IgM anti-HAV antibodies confirms recent infection.These antibodies are present for two to
four months after infection. IgG antibodies alone are evidence of past
infection. In the acute stage of the illness, blood biochemistry shows elevated
transaminase levels indicating hepatocellular damage. The pattern of liver function tests may be non-specific
in later illness.
Incubation period
The incubation period is fifteen to fifty days, with an average of 28–30 days. Public health significance and occurrence Hepatitis A occurs worldwide. In developing countries most people are infected during childhood. With good sanitation and hygiene in the developed world, most people now reach adulthood without experiencing infection. There are about 70–200 cases per year in Victoria. Notifications have been declining nationally since the late 1990s. Infection is more common in travelers to endemic areas, injecting drug users, children in childcare and men who have sex with men. Common source outbreaks due to contaminated food are rare.
Reservoir
Humans.
Mode of transmission
Infection is transmitted by the faecal-oral route from person to person or via fomites. Infectious food handlers may
contaminate non-cooked foods such as salads. Infection can also occur through ingestion of contaminated food or water.Filter-feeding shellfish such as oysters raised in contaminated waters may harbour the virus.The precise timing and mode of transmission are often difficult to define.
Period of communicability
Cases are most infectious from the latter half of the incubation period until a few days after the onset of jaundice,corresponding to a peak in transaminase levels in cases without jaundice. Most
cases are not infectious after the first week of jaundice. Long term carriage or excretion of the virus does not occur.
Susceptibility and resistance
All non immune people are susceptible to infection. Immunity after infection is
probably lifelong. Control measures
Preventive measures
Education about good hygiene is important, particularly hand washing before handling food and eating and after
using the toilet. Inadequate sanitation and housing may contribute to endemic illness.Inactivated hepatitis A vaccines are available for use in persons two years of age and over. Protection begins within
14–21 days after the first dose. A second dose is required for long term protection.The vaccine is recommended for travellers to high risk areas, persons in high risk occupations such as childcare workers and emergency services personnel, injecting drug users and men who have sex with men.
Control of case
Treatment is generally supportive.Exclude from childcare, school or work for at least one week after the onset of
illness or jaundice and until they are well.Children must have a medical certificate
of recovery before returning to school or
child care.
Educate the patient and their family on the need for strict hygiene practices.
Infected persons should not prepare meals for others while infectious, nor share utensils, toothbrushes, towels and face washers.
Dispose of or thoroughly wash nappies of infants that have hepatitis A.
Control of contacts
Normal immunoglobulin (IG) 0.02 mL/kg body weight intramuscularly is recommended for:
• household and sexual contacts of the case
• staff and children in close contact with a case in a childcare centre.
IG is not recommended for usual office, school or factory contacts. IG must be given within seven to ten days of
exposure to be effective. IG is rarely given to persons exposed to a potential common source of hepatitis A such as food or water because cases related to such a source are usually recognised too long after the exposure for IG to be effective. Timely administration of IG will prevent or modify clinical illness for approximately six weeks after the dose. However, people exposed and infected before the administration of IG may still experience a mild infection, and may have the potential to infect others if strict personal hygiene is not maintained. Surveillance of contacts in a household or workplace should be maintained. Live vaccines such as Measles Mumps Rubella (MMR) should not be administered for three months after a dose of IG, and may also be ineffective if given in the 14 days prior to IG. Reschedule such routine vaccinations. When the case is a food handler:
• consider serological testing of coworkers to determine whether they have been infected or are susceptible
• place uninfected susceptible coworkers under surveillance and give them IG prophylaxis. These persons remain at a risk of developing mild illness modified by IG but can generally continue to work provided good personal hygiene and food handling practices are maintained
• undertake surveillance for hepatitis A in patrons by seeking a history of exposure to the food premises from
cases notified over the next two to three months
• carefully consider the role of the infected food handler. If transmission to patrons appears likely, consider urgent
follow-up of exposed patrons to offer them IG prophylaxis.Note that when the index case is a patron, it is usually
too late to offer IG prophylaxis to other diners, although personal contacts of the patron case should be offered IG
according to the usual protocol.When the case is a health care worker,the role of the case should be assessed
and consideration given to the provision of IG prophylaxis for co-workers and patients in their direct care whilst
infectious. Surveillance of contacts in the health care facility should be maintained.
Control of environment
A source of infection should always be sought. For apparently sporadic cases,consider contact with another known case and recent travel to an area where the disease is endemic. Acquisition of infection from young children, particularly those in childcare should be considered. Special attention should be given to toilet hygiene in schools and childcare centres. Ensure that soap and water are available and are used regularly to wash
hands.Food premises, health care facilities or child care centres where a case has worked whilst potentially infective should be requested to carry out a clean up in accordance with the Department’s Guidelines for the investigation of gastrointestinal illness.
Treatment
There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and may take several weeks or months. Most important is the avoidance of unnecessary medications. Acetaminophen / Paracetamol and medication against vomiting should not be given.Hospitalization is unnecessary in the absence of acute liver failure. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.
