Hepatitis A outbreak in Kerala, 10 deaths: Doctor explains causes, symptoms and more

Hepatitis A typically spreads through the ingestion of contaminated food or water or through close contact with an infected person. Photo: iStock/SyhinStas

For the past few days, many cases of Hepatitis A have been reported from Kerala's Malappuram district. Around 4,000 Hepatitis A cases have been documented in the district, with eight fatalities occurring in the past five months, including two recent deaths. Hepatitis A primarily spreads through contaminated water and food. Personal hygiene and environmental cleanliness are crucial for prevention. One of the common symptoms of Hepatitis, including Hepatitis A, is jaundice. Dr. Rajeev Jayadevan, a prominent gastroenterologist and former president of the Indian Medical Association (IMA), says that there is the possibility of the Hepatitis A disease getting transmitted to others if its virus enters one’s body.

"The Hepatitis A virus can be present in the patient's stool up to two weeks before jaundice symptoms manifest themselves. It may persist for a week or more after symptoms appear, and in some cases, the virus can linger in the stool for weeks after symptoms vanish. This varies among individuals. Infected persons must practise thorough personal hygiene, including diligent hand washing, to prevent disease spread," he advises. Dr. Rajeev Jayadevan provides insights into the diseases:

What is jaundice?
Jaundice occurs when the skin and eyes turn yellow due to the deposition of yellow-coloured bilirubin in body cells. Bilirubin levels in the blood can rise for various reasons.
Why do people dread jaundice?
Many people link jaundice with severe liver disease. However, elevated bilirubin levels can result from multiple causes. It may cause no issues for some individuals, while for others, it can range from minor to serious problems. The initial step is to identify the underlying cause of jaundice. For instance, elevated bilirubin levels in liver cirrhosis patients may stem from impaired liver function. But in some other conditions, the rise in bilirubin may not be due to this.

What is hepatitis? 
Hepatitis can be termed as the inflammation of the liver. It can be due to many reasons including viral infection and excessive consumption of alcohol. The disease caused by the virus is called viral hepatitis. There are three main types of viral hepatitis categorized as A, B, and C. 
How does hepatitis A spread?
Hepatitis A spreads through contaminated water and food, particularly in areas where food is prepared in unsanitary environments. The virus enters the body through the mouth and reaches the liver. Individuals heavily infected with the hepatitis A virus have a significant viral load in their bile ducts. The virus passes through their intestinal tract and is excreted in faeces. If the faeces contaminate water and are ingested by others, they will also become infected.

It's crucial not to defecate in the open, as the virus can contaminate drinking water sources. Virus-containing waste can mix with water through wells, bodies of water, broken drinking pipes, etc. Houseflies can spread the virus in contaminated areas. Therefore, it is important not to leave food items exposed. Boiling drinking water can prevent virus infection. Additionally, it is worth noting that the virus can survive outside the human body for over a month and may be found on food preparation utensils and unhygienic items. However, the virus does not spread through saliva.

Kolkata: A healthcare worker prepares to vaccinate beneficiaries during the COVID-19 dry run for immunization activity in Kolkata. (File Photo: Kuntal Chakrabarty/IANS)
Since the body's immune system is capable of destroying the virus, drugs are usually unnecessary to treat Hepatitis A. Photo: IANS

When is the virus most likely to spread from an infected person? 
The virus can start spreading two weeks before the patient shows symptoms, making it challenging to prevent its spread in crowded habitations. As it progresses into jaundice, the viral load decreases, reducing the rate of transmission.
Should infected people be isolated to prevent the spread? 
Individuals with jaundice do not need to be isolated. The virus can spread only when parts of the patient's stool somehow get into other people's food or water. Therefore, people suffering from hepatitis should avoid handling others' food and water. Washing hands with soap after defecation can help prevent the spread of infection.

Should everyone with jaundice be hospitalized? 
Not everyone with hepatitis A needs to be admitted to the hospital. Have a doctor check the extent of liver damage and seek hospital treatment as directed.
Should the hepatitis A patient take antiviral drugs? 
Since the body's immune system is capable of destroying the virus, drugs are usually unnecessary. But remember, unscientific and unnecessary drug use can seriously affect liver function.

Hepatitis A is one of the least troublesome liver viruses. Photo: Shutterstock

Is hepatitis A dangerous? 
Hepatitis A is one of the least troublesome liver viruses. In some people, jaundice may persist for a long time. In individuals with cirrhosis of the liver or other underlying medical conditions, the disease can be severe and may turn fatal in rare cases. Hepatitis A is more common in young people. Often, the danger arises when people decide on their own that their jaundice is mild without getting a diagnosis. The first step is to find out the real cause of jaundice.

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