Viral Hepatitis

Viral hepatitis is a contagious disease, its course is characterized by general intoxication and predominant liver damage. Term “Viral Hepatitis” combines two main nosological entities - viral hepatitis A (infectious hepatitis) and viral hepatitis B (serum hepatitis).

Today is detected a group of viral hepatitis that are not A and not B. Agents are quite resistant in the external area. When the talk is about Viral Hepatitis A, the source of infection are diseased people at the end of their incubation period because at this time hepatitis agent is discharged together with excrements and is transmitted via food, water, objects if hygiene rules are not followed. In Viral Hepatitis B the source of infection are diseased people in acute stage and also carriers of hepatitis B antigen. Main way of infection is via blood when using non-sterile syringes, needles, stomatological, surgical and gynecological instruments. Also is possible to get infected with hepatitis via blood transfusion.

Symptoms and Course
Incubation period of hepatitis A is from 7 to 50 days, and with hepatitis B from 50 to 180 days. The disease courses cyclically and it has next periods: pre-bilious, bilious, post-bilious. Pre-bilious period of hepatitis A in half of patients courses like influenza showing the same symptoms: high temperature, chilly sensation, headache, pain in joints and muscles, sore throat. Hepatitis may also show next symptoms: pain in anticardium, low appetite, nausea, vomit, weakness, giddiness, performance deterioration, problems with sleep. 

Pre-bilious period of hepatitis B is characterized with aching pains in joints, bones and muscles at night, sometimes redness of skin. At the end of pre-bilious period patient's urine becomes darker and fecal masses do discolor. Clinical picture of bilious form of hepatitis A and hepatitis B is similar: icterus of sclera,  mucus membrane, oral pharynx and finally skin. Severity of biliousness increases during the week. Body has normal temperature.

Patient may have weakness, sleepiness, lower appetite, pains in right hypochondrium and sometimes skin itch. Liver is increased, indurated, painful during palpation, and even spleen increase. In blood may be found leukopenia, neutropaenia, monocytosis. Duration of  bilious period of hepatitis A is from 7 to 15 days, and of hepatitis B is about one month.

Most threatening complication is growth of hepatic impairment showing with disturbance of memory, strengthening of weakness,  giddiness, excitement, vomit, yellowness of skin, lowering of liver size, fever and other symptoms. Often  hepatic impairment results in hepatic encephalopathy. In case of favorable course, after biliousness comes period of recovery with quick disappearance of clinical and biochemical manifestations of hepatitis.

Recognition
Is based on clinical and epidemiological data. Diagnosis of hepatitis A is made by taking into account staying into focus of infection 15 days before disease, short pre-bilious period showing symptoms of influenza, rapid development of  biliousness, short  bilious period. Diagnosis of viral hepatitis B is made if patient had operational intervention about two months before examination. Laboratory analysis help to confirm diagnosis.

Treatment
There is no etiotropic therapy. Main treatment is regimen and nutrition. Diet should be caloric, where should be excluded roast food, smoked food, pork, lamb, chocolate spices, alcohol. It is recommended abundant drinking up 2-3 liters daily and also vitamin complex.
In hard cases is made intensive fluid therapy (5% glycose solution intravenously).  In case of development of hepatic failure doctors prescribe corticosteroids.

Preventive Measures
In order not to get infected with viral hepatitis A, you should:
1. monitor food and water
2. follow rules of hygiene
In order not to get infected with viral hepatitis B, you should:
1. careful monitoring of donors
2. quality sterilization of needles and other medical instruments