The nation is experiencing multiple outbreaks of the highly contagious Hepatitis A virus (HAV), with Florida recently declaring a statewide emergency as a result of passing 2000 cases in 2019. Hepatitis A is one of several types of infections that affect the liver but cause symptoms that can be seen throughout the body.

Your skin is the largest organ, but the liver is the largest internal organ. It is located on the right side of your abdomen just under the lowest rib. The liver is susceptible to damage from drugs and alcohol, as well as inflammation from certain viruses (hepatitis means “inflammation of the liver”). If the liver is diseased, it can become enlarged and tender. This compromises its ability to perform functions like helping your body eliminate toxins, digest food, store energy, and more.

Hepatitis A is an issue more prevalent in areas where sanitation is questionable, such as off-the-grid. It is contracted by the consumption of food and water with feces (even tiny amounts) containing the virus. It is also easily transmitted from person to person through sexual contact, especially that involving oral/anal contact. The virus, fortunately, is not thought to be airborne.

Certain risk factors exist that cause a greater chance of getting Hepatitis A:

• Living in parts of the world where Hepatitis A is frequently seen
• Having close or sexual contact with someone who has the illness
• Working or living in less than sanitary conditions
• Using illegal drugs
• Attending day care or working in a day care center

Others at high risk include those who are HIV positive, men who have sexual contact with other men, or those with blood-clotting disorders like hemophilia. Many of those who are becoming infected are part of the homeless community; Hepatitis A is just one of several epidemic diseases on the rise in that part of the population.

Hepatitis A is a concern in day care centers because toddlers in diapers can’t wash their own hands and often touch surfaces and other children.

Hepatitis A symptoms may not appear until a few weeks after exposure. Some infected individuals have no symptoms at all, but If you do, they can include:

• Fatigue and malaise (general ill feeling)
• Low-grade fever
• Nausea and vomiting
• Abdominal pain, mostly on the upper right quadrant
• Clay- or grey-colored bowel movements
• Loss of appetite
• Dark urine
• Severe itching
• Joint and muscle aches

Although sufferers may experience several of the above symptoms, the hallmark of hepatitis is “jaundice”, a yellowing of skin and eyes that occurs due to an excess of a yellowish substance called “bilirubin” in your system. Bilirubin is formed by the breakdown of old red blood cells in the liver. A healthy liver eliminates bilirubin as part of this process.

These symptoms may be relatively mild and go away in a few weeks. Children, for some reason, seem to commonly go without symptoms at all. Mild cases of hepatitis A don’t require treatment. Most people who are infected recover completely with no permanent liver damage. Once recovered, antibodies formed against hepatitis A seem to give protection from future infections with the same virus.

Getting a hepatitis A vaccine or an injection of immunoglobulin (an antibody) within two weeks of exposure to hepatitis A may protect you from infection. Consider if:

• You’ve traveled recently to areas with poor sanitation
• A restaurant you frequent reports a hepatitis A outbreak
• Someone close to you is diagnosed with hepatitis A
• You recently had sexual contact with a hepatitis A sufferer

In rare cases, hepatitis A can cause a sudden loss of liver function, especially in older adults or people with chronic liver diseases. Acute liver failure requires a stay in the hospital for monitoring and treatment. Some people with acute liver failure may need a liver transplant.

Prevention of Hepatitis A is possible with a few precautions. Take these steps to prevent infection:

• Wash hands after using the bathroom and before preparing food
• Wash dishes with soap in hot water
• Avoid eating or drinking anything that may not be properly cooked or filtered
• Make sure children don’t put objects in their mouths
• Use condoms to avoid sexual transmission
• Don’t share personal items, if possible, like toothbrushes or razors with infected persons

If you’re traveling to a country where hepatitis A is known to be commonplace:

• Peel and wash fresh fruits and vegetables.
• Avoid raw or undercooked meat and fish.
• Avoid any water that isn’t bottled; if unsure, boil before drinking. As a matter of fact, use bottle water to brush your teeth!

In all circumstances, wash your hands often, especially after using the toilet or changing a diaper as well as before preparing food or eating.

Some natural substances may encourage good liver health and were used in the past to treat those with hepatitis. Taking zinc supplements, avoiding fatty foods and alcohol and staying hydrated may help.

There is little hard data proving their effectiveness, but natural remedies have been used in the past to treat liver problems. They include:

• Milk Thistle
• Reishi Mushroom
• Artichoke
• Dandelion
• Turmeric
• Licorice
• Red Clover
• Green Tea

Do your own research and reach your own conclusions.

Although viral diseases are difficult to treat off the grid, a focus on prevention will help make sure your people have the least chance of getting hepatitis.

Joe Alton MD

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