HEPATITIS A

Hepatitis A is an inflammation of the liver disease due to hepatitis A virus infection (VHA) is an RNA virus of the family picornaviruses (enteroviruses), measuring 27-32 nm not beramplop.Hepatitis A is caused by a virus that is spread by feces / stool, the person usually through food (fecal - oral), not through sexual activity or through blood. Hepatitis A is lighter than most other types of hepatitis (B and C). While hepatitis B and C is spread through the media of blood and sexual activity and more dangerous than Hepatitis A.Hepatitis A is not a new disease, already existed before the time of Hippocrates. At first all hepatitis called jaundice (jaundice) and hepatitis has not been divided into groups A, B and so on as it is known today. Tahun1912 called''On''by Cockkayne infectious hepatitis and in 1947 Fred Mc Callum first introduced the term hepatitis A and B. With the development of technology with the immune electron microscopic, the viruses hepatitis A is found clearly in 1973 (Feinstone et al, 1973). Since then begin to develop research on hepatitis, including the manufacture of vaccines. The term hepatitis A, B and so on has been standardized by the WHO and until now scientists have found 7 types of viral hepatitis A, B, C, D, E, G and TT. 

CLINICAL SYMPTOMSOften there are no minor children; sudden fever, loss of appetite, nausea, vomiting, jaundice (yellow skin and eyes), dark colored urine, pale stools. Hepatitis A can be divided into 3 stages: (1) introduction (prodromal) with symptoms of fatigue, lethargy, fever, loss of appetite and nausea, (2) stage with symptoms of yellow (jaundice stage), and (3) stages of healing (konvalesensi) . Yellow symptoms are not always found. To ensure diagnostic examination of liver enzymes, ALT, AST. Because the hepatitis A can also be an inflammation of the bile ducts, then checks gamma-GT and alkaline phosphatase can be done in addition to bilirubin levels. 
1). Yellow Eyes 

In infants and small children, there is usually no obvious symptoms in adults but there were initial complaints such as no appetite, nausea, vomiting, headache, body weakness, joint and muscle pain, and allows the right upper abdominal pain due to enlargement of the liver. These symptoms can occur in the first 1-2 weeks before the typical symptoms of hepatitis that is changing the color of urine (such as the water became dark tea) and faeces as soil or putty color. Also the color on the eyes and skin become yellow flashy and itchy skin 
2). Hearts are broken. 

Same with the symptoms of hepatitis are generally accompanied by heat loss, + 39 ° C. These diseases usually heal itself, the color yellow / jaundice will disappear and the color of the stool will be normal preformance 4 weeks after clinical symptoms appear.






3). Stomach menbesar / ascites

HEPATITIS A STADIUMMost VHA infections in children are asymptomatic, meaning that does not cause symptoms and will heal itself. If infected and become sick then there are three times VHA infection symptoms are:1). Incubation period.That is the period between the entry of the virus until symptoms appear early in the form of urine becomes dark yellow. The incubation period lasts 2-7 weeks, at 4 weeks of hepatitis A virus can be detected in the stool at the end of the incubation period. Time of exposure to illness from approximately 2 to 6 weeks. symptoms you will experience symptoms such as fever, weakness, fatigue, and lethargy, in some cases, vomiting vomiting that often occur continuously thus causing the whole body feels weak. A fever is a fever that occurs continuously, unlike other fever is on dengue fever, tuberculosis, thypus, etc..2). The period of symptomatic or the onset of symptoms:(A) The prodromal phase.This phase occurs a few days with complaints arise, such as flu, nausea, vomiting and discomfort in the upper right abdomen, sometimes diare.Leukosit menurunTransaminase serum slightly increased 10-100 times the normal price before arising jaundice (AST: L = 10-34 u / l W = 10-31 u / l) (ALT: L = 9-43 u / l W = 9-36 u / l) End of period prodormal: bilirubiuria arise that precede jaundice(B) The acute phase.After subsequent prodromal phase is the acute phase.Symptoms vary from very mild called silent an icteric, sub-clinical symptoms that can only be detected by he found abnormal liver function tests, until the symptoms of severe hepatitis and fulminant hepatitis is liver failure. Classic sign of hepatitis, is a change in color of urine becomes dark like the color of strong tea, eyes and skin turn yellow, pale stools, often followed by itching - itching on the body. Nausea and vomiting are typical symptoms of hepatitis children. Colored feces will return in 2-3 weeks.3) The period of healing.Healing begins with the disappearance of symptoms and general clinical and laboratory recovery takes about 6 months.

How Transmission• Often through food (salads, fruits, other raw foods) or water mixed with the feces of the sick• Through the seafood contaminated with dirt, mussel, oysters, clams and kupang raw or half cooked or also through relationships with people affected inntim• Often occurs in areas with levels of cleanliness and healthy living habits are low.

COMPLICATIONSAlthough relatively rare, VHA infection may cause some complications, among others:a. Hepatitis A relapse (recurrence).In 3-20% of cases VHA infection with jaundice (yellow) can occur relapse or recurrence within 2-12 weeks after initial improvement of liver function tests.b. Prolonged cholestatis.This complication is relatively rare and occurs in bile duct obstruction. Symptoms other than hot, also itching - itching, diarrhea with weight loss. Elevated bilirubin levels above 170 umol / L. Prognosis is usually good.c. Hepatitis fuminan.VHA is a severe complication with the incidence of 0.1 to 0.4% with symptoms of disturbance of consciousness, bleeding, severe liver dysfunction can be to death.d. Autoimmune hepatitis.This complication is an atypical form of infection VHA and proven as the trigger of type 1 autoimmune hepatitis khronik.

PREVENTIONPrevention can be done properly if we know the ways of transmission of hepatitis diseases. Hepatitis A is transmitted through contaminated food and beverages feces of hepatitis A. Snack habits food and beverage at any place increases the risk of contracting hepatitis A. Raw or undercooked foods potentially contaminated with this virus.Maintain personal hygiene such as washing hands thoroughly; people close to the patient may require immunoglobulin therapy. Immunization with hepatitis A can be done in the form itself (Havrix) or form a combination with hepatitis B vaccine (Twinrix). Immunization of hepatitis A occur twice, namely primary and booster vaccinations are carried out 6-12 months later, while hepatitis B immunization performed three times, namely basic, one-month and 6 months later. Hepatitis A immunization is recommended for people potentially infected as boarders and those who frequent snacks outside.
Some means of prevention against hepatitis A:1. ImmunizationImmunizations are very effective in preventing infection of a disease. After immunization of the body will produce antibodies which are immune substances against the disease. Hepatitis A immunization given to children aged between 2 to 18 years once. Adults require re-immunization (booster) after 6 to 12 months of first immunization. Acquired immunity from immunization is able to survive for 15 to 20 years. But someone who has been immunized may be exposed to hepatitis A if he is infected with VBA between 2 to 4 weeks after immunization, because at that time the body not produce antibodies in sufficient quantities.Those who should get this immunization is:• Workers are ordinary restaurant or food handling• Teens who live in the dormitory students who had close contact with his friends.• Workers and the kids at daycare.• People suffering from chronic liver disease• Laboratory Workers2. Temporary immunityThose who frequently travel to other areas should receive temporary immunity to prevent infection, especially if local VHA goal is to hepatitis A endemic areas or areas of poor sanitation. Temporary immunity may be obtained by administration of immunoglobulin (Ig). Ig for the prevention of hepatitis A hepatitis A, which contains the antivirus is very effective after 2 weeks of delivery. For those who must live in endemic regions, Ig anti VHA should be repeated every 3 to 5 months.3. Maintain cleanlinessWashing hands with soap after each bowel movements and little is highly recommended to prevent transmission of VHA. The same should also be carried on just before eating, processing and preparing food. Supervise and provide pngertian in children for not inserting objects into his mouth.

THINGS THAT NEED ATTENTIONSomeone who is a 'carrier' hepatitis will have a high risk to develop into liver cancer. Therefore, there are several things to note:1. Medical check-up every six months each year (to determine the work function of the liver)2. Always wash hands with soap after contact with blood or body fluids3. Ensure that household members and the people closest to you to do blood tests and is not infected and has conducted immunization4. Tell your doctor / dentist if you are a carrier and say whatever medication you are taking at this time (if any). This is to avoid the possibility of giving a drug that doctors can be dangerous for your heart5. See your doctor if you experience symptoms: a time you always feel tired, body weight continued to decline, sensing a change in habit or experience pain in the upper right abdomen6. If the carrier is pregnant, do hepatitis B inspection regularly during pregnancy. Your doctor will design for your baby's birth was not affected by giving hepatitis B immunoglobulin (HBIG) or to provide vaccinations at the time of 12 hours before birth.
What must be avoided1. Avoid smoking and consuming alcoholic beverages2. Do not form the blood donors, organs or sperm3. Do not share food that you eat and do not chew food for babies

CONCLUSION• Hepatitis A is an inflammation of the liver disease due to hepatitis A virus infection (VHA) is an RNA virus of the family picornaviruses (enteroviruses), measuring 27-32 nm did not envelope.• Clinical symptoms;sudden fever, loss of appetite, nausea, vomiting, jaundice (yellow skin and eyes), dark colored urine, pale stools.• There are three stages of hepatitis A that isThe incubation period, symptomatic period or the onset of symptoms, period of healing.• TransmissionOften through food (salads, fruits, other raw foods) or water mixed with the feces of the sick, often occurs in areas with levels of cleanliness and healthy living habits are low.• complications include: Hepatitis A relapse (recurrence), Prolonged cholestatis, fuminan hepatitis, autoimmune hepatitis• Some means of prevention against hepatitis A: Immunization, temporary immunity, Maintain cleanliness