People traveling in developing countries, where standards of sanitation and food preparation might not be as stringent as in the United States, should be especially careful.
Symptoms, if they are noticed at all, might be vague and include fatigue, headache, nausea, and loss of appetite. Children are more likely to be asymptomatic than adults. Pruritus (itching) and jaundice, with its accompanying symptoms of urine the color of dark tea and stools having the appearance of light clay, are common among older adults. Patients who become very ill might need complete rest for up to a month, and a few will need hospital care. Jaundice, however, is often the climax of HAV symptoms. Signs of the illness tend to fade once jaundice has appeared. In rare instances, HAV can cause liver failure.
Although no treatment exists for HAV, it is important to treat the symptoms. Patients experiencing fatigue should rest and not to push themselves. All HAV patients must drink plenty of fluids because dehydration can easily develop as a complication, especially if the patient has had diarrhea. The good news about HAV is that if a person receives the proper vaccine series, the disease is almost always preventable. The HAV vaccine series has been used extensively worldwide and has proved to be a safe and extremely effective vaccine.
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The first hepatitis virus to be discovered, hepatitis B (HBV), has infected an estimated 2 billion people worldwide. About 300 million are chronic carriers of the virus, including about 1.25 million Americans. HBV can be deadly; its complications kill about 1 million people every year, and it is the most prevalent cause of cirrhosis and liver cancer in the world, particularly in Africa and Southeast Asia. Yet most people infected with HBV lead fully normal lives.
The HBV virus can be found in body fluids, including saliva, blood, tears, and breast milk, though it is transferred between people only through blood and semen. Casual contact, such as hugging or shaking hands, does not spread the disease; in fact, not everyone infected with HBV is contagious. HBV can be contracted only through sexual contact, a blood exchange, or from a pregnant mother to her fetus—a method of transmission common in Africa and Asia.
Before 1975, blood and platelets collected from blood donors (during blood drives, for example) were not screened for HBV so transfusions once accounted for many HBV infections in this country. Today, donated blood is tested for HBV, but the virus continues to be transferred through more subtle blood exchanges, such as when an infected person shares a razor or nail clippers, or exposes another person through a bleeding skin condition.
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Immunization is key to preventing hepatitis B. People who have been vaccinated are virtually 100 percent protected, so HBV is a disease that could be eliminated. For now, though, its important for individuals at risk to take precautions. Health-care workers, anyone who received a blood transfusion before 1975, and anyone who lives with (or is sexually intimate with) an HBV-infected person are candidates for screening. In fact, it is recommended that sexually active homosexual men, intravenous drug users, dialysis patients, and anyone who has more than one sex partner within six months be screened for HBV. Anyone who receives results that indicate he or she is not immune should receive the vaccine series.
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