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Viral Hepatitis Fact Sheet 1 of 3 http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health... Home > For Consumers > Conditions and Diseases > Communicable Diseases Information > Factsheets > Viral Hepatitis Fact Sheet Viral Hepatitis Fact Sheet Fact sheet on viral hepatitis. Background The word "hepatitis" means inflammation of the liver. This can be caused by a number of things, such as chemicals, alcohol, drugs and infection by viruses. The viral hepatitides are a group comprising of several different viral hepatitis infections, which may have similar clinical presentations but which differ in their epidemiology, etiology, immunology, and pathology. The symptoms of acute viral hepatitis include fever, headache, lethargy, nausea, dark urine, pale stools and jaundice. The most commonly encountered viral hepatitidies are type A, type B and type C. Hepatitis A Commonly referred to as infectious hepatitis, hepatitis A is caused by an enterovirus. Infection, particularly in children, may be asymptomatic, or symptoms may be mild, thus the incidence of hepatitis A is difficult to determine. Hepatitis A symptoms, when present, may include abdominal discomfort, loss of appetite, nausea, low-grade fever and tiredness, sometimes followed by jaundice, dark urine and pale faeces. The infectious period is from two weeks before jaundice occurs, then during the first week of jaundice. There is no specific treatment for hepatitis A. Most patients are told to rest for one to four weeks after diagnosis is made, and to avoid intimate contact with other people. Transmission Transmission of infection is by the faecal-oral route, usually by ingesting water or food that has been contaminated with faecal matter containing the virus. Recent significant outbreaks in Australia have been associated with contaminated foods such as oysters. Prevention Control of the spread of the infection includes: Good hygiene, including adequate hand washing and cleaning procedures, Excluding employees from work or children from care centres, for seven days after the onset of jaundice or illness, and Vaccination of groups at risk. Details of Hepatitis A vaccine and vaccination recommendations are available in the Immunisation Handbook 8th edition, 2003. Surveillance and reporting Hepatitis A is a notifiable disease. Notifications are reported to State and Territory health departments, and then collated nationally in the National Notifiable Diseases Surveillance System (NNDSS). NNDSS data are published in Communicable Diseases Intelligence (CDI) and can be 12/02/2007 5:33 PM Viral Hepatitis Fact Sheet 2 of 3 http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health... accessed on the department's website. Top of page Hepatitis B Hepatitis B virus (HBV) belongs to the hepadnavirus family. Most people infected with the virus do not develop clinically recognised illness. It is estimated that less than 10 per cent of children and 30-50 per cent of adults who experience an acute hepatitis B infection will have jaundice. Of those that develop clinical disease, the severity varies considerably, some cases detectable only by liver function tests and others developing into liver failure. Some individuals, who are carriers of the virus for many years, have a very high risk of developing chronic hepatitis and hepatocellular carcinoma later in life. HBV may cause as many as 80 per cent of all cases of hepatocellular carcinoma worldwide. Transmission Transmission occurs by exposure to infective body fluids. After inoculation with the virus, there is an incubation period usually between 45 and 180 days. In infected individuals, hepatitis surface antigen (HBsAg) has been found in most body secretions. Transmission usually occurs from inoculation or mucosal contact with blood or sexual secretions from a person with active infection (HBsAg positive). Known modes of infection include blood transfusion, sharing of needles and syringes, sexual contact and mother to baby during birth. Unlike HIV, HBV is stable in the environment (eg. on surfaces) for several days, posing the risk of indirect inoculation. About 2-4 per cent of those infected as adults and most infants, who are infected, will remain so for many years, becoming virus carriers and a potential source of infection to others. All people who are HBsAg positive are potentially infectious. Chronically infected patients who are HBcAg positive may also be infectious. Prevention Control of the spread of infection includes: Avoiding sharing of injecting equipment such as needles and syringes; Precautions when handling blood-contaminated items; Good hand washing, cleaning and disinfecting practices; Covering open sores, cuts and abrasions; Prevention of aggressive behaviour such as biting and scratching; and. Vaccation of groups at risk. There is currently no cure for hepatitis B. A safe and effective vaccine is available (see page NHMRC Immunisation Handbook, 8th Edition) and vaccination has recently been added to the NHMRC Standard Vaccination Schedule. Surveillance and reporting Hepatitis B is a notifiable disease. Notifications are reported to State and Territory health departments, and then collated nationally in the National Notifiable Diseases Surveillance System (NNDSS). NNDSS data are published in Communicable Diseases Intelligence (CDI) and can be accessed on the department's website. Carrier rates are likely to be about 0.1 to 0.2 per cent amongst Caucasians in Australia. Higher carriage rates often occur in Mediterranean and Asian population groups, and can be as high as 10 per cent in some Aboriginal communities. Resources Australian Immunisation Handbook 8th edition. Recommendations on Hepatitis B Immunisation, NHMRC 1996. Top of page 12/02/2007 5:33 PM Viral Hepatitis Fact Sheet 3 of 3 http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health... Hepatitis C Hepatitis C (HCV) is caused by an enveloped RNA virus which belongs to the family Flaviviridae. While the virus is frequently asymptomatic, infection may results in chronic carriage of the virus in at least 50 per cent of cases. About 20 per cent of these patients develop cirrhosis of the liver within approximately 20 years and 5-10 per cent of these will develop liver cancer within 5-10 years. Symptoms of hepatitis C may include abdominal discomfort, loss of appetite, nausea, fever, tiredness, joint pain, dark urine, and jaundice. Transmission Hepatitis C is essentially a bloodborne disease, and the current data suggest that it is spread mainly through the sharing of needles and syringes by injecting drug users. It accounted for up to 90 per cent of all transfusion-related cases of non-A, non-B hepatitis before the screening of blood donations. Mother-to-child transmission may also occur. In Australia, injecting drug use is currently the most frequent route of transmission. The incubation period ranges from two to six months, commonly 6-9 weeks. Hepatitis C is infectious from one or more weeks before the onset of symptoms to indefinitely in most infected persons. Prevention Control of the spread of the infection includes: Avoiding sharing of injecting equipment such as needles and syringes; Precautions when handling blood-contaminated items; Good hand washing, cleaning and disinfecting practices; Covering open sores, cuts and abrasions; Prevention of aggressive behaviour such as biting and scratching Recent evidence indicates over 50 per cent of people who are infected and who undergo treatment will be cured with available therapies. People who successfully complete treatment no longer experience hepatitis C related symptoms or progression of severe liver disease. There is currently no vaccine for hepatitis C. Surveillance and reporting Hepatitis C is a notifiable disease. Notifications are reported to State and Territory health departments, and then collated nationally in the National Notifiable Diseases Surveillance System (NNDSS). NNDSS data are published in Communicable Diseases Intelligence (CDI) and can be accessed on the department's website. For further information about the Hepatitis C Virus (HCV) please refer to the National Hepatitis C Resource Manual. It covers essential information on the hepatitis C virus, other hepatides, reducing transmission, testing, health maintenance, care and support, treatments, preventing discrimination, education and training, and a summary of jurisdictional responses to hepatitis C. Page last modified: 15 April, 2005 12/02/2007 5:33 PM