Hepatitis A is an inflammation of the liver (hepar in ancient Greek) caused by a viral infection. The course is always acute, not chronic, and is cured by the body itself in almost all cases.
Only in about 0.2 percent of cases can a severe course with acute liver failure occur. The damage to the liver cells is caused by the hepatitis A virus (HAV). Transmission occurs through contaminated drinking water or food. Vaccination against the disease is possible and should be considered especially by people who are planning a stay in one of the risk areas. Around half of all hepatitis A infections can be traced back to vacation trips.
The hepatitis A virus, which triggers the infectious liver inflammation, is an RNA virus (single-stranded ribonucleic acid). The virus occurs worldwide. Experts explain this by the fact that it is relatively insensitive to cold, cleaning agents and disinfectants. Unfavorable sanitary and hygienic conditions in combination with warm or tropical climates favor the presence and the resulting infections. This is why hepatitis A is also referred to as travel hepatitis. A large number of infected people in Central Europe bring the infection home with them from their vacation. Hepatitis A usually heals itself, although the process can take several weeks. In patients over 50 years of age, a severe course is also possible, which can lead to acute liver failure. Once a person has recovered from a hepatitis A infection, they are immune to the virus for the rest of their lives. Vaccination offers very reliable protection against infection.
The main distribution area of the hepatitis A virus is in Central and South America, Africa, South East Asia, the Middle East, Russia and the Mediterranean region. However, due to the high resistance of the virus, the disease can also occur in other regions. However, due to the good vaccination effect, the risk of infection for Central Europeans is rather low. According to the Epidemics Act and other ordinances, doctors and hospitals in Switzerland must report cases of hepatitis A. Laboratories are also obliged to report analytical findings.
After multiplying in the liver cells, the hepatitis A virus is mainly excreted via the intestine. The hepatitis A virus is spread via the stool one to two weeks before the affected person shows the first symptoms. The route of infection is fecal-oral. This means that the virus enters the mouth from stool. This means that infection is possible via contact or smear infection. Due to inadequate sanitary and hygienic conditions, the virus can get into drinking water and/or seawater and thus also use seafood as a transmission route. The risk of infection is high not only because of the virus’ high resistance to cold and heat. It survives in dry conditions for up to one month, in salt water for up to three months and is resistant to soaps. transmission routes directly to humans:
In addition to people with a history of liver disease, the following occupational groups are particularly at risk:
In principle, transmission of the hepatitis A virus is possible in all situations in which stool can be ingested directly or indirectly via the mouth. If you are affected and are staying in a risk area, prior vaccination is the best protection. It is always advisable to consider the above-mentioned infection routes for the sake of your health, as it is not only hepatitis A viruses that can be transmitted via these routes.
Doctors call the time from infection to the first signs of symptoms the incubation period. In the case of a hepatitis A infection, this is around two to seven weeks (around 15 to 50 days). An infected person is contagious one to two weeks before the onset of the disease and up to one week after the onset of symptoms. Although there are no clear symptoms during this phase, there is a general feeling of discomfort. Hepatitis A can often occur completely unnoticed and heal itself. When symptoms appear, these are in the initial course:
If the body takes longer to process the infection, further symptoms may occur:
If you are affected and experience the first flu-like symptoms, it is important that you inform your doctor about any travel to risk areas and, if applicable, that you belong to a risk group for hepatitis A. This knowledge provides us with possible clues. During a physical examination, we can feel a possible enlargement of the liver or spleen. If you already have clear symptoms – such as jaundice – we will carry out a blood test to determine certain values that indicate liver inflammation. In addition to various parameters such as bilirubin, gamma-GT, GOT and GPT, the detection of antibodies against the hepatitis A virus in particular is evidence of acute type A liver inflammation. The virus can also be detected directly in the laboratory via blood and stool. If a hepatitis A infection is suspected or proven (possibly by a post-mortem examination after death), the attending physician is obliged to report it.
As hepatitis A is benign in almost all cases, we do not initially need to take any further measures. We will talk to you about a healthy diet to support your liver function and may also arrange an appointment with a nutritionist to help you create a suitable meal plan. It is not usually necessary to monitor the course of the disease.
Vaccination protects you as the person affected from infection. If you are traveling to risk areas or are at high risk of infection for private or professional reasons, vaccination is always advisable; the same applies to people with various other pre-existing conditions. A vaccination provides good protection after a few weeks, and after a booster this often leads to lifelong immunity. The vaccine administered into the muscle is also available as a combination preparation against the hepatitis A virus and the hepatitis B virus. When traveling to risk areas, you can try to avoid infection with the hepatitis A virus by observing the relevant hygiene rules. You can do this in various ways:
The basic rule is: cook, fry, peel or do without.
If you keep a close eye on yourself, you may be able to recognize the disease at an early stage: You should consult a doctor promptly if you develop typical symptoms of the disease – for example, because you have been in an infectious environment or have returned from a trip.
A hepatitis A infection usually lasts two to four weeks. Sometimes it can last for several months. A chronic course is not known. In rare exceptional cases, liver inflammation type A can lead to a restriction of liver function up to acute failure. For example, if
A transplant may then be necessary. In 99.8 percent of cases, the body’s ability to heal itself is sufficient to overcome the hepatitis A infection. These can support you as the affected person through a favorable lifestyle in order to make a full recovery as quickly as possible.
The exchange with people who are affected by the same disease can be a great support in coping with the disease. Advice on finding a suitable self-help group is available from Selbsthilfe Zürich. Self-Help Zurich and the University Hospital Zurich are cooperation partners in the national project “Health literacy thanks to self-help-friendly hospitals”.
Since the healthy human body can cope with a hepatitis A infection on its own, direct treatment is not necessary. However, you should not drink alcohol during the period of illness. It is also best to reduce liver-stressing medication to a minimum in consultation with us. In addition to supportive measures for healing, it is particularly important to reduce the risk of infection for other people.