VIRAL HEPATITIS A
A liver disease caused by the hepatitis A virus (HAV).
Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, nausea, diarrhea, fever (adults will display symptoms more often than children)
Long-term effects: There is no chronic, or long-term, infection. Once someone has had hepatitis A, he or she cannot get it again. About 15 percent of people infected with HAV will have prolonged or relapsing symptoms over a six- to nine-month period.
Transmission: Found in the stool of people with hepatitis A, HAV usually is spread from person to person by putting something in the mouth (even though it looks clean) that has been contaminated with the stool of a person who has hepatitis A.
People at risk: Household contacts of infected people; sex contacts of infected people; travelers to countries where hepatitis A is common; men who have sex with men; users of injection and noninjection drugs
Vaccine available? Yes
VIRAL HEPATITIS B
A disease caused by a virus that attacks the liver. The hepatitis B virus (HBV) can cause lifelong infection, cirrhosis -- or scarring -- of the liver, liver cancer, liver failure and death.
Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, nausea or vomiting, joint pain (about 30 percent of people have no signs or symptoms, and signs and symptoms are less common in children than adults)
Long-term effects without vaccination: Chronic infection occurs in 90 percent of infants infected at birth, 30 percent of children infected at age 1 to 5, and 6 percent of people infected after 5 years of age. Death from chronic liver failure occurs in 15 percent to 25 percent of chronically infected people.
Transmission: Occurs when blood from an infected person enters the body of a noninfected person. HBV is spread by having unsafe sex with an infected person; by sharing drugs, needles or "works" when injecting drugs; through needle sticks or sharps exposure on the job (as with health care workers); or via transmission from an infected mother to her baby during birth.
People at risk: Those who have multiple sex partners or a diagnosis of a sexually transmitted disease; men who have sex with men; sexual contacts of infected people; injection drug users; household contacts of chronically infected people; infants born to infected mothers; infants or children of immigrants from areas with high rates of HBV infection; health care and public health care workers who are exposed to blood; hemodialysis patients.
Vaccine available? Yes. Other preventive measures include not sharing personal items (such as razors or toothbrushes) that may have blood on them and weighing the risk of tattooing or body piercing (HBV can be transmitted through tools that have someone else's blood on them or by unhygienic piercing or tattooing practices).
VIRAL HEPATITIS C
A liver disease caused by the hepatitis C virus (HCV).
Symptoms: Jaundice, fatigue, dark urine, abdominal pain, loss of appetite, nausea.
Long-term effects: Chronic infection occurs in 75 percent to 85 percent of infected people; cirrhosis occurs in 20 percent of chronically infected people; and 1 percent to 5 percent of infected people may die from chronic liver disease. HCV is the leading indication for liver transplants.
Transmission: Occurs when blood from an infected person enters the body of a person who is not infected. HCV can be spread through sharing needles or "works" when shooting drugs and through needle sticks or sharps exposures on the job (for example, health care workers), and can be caused by an infected mother passing on the virus to her baby during birth. (Locally, it's suspected that possible new HCV cases may be linked to the improper use of syringes and single-use vials of anesthetic medications during colonoscopies.)
People at risk: Users of illegal injectable drugs and recipients of blood clotting factors made before 1987 (both high risk of infection); hemodialyis patients, recipients of blood and/or solid organs before 1992, people with undiagnosed liver problems and infants born to infected mothers (all intermediate risk of infection); and health care/public safety workers, people who have sex with multiple partners, and people having sex with an infected steady partner.
Vaccine available? No. Prevention includes not shooting drugs; not sharing personal items that may have blood on them; for health care workers, following routine barrier precautions and handling needles safely; being aware of the risks of body piercing or tattooing; using safe sex practices (while HCV can be spread by sex, it's rare); and, for those who are HIV positive, not donating blood, organs or tissue.
VIRAL HEPATITIS D
A liver disease caused by the hepatitis D virus (HDV), which needs the hepatitis B virus to exist. It can be acquired either as a co-infection with the hepatitis B virus, or as a superinfection (a reinfection or second infection with another virus) in people with an existing chronic hepatitis B infection alone.
Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, nausea or vomiting, joint pain or dark (tea-colored) urine.
Long-term effects without vaccination: People who have an HBV/HDV co-infection may have more severe acute disease and a higher (2 percent to 20 percent) risk of developing acute liver failure compared with those infected with HBV alone. Progression to liver cirrhosis is believed to be more common with HBV/HDV chronic infections.
Transmission: Occurs when the blood from an infected person enters the body of a person who is not immune. HDV can be spread by having unsafe sex with an infected person; by sharing drugs, needles or "works" when shooting illegal drugs; through needle sticks or sharps exposures in health care jobs; or be passed from an infected mother to her baby during birth.
People at risk include: Users of illegal injectable drugs; men who have sex with men; hemodialysis patients; sex contacts of infected people; health care and public safety workers; and infants born to infected mothers (although that's very rare)
Vaccine available? Hepatitis B vaccine should be given to prevent HBV/HDV co-infection.
VIRAL HEPATITIS E
A liver disease caused by the hepatitis E virus (HEV). Hepatitis E is uncommon in the United States
Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting, dark (tea-colored) urine
Long-term effects: No chronic, or long-term, infection (but note that hepatitis E is more severe among pregnant women, especially in the third trimester).
Transmission: Found in the stool of people and animals with hepatitis E, HEV is spread by eating or drinking contaminated food or water. Transmission from person to person occurs less commonly than with the hepatitis A virus. Most outbreaks in developing countries have been associated with contaminated drinking water.
People at risk: Travelers to developing countries, particularly in South Asia and North Africa. Rare cases have occurred in the United States among people with no history of travel to endemic countries.
Vaccine available? No. Prevention includes washing hands with soap and water after using the bathroom, changing a diaper, and before eating or preparing food; avoiding drinking water (and beverages with ice) of unknown purity, uncooked shellfish, and uncooked fruits or vegetables that are not peeled or prepared by the traveler.