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HEPATITS A (HAV)

Overview:

Hepatitis A (also known as Infectious Hepatitis) is a disease that affects the liver. Hepatitis A is the most common type of viral hepatitis, usually seen among children or young adults. It can be a problem for fire fighters, especially if their meals are prepared by an already infected person or they can become infected by contaminated materials at a fire, hazardous materials incident, USAR, or SCUBA. 

 

Mode of Transmission:

Fecal-Oral

 

Examples of Transmission:

Hepatitis A is transmitted via the fecal-oral route (through contact with small amounts of an infected person’s stool, usually due to inadequate hand washing).

 

  • Eating contaminated food (prepared by someone who is infected with HAV that did not wash their hands after using the bathroom)

  • Drinking unclean water or washing food in untreated water

  • By coming into contact with items and surfaces contaminated with HAV (HAV can survive on an unwashed surface for up to 4 hours.

  • Through openings in the skin such as cuts or abrasions. These opening can be visible or so small that they are not visible to the naked eye.

 

Specific jobs (ex. HazMat, USAR, SCUBA) place firefighters at greater risk of coming into contact with contaminated water. First responder duties, especially disaster response, also increase the chance that a firefighter will come into contact with contaminated water. The Hepatitis A virus is extremely hardy. It is able to survive the body’s highly acidic digestive tract and can live outside the body for months. High temperatures, such as boiling or cooking food or liquids for at least 1 minute at 185°F (85°C), kill the virus, although freezing temperatures do not.

 

Prevention:

Vaccine available- 2 series 6 months apart

 

Precautions:

Universal 

 

Signs and Symptoms:

  • Joint pain •    Fever

  • Fatigue          •    Loss of appetite

  • Abdominal pain, •    Nausea, vomiting, 

  • Dark yellow urine      •    Clay-colored bowel movements  

  • Fever •    Jaundice (a yellowing of the skin or eyes)

 

It takes about 15-50 days to develop symptoms of hepatitis A after exposure. Symptoms typically last two weeks or longer. Most patients recover on their own, but their average time lost from work is five weeks. Some of those that are infected may have relapsing symptoms over a six to nine month period. One in five infected adults gets sick enough to require hospitalization. For the most part HAV does not usually cause long term health complications.

 

General Post Exposure Treatment: 

Persons who have recently been exposed to HAV and who have not been vaccinated previously should be administered a single dose of single-antigen Hepatitis A vaccine or IG (0.02 mL/kg) as soon as possible, within 2 weeks after exposure. The guidelines vary by age and health status:

 

  • For healthy persons aged 12 months–40 years, single-antigen Hepatitis A vaccine at the age-appropriate dose is preferred to IG because of the vaccine’s advantages, including long-term protection and ease of administration, as well as the equivalent efficacy of vaccine to IG.

  • For persons aged 41 years and older, IG is preferred because of the absence of information regarding vaccine performance in this age group and because of the more severe manifestations of Hepatitis A in older adults. The magnitude of the risk of HAV transmission from the exposure should be considered in decisions to use vaccine or IG in this age group.

 

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Paperwork Required

  1. OC Public Health Communicable Disease Exposure Form (policy 330.96) with Fire incident number on top. Should be faxed while still in the hospital Fax: (714) 564-4050 But per policy must be received within 1 working day.

OC Public Health Communicable Disease Exposure Form

  1. The City “Report of Employee Injury” form

  2. Medical Service Order- RM -67 (when medical care is required)

 Post Exposure Follow-up: N/A- Once you recover from Hepatitis A, you develop antibodies that protect you from the virus for life. A recent review evaluated the projected duration of immunity from vaccination, concluded that protective levels of antibody to HAV could be present for at least 25 years in adults and at least 14–20 years in children.

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