Hepatitis A (also called infectious hepatitis) is the least serious variant of the three forms of hepatitis. In this disease the liver is inflamed. In hepatitis A, a virus is responsible for the liver inflammation. The disease mainly affects children, but adults can also become ill from hepatitis A. The disease is usually not too serious.

Difference with hepatitis B and hepatitis C

Hepatitis comes in different variants. The best-known forms are A, B and C. The three types of liver infections are all caused by a virus, but by different types of virus. Hepatitis A is a lot more harmless than hepatitis B and C. Unlike its sister diseases hepatitis B and C, the A variant never becomes chronic. In children the disease often passes quickly, but adults can be ill for a long time.

Symptoms

• Feeling limp
• Mild fever
• Nausea
• Less appetite
• Pain in upper abdomen
• Stool is lighter in color
• Urine turns darker
• Jaundice (yellowing of the skin and eyes)

The symptoms are different for everyone. Hepatitis A manifests itself as a mild flu, especially in young children. It is therefore often not clear that a child has had hepatitis A. In addition, jaundice does not always occur. This mainly affects adults. The liver filters the waste product bilirubin from the blood. Bilirubin is created when old blood cells break down. When the liver does not do its job properly, bilirubin builds up in the blood, causing the skin and eyes to turn yellow. This can also cause itching and the stool can look like putty.

Cause

The hepatitis A virus is highly contagious through feces. A while before the symptoms of hepatitis A appear, the virus can spread quickly through feces. This can be prevented by washing hands and preparing food hygienically.

The course of hepatitis A

As mentioned earlier, hepatitis A in children usually proceeds in the same way as flu. In some cases, young children can become seriously ill. Large children, teenagers and adults are hit harder by hepatitis A. A few weeks after infection, the symptoms associated with hepatitis A occur. Complaints such as nausea, vomiting and weakness occur. The urine turns dark after a few days. Feces become light in color, making the feces look like putty. Then jaundice occurs. First the whites of the eyes turn yellow and then it is the skin’s turn. After a few weeks, complaints such as nausea and jaundice disappear. The feeling of weakness may last for several months, but eventually the patient will become symptom-free.

Diagnosis

Blood tests can show whether a patient has been affected by the virus that causes hepatitis A. Antibodies against the hepatitis virus can be found in the blood and the blood can also be tested to determine whether the liver is still functioning sufficiently. The liver values are usually somewhat higher if there is inflammation of the liver. In older patients, more research is often needed to check whether there are, for example, gallstones or tumors of the bile ducts or the pancreas.

Therapy

Hepatitis A cannot be controlled with medication. The disease should go away on its own. Because there is a virus, there is no point in prescribing antibiotics. It is important that the patient does not exert himself too much and does not drink alcohol to avoid straining the diseased liver. A patient may have to stop taking certain medications for other ailments/diseases because they are too stressful for the liver. If hepatitis A is diagnosed, the GP will inform the GGD. The GGD vaccinates the people with whom the patient has come into contact.

Preventing hepatitis A

In the Netherlands, the risk of infection with hepatitis A is small. If you go on holiday to non-Western countries, you run a high risk of contracting the highly contagious hepatitis A. If you go on holiday to tropical countries, it is wise to get vaccinated against hepatitis A at the GGD. Do not drink water from the tap in non-Western countries. Observe the hygiene regulations, especially on holiday in a Mediterranean country. Wash your hands after using the toilet and before cooking.

Hepatitis A in the Netherlands

Fifty years ago, hepatitis A was just as common in the Netherlands as it is today in tropical countries. This was because people lived very close together. Nowadays every family in the Netherlands has their own house. In addition, the Netherlands has clean water. Hepatitis A has now mainly become an imported disease in the Netherlands. In the Netherlands, Turkish and Moroccan children have the greatest risk of hepatitis A, because the disease is common in Turkey and Morocco. In the Netherlands, a sick child often also infects classmates or family members. Such a local epidemic can be quickly contained by vaccinating people in the area.