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Hepatitis A

Hepatitis A, also known as "Infectious Hepatitis," is a viral disease of the liver that causes fever, weight loss, nausea and abdominal discomfort, followed by jaundice (yellowing of the skin). It usually lasts 1-2 weeks, but can occasionally last several months. It is rarely fatal.

Outbreaks of hepatitis A occur commonly in institutions, day care centers, low-cost housing projects and rural areas. Epidemics in this country are most common among school-age children and young adults. Wastewater treatment plant workers are also commonly exposed to sewage contaminated with the hepatitis A virus.

MODE OF TRANSMISSION

Hepatitis A is transmitted from person to person through the oral-fecal route (by swallowing materials contaminated with human feces.) It is not to be confused with hepatitis B which is transmitted through infected blood. The most contagious time for hepatitis A is a week or two before the begining of symptoms.

Hepatitis A is often associated with contaminated water and food, including milk, sliced meats, salads, and raw or undercooked clams, oysters or mussels. It is possible, although extremely rare, for hepatitis A to be transmitted through transfusions of blood from an infected donor.

The incubation period averages 28-30 days, but can be as short as 15 days or as long as 50 days.

SAFE WORKING PROCEDURES

  • Hospital and health care workers should be trained in hepatitis A precautions and modes of transmission. Employees should be notified of who has the disease, or at least for whom "enteric" precautions must be taken.
  • "Enteric" precautions should be taken for all patients who have hepatitis A. Gloves should be worn. Gowns should be worn if clothing may become soiled. Hands must be washed after touching the patient or potentiallv contaminated articles and before taking care of another patient.
  • Articles contaminated with infective material should be discarded or bagged and labeled before being sent for laundering, decontamination or reprocessing.
  • Isolation of the patient in a separate room is only required if the patient's hygiene is poor. A patient with poor hygiene does not wash hands after touching infective material, contaminates the environment with infective material, or shares contaminated articles with other patients.
  • Day care centers should stress measures to minimize the possibility of fecal-oral transmission, including careful handwashing after every diaper change and before eating.
  • Employees of day care centers where there has been an outbreak of hepatitis A, or employees who have had direct fecal-oral exposure to excretions of infected persons should be given immune globulin (IG). The Centers for Disease Control (CDC) do not recommend routine IG vaccination for all employees who take care of patients with hepatitis A.
  • Enteric precautions and isolation procedures generally need to be taken until 7 days after jaundice begins.
  • Proper needle disposal precautions should be taken although it is extremely unlikely that hepatitis A would be transmitted through a needle stick. This includes disposal of all used needles and sharps in puncture proof containers. Used needles should never be broken or recapped.


For more information about protecting workers from workplace hazards, contact the AFSCME Health and Safety Program at (202) 429-1228, or 1625 L Street, N.W., Washington, DC 20036.