Hepatitis is associated with inflammation of liver cells and is usually caused by a virus or drugs including alcohol.

The commonest and most worrying form of hepatitis is known as Hepatitis B, a blood borne infection which can be transmitted sexually or through contaminated blood products. Unfortunately new born babies can be infected from mothers who are carriers of the disease.

Approximately 5 - 10% of infected persons become carriers of the virus when they fail to eliminate it after an acute attack, building up a reservoir for future transmission.

The other common form of the disease, Hepatitis A, is not a blood borne infection but enters the body through the mouth after failing to wash hands thoroughly after using toilet facilities. The virus passes into the gastro intestinal tract from where it gains access to the liver. It is more often seen in children and young adults and does not produce a carrier situation.

The incubation period for Hepatitis A is approximately 4 weeks but can vary between 2 to 6 weeks. Hepatitis B has a longer incubation period ranging from approximately 4 to 25 weeks with the average onset of signs and symptoms between the 8th to the 12th week.

There are forms of hepatitis (types C,D,E,F,G and H have been described!) caused by other viruses but they are not common.

The onset of all forms of viral hepatitis is characterised by loss of appetite, nausea and vomiting. A low grade fever is common and diarrhoea may be an initial feature. These symptoms can be followed several days later by jaundice, the passing of dark urine and pale stools.

Jaundice (yellowing of the whites of the eyes, the urine and the skin) is not always a feature of Hepatitis B but an itchy skin rash may appear and about 25% of patients with Hepatitis B can suffer from aching in the joints.

The clinical picture of hepatitis can vary from very few symptoms to the rapid onset of a severe and fatal illness. Almost all cases of hepatitis A infections and between 90 - 95% of those people who suffer from hepatitis B recover completely from their illness.

The diagnosis of hepatitis is confirmed by laboratory examination of blood. Treatment can include bed rest in the acute stage of the disease particularly if symptoms are severe.

A return to normal activity should be gradual and strenuous physical activity and alcohol intake should be avoided in the convalescent stage of the disease.

Hospitalisation may be required in severe cases particularly in the elderly who may have associated medical conditions. Your doctor will advise on what drugs if any can be taken whilst recovering from hepatitis.

Chronic forms of the disease can linger on for many years.

Prevention of the spread of Hepatitis A consists of good hygiene and efficient sewage disposal, and an effective vaccine is now available. People in contact with known cases of hepatitis should take all precautions to prevent contact with faeces and blood.

Those who suspect or know they are suffering from hepatitis B should not put others at risk. Condoms can prevent the sexual transmission of the disease.

Hepatitis B vaccine is available for active immunisation against hepatitis B and should be given to all those at risk of the disease including new born babies, of mothers who are carriers of the disease.

Your doctor is in a position to advise on each individual case and should be consulted if you are concerned about the need for immunisation.

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