Mode of transmisison: faecal oral route; occ. spread through IVDU

Incubation: 28-30d (15-50d)

Period of infectivity: 1-2wk before and 1-3 days after onset of jaundice

Vaccines:

• Monovalent inactivated HAV - Havris

• transplant

• chronic liver disease (children)

• clost contacts of hep A

• Twinrix - combined inactivated HAV-recombinant HepB

• Hepatyrix - combined HAV purified salmonella typhi Vi polysaccharide

• vaccination should be delayed suffering from acute sevre febrile illness

• safety with pregnancy not been determined

efficacy: high efficacy; almost elimiinated

second dose 6-18mo = long term protection

public health measures: in outbreak; \<2wks o f exposure

age \<12mo - IG

12-40: vaccination

≥41 - IG

• RNA virus

  • replicates in liver

  • excreted large quantities via biliary tract into faeces

  • hardy virus

clinical

• self limiting

• infants and preschool:

  • asymptomatic/mild

    • without jaundice

• Acute febrile illness with jaundice (anorexia, nausea, abdo pain, malaise)

  • usually last \<2mo

    • 10-15% ahve prolonged/relapsing:

      • last up to 6mo

  • liver enzymes back to normal 6mo

    • persisting liver damage = rare

• no carrier state exists