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Lesson 56. Viral Hepatitis
1-55. HEPATITIS Hepatitis is inflammation of the liver with destruction of liver cells. Hepatitis may be viral or non-viral in origin. a. Viral hepatitis includes: - (1) Type A hepatitis virus (infectious hepatitis).
- (2) Type B hepatitis virus (serum hepatitis).
- (3) Type non-A/non-B hepatitis virus.
b. Non-viral hepatitis includes: - (1) Toxic hepatitis (acute liver cell necrosis).
- (2) Drug induced hepatitis.
1-56. VIRAL HEPATITIS a. Type A hepatitis virus, also called infectious hepatitis, is a highly contagious form of hepatitis. Modes of transmission include: - (1) Oral ingestion of contaminated materials such as water, milk, or shellfish from contaminated waters.
- (2) Fecal/oral contamination from poor sanitation.
- (3) Person-to-person contamination from blood, saliva, or feces.
- (4) Blood transfusions are RARELY, if ever, a source of Type A hepatitis virus.
b. Type B hepatitis virus, known as serum hepatitis, is the type that poses a threat to health care workers. Type B hepatitis virus is spread through: - (1) Contact with contaminated body secretions.
- (2) Parentally, through contact with contaminated needles, syringes, blood, and blood products.
- (3) By transmission from mothers to babies.
c. A third type of hepatitis virus is identified as type non-A/non-B. Although the cause for this type of hepatitis is unclear, its mode of transmission appears to be blood-borne. Type non-A/non-B hepatitis virus is responsible for 80 percent—90 percent of all the post transfusion cases of hepatitis. It is associated with: - (1) Blood transfusions and transfusion products.
- (2) Parenteral drug abusers.
- (3) Personnel associated with renal transplant and dialysis units.
- (4) Institutions with long-term residents.
d. Refer to Table 1-1 for a comparison of the types of viral hepatitis. | | Type A Hepatitis Virus
(Infectious Hepatitis) | Type B Hepatitis Virus
(Serum Hepatitis) | Type non-A/non-B
(Hepatitis Virus ) | Mode of Transmission | - Fecal-oral contamination
- Person-to-person
- Water-borne
- Food borne
| - Body secretions of infected persons
- Contaminated needles, syringes
- Mothers to babies
| - Transfusions
- Transfusion products
- Personnel in Renal and Dialysis units
- Institutions with long-term residents
| Incubation Period | 2-6 weeks
Mean: 30 days | 4-24 weeks
Mean: 90 days | 2-15 weeks
Mean: 60 days | Prodromal Phase (Pre-icteric) | - Generally asymptomatic at first with abrupt onset of flu-like symptoms: headache, malaise, fever, lassitude, and nonspecific
- GII symptoms such as anorexia, nausea, upper abdominal disconfort and vomiting
| - Insidious onset of variable symptoms: Includes same symptoms as Type A.
- Arthralgias Uticarial skin rashes
| - Isidious onset of symptoms.
- Similar to type B, but less severe
| Icteric Phase | - Jaundice
- Dark urine
- Pale stools
- Tender and enlarged liver
- Pruritis
When jaundice reaches its peak usually within two weeks, symptoms tend to subside | - Prolonged acute phase with anorexia, malaise and abdominal pain
- Jaundice may or may not occur
| - Similar to Type B, but less severe
- Most cases are without jaundice
| Post-Icteric Phase | | - Prolonged convalescence of 3-6 months
| - Prolonged convalescence
- Probability of a carrier state
| Table 1-1. Types of viral hepatitis. |
