Hepatitis is the inflammation of the liver and refers to a group of viral infections that affect the liver. The liver, a vital organ, processes nutrients, filters the blood, and fights infections. When inflamed or damaged, the liver's function can be affected. Heavy alcohol use, toxins, some medications and certain medical conditions can cause hepatitis, yet it is most often caused by a virus.

In the U.S., the most common types of viral hepatitis are Hepatitis A, Hepatitis B, and Hepatitis C – infections caused by three different, unrelated viruses. Other types of viral hepatitis are Hepatitis D and Hepatitis E. Many who are chronically infected with viral hepatitis do not know they are infected.

Hepatitis A (HAV) is a virus that causes acute(time-limited) inflammation of the liver. HAV infection results in lifelong immunity to further infections and does not lead to chronic disease. Hepatitis B (HBV) is a virus that causes acute and sometimes chronic inflammation of the liver leading to liver damage, cirrhosis, cancer, and death. Hepatitis C (HCV) is a virus that causes liver disease which is found in the blood of persons who have the disease. HCV is spread by contact with the blood of an infected person. Hepatitis D (Delta) is a virus that causes inflammation of the liver. Unlike the other hepatitis viruses, HDV cannot sustain an infection without the help of HBV. Hepatitis E is a viral disease that causes inflammation of the liver. HEV does not cause chronic disease and in the United States, HEV is rarely found.

Vaccination recommendations
Symptoms of the disease
Transmission of the disease
Incidence of Hepatitis
When to return to work/school
For more information

Vaccination recommendations
The U.S. Centers for Disease Control and Prevention (CDC) and the Texas State Department of Health and Human Services recommend that all children and many adults should be vaccinated against Hepatitis A and Hepatitis B. There is no vaccine for Hepatitis C. Locally, you can get the vaccine and other health care services from:

• Harris County Public Health
• City of Houston Health Department

Information available in English, Spanish, and Vietnamese.

Symptoms of the disease
HAV symptoms, ifpresent, are usually sudden and can include fever, tiredness, loss of appetite, nausea, abdominal discomfort, dark urine, and jaundice (yellowing of the skin and eyes). It can take 15-50 days to develop symptoms (average 28 days).

HBV symptoms can vary in severity from no symptoms to mild flu-like symptoms, dark urine, light stools, jaundice, fatigue and fever. Children frequently have no initial symptoms but are at increased risk for chronic HBV infection. Adults frequently experience a range of symptoms but they usually completely recovered within six months. Symptoms develop within 30-180 days of exposure to the virus.

HCV symptoms are not present in nearly 80% of people with the disease. For those with symptoms, these symptoms  may not appear for 10-20 years, or even longer, usually come and go, and are mild and vague. Most often when symptoms do appear, the damage may be very serious.

Transmission of the disease
Hepatitis A is spread when a person ingests microscopic amounts of fecal matter from contact with objects, food, or drinks contaminated by the feces or stool from an infected person. Virus is present in the stool of persons with hepatitis A for several weeks. Although anyone can get Hepatitis A, some people are at greater risk such as those who travel to or live in countries where Hepatitis A is common, have sexual contact with someone who has Hepatitis A, or are household members or caregivers of a person infected with Hepatitis A.

Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment. Hepatitis B can also be passed from an infected mother to her baby at birth. Hepatitis B is not spread through breastfeeding, sharing eating utensils, hugging, kissing, holding hands, coughing, or sneezing.

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. This can happen through sharing needles, syringes, or other drug-injection equipment with an infected person. Also using personal items that may have come into contact with an infected person's blood, such as razors, nail clippers, toothbrushes, and getting tattoos or body piercings at an unlicensed facility or informal setting. Before widespread screening of the blood supply began in 1992, Hepatitis C was also commonly spread through blood transfusions and organ transplants. Hepatitis C is not spread through breastfeeding, sharing eating utensils, hugging, kissing, holding hands, coughing, or sneezing.

Incidence of hepatitis
In 2007, there were 2,979 acute cases of hepatitis A reported to the CDC and an estimated 25,000 new infections. The occurrence of HAV infection has been steadily decreasing over the past several years due to increased vaccinations.

In the U.S., hepatitis B is primarily a disease of adults 20 to 50 years of age. About 1.25 million people are chronic carriers, and the disease causes about 5000 deaths each year. infection with HBV is almost always preventable by following good hygiene habits and obtaining a vaccination.

About 4 million people in the U.S. have antibodies to HCV, meaning they have been infected with the virus at some point; as many as half of them do not know they have the infection.

When to Return to School/Work

The CDC and Texas State Department of Health Services provide the following general guidelines to determine when one can return to work after developing any form of hepatitis:

NOTE: Individuals who have had any form of hepatitis and received treatment should stay away from school and work for as long as symptoms exist and with a fever is present. This could be for an extended period of time. It is highly recommended that an individual seek guidance from their health care professional or the local health department to determine when it is appropriate to return to work or school.

For more information
To learn more about hepatitis vaccines, please talk with a health care provider or call the Texas Department of State Health Services (DSHS) Immunization Branch at 800.252.9152 or 512.458.7284. For general information about hepatitis, visit the website on hepatitis provided by the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC).