Viral hepatitis is a major global health problem. From 5 forms of primary viral Hepatitis all can cause acute disease and Hepatitis B, D and C cause chronic illness and lead to cirrhosis and hepatocellular carcinoma. It is estimated that there are more than 350 million cases of chronic hepatitis B (WHO, 1999) and 170 million cases of HCV worldwide (Weekly epidemiological Record, 1997, pp. 341-344).
Hepatitis A causes an acute self limited disease and is transmitted primarily by the fecal-oral route. IT is endemic in developing countries and is associated with poor environmental sanitation and low socioeconomic status. Hepatitis A infection is usually asymptomatic in infants but causes acute symptomatic disease in older children and adults. Worldwide approximately 1.5 million clinical cases of hepatitis A occur each year (Lavanchy, 2002). In highly endemic areas most people are asymptomatically infected during childhood and clinical Hepatitis A is uncommon. Although Hepatitis A is mostly self-limiting and rarely fatal, it may represent a significant economic burden in countries with low or intermediate incidence (Lavanchy, 2002).
Investment in sanitation and clean water supply will reduce the burden of Hepatitis A related diseases. Institutions like daycare and nursing homes should be educated about the importance of implementation of measures to minimize the fecal-oral transmission including regular hand washing and use of disinfecting agents after contact with fecal material and before meals (Heyman, 2008).
Currently there are four inactivated vaccine available and WHO recommends their use for high-risk population in low endemic countries with high disease prevalence (Heyman, 2008).
In case of outbreak early use of vaccination has been successful in halting the spread. Close contacts of infected patients should be given post exposure prophylaxis with Hepatitis A vaccine and immune globulin (IG) within 2 weeks... [continues]
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