Meghan Hodges
Hepatitis is an infection that affects the liver and is caused by a group of viruses. There are several types of hepatitis, but the three most common are hepatitis A, hepatitis B, and hepatitis C. Hepatitis A is usually transmitted through the ingestion of contaminated food and water, and has been associated with outbreaks in the United States. Hepatitis E is also transmitted through contaminated water and is more prevalent in Asia and Africa.
| Characteristics | Values |
|---|---|
| Type | Hepatitis A (HAV) and Hepatitis E (HEV) |
| Transmission | Transmitted through the consumption of contaminated water or food |
| Cause | Caused by the hepatitis virus, found in the stool (feces) of infected people |
| Symptoms | Mild to severe illness, acute liver failure, urticarial and maculopapular rash, acute kidney injury, autoimmune hemolytic anemia, aplastic anemia, acute pancreatitis, glomerulonephritis, and thrombocytopenia |
| Incubation Period | 2-6 weeks |
| Treatment | Hepatitis A and E usually resolve after 4-8 weeks of illness without any special treatment |
| Prevention | Universal childhood vaccination and public drinking water regulations |
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What You'll Learn
Hepatitis A
There is no specific treatment for Hepatitis A, but the illness usually resolves within a few weeks without treatment. Rest, hydration, and healthy eating are recommended to aid recovery. In more severe cases, hospital care may be required. Good hygiene, including thorough handwashing after using the bathroom, is important for preventing the spread of Hepatitis A. Additionally, a vaccine is available and is part of routine childhood immunization programs in some countries, which has contributed to a decline in outbreaks.
According to the World Health Organization (WHO), there were 7134 deaths worldwide caused by Hepatitis A in 2016, accounting for 0.5% of deaths due to viral hepatitis. The global prevalence of Hepatitis A varies significantly by country, with higher rates reported in Kenya, Tunisia, and Uganda.
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Hepatitis E
HEV has four major genotypes that cause human disease (genotypes 1, 2, 3, and 4). Genotypes 1 and 2 are restricted to humans and are often associated with large outbreaks and epidemics in developing countries with poor sanitation conditions. They are mainly transmitted through the contamination of drinking water, often leading to large-scale outbreaks affecting several hundred to several thousand people. Genotypes 3 and 4 infect humans, pigs, and other animal species and have been responsible for sporadic cases of hepatitis E. The transmission of these genotypes is mainly zoonotic, through the consumption of uncooked or undercooked meat, with the environment also a likely source of infection.
The symptoms of hepatitis E typically last 1-6 weeks and may include jaundice, fatigue, and nausea, although most HEV infections are asymptomatic. In rare cases, acute hepatitis E can be severe and result in fulminant hepatitis (acute liver failure), which can be life-threatening. Pregnant women, especially those in the second or third trimester, are at an increased risk of acute liver failure and mortality. Additionally, people who have had solid organ transplants and those with compromised immune systems are at risk of more severe outcomes, including long-term liver problems, liver failure, and chronic hepatitis E infection.
There is no specific treatment for hepatitis E, and most people recover with rest and symptom management. A preventive vaccine (HEV 239) is approved for use in China and has been used as an outbreak response measure. To lower the risk of HEV infection, it is recommended to drink only purified water when visiting countries where hepatitis E is common and to avoid raw or undercooked meat.
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Fecal-oral transmission
Hepatitis A is a highly contagious liver infection that is transmitted via the faecal-oral route. This route of transmission involves pathogens in faecal particles passing from one person to the mouth of another. This can occur when people do not wash their hands after using the toilet and then touch or prepare food.
The main causes of faecal-oral disease transmission include inadequate sanitation, leading to open defecation, and poor hygiene practices. If water bodies are polluted with faecal material, humans can be infected with waterborne diseases. Fecal contamination of food is another form of faecal-oral transmission. This can occur when food is prepared in the presence of faecal matter.
In addition to hepatitis A, hepatitis E is another type of hepatitis that is transmitted through the fecal-oral route. It is more prevalent in Asia and Africa and can cause fetal complications in pregnant women.
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Shellfish consumption
Shellfish, especially bivalve shellfish like oysters, clams, mussels, and scallops, are filter feeders. This means they absorb food particles and nutrients by filtering out seawater. As a result, they can retain and concentrate the HAV virus from polluted water, which is then passed on to humans when the shellfish are consumed raw or partially cooked. It is important to note that HAV can persist in shellfish even after steaming for up to five minutes. Therefore, it is recommended to cook shellfish at boiling temperatures for at least five minutes before consuming.
Several outbreaks of hepatitis A have been linked to shellfish consumption. For example, in 1988, a massive outbreak in China affected several hundred thousand people due to contaminated cockles. Other outbreaks have occurred in Sweden, the USA, Great Britain, and Spain. These outbreaks are likely underreported due to the relatively long incubation period of the virus, which can range from two to six weeks. Symptoms of hepatitis A include fatigue, poor appetite, nausea, vomiting, diarrhoea, abdominal discomfort, jaundice, and tea-coloured urine.
To prevent hepatitis A transmission through shellfish consumption, it is crucial to follow good hygiene practices and obtain shellfish from reliable sources. Shellfish importers should possess health certificates from relevant authorities, confirming the safety of each batch. Additionally, proper handling and cooking of shellfish are essential. This includes scrubbing and rinsing the shellfish in clean water, removing the shells and viscera before cooking, and ensuring thorough cooking to destroy the virus.
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Groundwater contamination
Groundwater is a crucial source of drinking water for millions of people worldwide. As such, groundwater contamination is a pressing issue that can have serious health consequences. Groundwater contamination occurs when human-made products such as gasoline, oil, road salts, and chemicals seep into the groundwater, rendering it unsafe and unfit for human use. These contaminants can come from a variety of sources, including storage tanks, septic systems, hazardous waste sites, landfills, and atmospheric pollutants.
Storage tanks, both above and below ground, can contain various liquids such as gasoline, oil, and chemicals. Over time, these tanks can corrode, crack, and leak, allowing the contaminants to reach the groundwater. Similarly, improperly designed, located, constructed, or maintained septic systems can leak bacteria, viruses, household chemicals, and other pollutants into the groundwater.
There are over 20,000 known abandoned and uncontrolled hazardous waste sites in the United States alone, and this number continues to grow annually. If proper containment measures are not in place, hazardous materials from these sites can leak and eventually reach groundwater supplies. Landfills, which are meant to have a protective bottom layer to prevent contamination, can also pose a risk if this layer is missing or damaged, allowing contaminants like car battery acid and household cleaners to seep into the groundwater.
Atmospheric contaminants, such as those found in the atmosphere or bodies of surface water, can also be transferred to groundwater supplies as part of the hydrologic cycle. Additionally, natural and human-induced chemicals can be present in groundwater, even if it appears clear and clean. As groundwater flows, metals like iron and manganese can dissolve and accumulate in high concentrations. Industrial discharges, urban activities, agriculture, and waste disposal can all negatively impact groundwater quality.
The consequences of groundwater contamination can be severe. Contaminated groundwater can lead to the spread of diseases such as hepatitis and dysentery, as well as cause poisoning from toxins in well water supplies. It can also harm wildlife and increase the risk of certain types of cancer in those exposed to polluted water. Therefore, it is essential to address the issue of groundwater contamination to protect public health and ensure access to clean and safe drinking water.
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Frequently asked questions
Hepatitis A and Hepatitis E are most often transmitted through the consumption of contaminated water or food.
Hepatitis A is a common form of viral hepatitis, with around 1.5 million people infected each year. It accounts for 20-25% of hepatitis cases in developed countries.
Hepatitis A is transmitted through the faecal-oral route, meaning a person ingests contaminated faeces from an infected person. This can occur when an infected person does not wash their hands properly after using the bathroom and then touches or prepares food.
Hepatitis A can cause mild to severe illness and, in rare cases, acute liver failure, which can be fatal. Most people recover within three to six months without treatment.
