Download - Hepatitis A laporan
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Hepatitis A, B, and C
HEPATITIS implies a (usually infectious) inflammatory process
damaging the liver. The onset is usually insidious with anorexia,vague abdominal discomfort, nausea and vomiting, sometimes joint
pains and rash, often progressing to jaundice. Fever may be absent
or mild. Severity ranges from asymptomatic cases acute liver
damage. Chronic active hepatitis is usually (but not always) caused
by hepatitis B virus, and prolonged Hepatitis B carrier states with
obvious signs of disease are very common in some parts of the
orld. Up to 20 percent of the population are affected in certain
areas of Asia. Because of this Hepatitis B virus is the cause of up to
80 percent of all cases of hepatic (liver) cancer worldwide. The
virus is second only to tobacco among known human cancer-
promoting agents.
Hepatitis B virus has been found in virtually all body secretions
and excretions, however only blood (and serum derived fluids),
saliva, semen and vaginal fluids have been shown to be infectious.
For transmission to occur the virus infected body fluid must be
introduced through the skin. This can be done by contaminated
needles and syringes and other IV equipment. Infection can also be
spread through contamination of wounds or lacerations. Even a
tiny drop of infected fluid can result in infection if it makes contact
ith the mucous membranes of the mouth, nose or vagina. This is
probably the major route of transmission in areas of the worldhere Hepatitis B is endemic, and in residential institutions.Transmission by close personal contact can occur, especially
between sexual partners and most frequently between male
homosexuals. Communally used razors or toothbrushes have also
been occasionally implicated. Note however fecal-oral transmission
has NOT BEEN demonstrated.Incubation period is usually 40 to 180 days, but cases are infective
many weeks before the first onset of symptoms so quarantine
measures are not really useful. Chronic carrier-states in which the
patient is otherwise well but carries the virus can last for many
years; equally, chronic states in which the liver is being insidiously
damaged by active disease can occur.Other forms of hepatitis can be produce symptoms similar to the
other (A and B) forms of hepatitis. C is the most significant as it is
most often transmitted by blood transfusions, and increasingly it is
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recognized that blood should be tested for this virus. It can have
long-term effects similar to although usually not as severe as
Hepatitis B.Like hepatitis B, Hepatitis C causes inflammation of the liver,
caused by viral damage to the main liver cells. Hepatitis C is spreadby blood. Blood transfusion has therefore been an important route
by which it is passed on. About one potential blood donor in 300
has the virus in Western countries. (Of course this route of
infection could be ended by nationwide testing of donated blood). Other ways of transmitting the disease involve the sharing of
needles by drug abusers, and the use of unsterilised tattooing
instruments. Sexual intercourse with an infected partner carries a
small risk, very much less than the risk of catching AIDS, or even
Hepatitis B. It seems improbable that family contacts of other
kinds can spread the disease. However, in practice it is not possibleto discover how a particular patient has been infected in half the
cases of the disease, so that all patients with Hepatitis C should
observe normal hygienic practices scrupulously, and be especially
careful in disposing of material contaminated with their blood.Only a small proportion of Hepatitis C infected patients will
develop the symptoms of an acute hepatitis, with loss of appetite,
mild fever, and jaundice. Whether or not such symptoms develop,
between half and three quarters of patients will clear the virus and
develop immunity to it, exactly as happens with Hepatitis A and
ith most viral illnesses such as influenza or measles, for example.But between a quarter and a half of those initially infected will
continue to be infected over many years. Some of these people have
little or no liver damage, and their only long-term risk is that they
may develop primary liver cancer. But half or more of those who
are chronically infected will show progressive damage to the liver
due to chronic Hepatitis C infection.The risk is similar to that with chronic infection with Hepatitis B -
a relatively low risk in most Western countries - and a risk that can
be minimized by taking care of the liver by avoiding alcohol,
adopting a balanced diet, and ensuring that one is protected against
Hepatitis B by accepting vaccination for it.The symptoms suffered by those with Chronic Hepatitis C vary
from person to person. Some people have no symptoms until the
liver has been quite severely damaged. Others suffer tiredness,
fatigue, nausea, and perhaps mild abdominal discomfort. The
major threat of this condition is that it slowly damages the liver,
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ith the inflammation leading to scars forming, and eventually,
hen scarring of the liver starts to impair its ability to perform its
normal functions, cirrhosis of the liver results, and in time, this
cirrhosis will prove fatal. Fortunately, Hepatitis C advances to
cirrhosis very slowly - usually over decades rather than years.If there is a suspicion of chronic active hepatitis from any cause,
blood tests are required to show whether hepatitis virus infection is
present, and liver function tests can identify those in whom some
liver damage is occurring. To establish the severity of liver damage,
a liver biopsy may be required. A liver biopsy involves taking a
sample of the liver with a specially designed needle. Under local
anesthetic, this is passed between the lower right ribs into the
center of the liver. The sample taken is about the size of a pin. It
takes only a minute or so to get the sample, but the overall
procedure involves a full day, because a period of observation is
required afterwards to make sure there is no bleeding from thepuncture site in the liver itself. In a normal, or even a moderately
damaged liver, the risk of any complication of the biopsy is very
slight. Very rarely, complications of the biopsy may require
surgery to repair the puncture site.Treatment is available if the benefits outweigh the risks. If blood
tests (liver function tests) are abnormal, indicating that some
damage to the liver is occurring, but the liver biopsy shows only
minor degrees of damage, what is sometimes referred to as
"treatment for persisting hepatitis" is not usually undertaken, as
the risk and inconvenience of treatment outweigh the potentialbenefits.If a biopsy shows progressive liver damage, treatment for
"aggressive hepatitis", or the beginning of cirrhosis, can be
considered. The only useful treatment so far is with alpha
interferon - a natural substance produced in the body as part of the
inflammatory response to bacteria and viruses. Given by injection
three times a week over several months, this expensive treatment
ill stimulate a cure in up to a quarter of patients, and will usefully
slow the progress of the infection in another quarter or more.Interferon is not without side effects, but overall, more than half of
all patients do benefit to varying degrees.Hepatitis B
It is imperative that the families be vaccinated against Hep B prior
to relocating to Indonesia. Should time not permit then they should
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at least start the program and they can continue it at a reputable
clinic on their arrival in Indonesia .The vaccination is very effective if given correctly and offers good
immunity to Hepatitis B. It is now also becoming compulsory from
birth in certain developing countries, to prevent the spread ofHepatitis B.How is HBV spread?
HBV is found in blood and certain body fluids of people who are
infected with the Hepatitis B Virus (HBV), fluids such as serum,
semen, vaginal secretions, and saliva. HBV is not found in sweat,
tears, urine, orrespiratory secretions. Contact with even small amounts of infected
blood can cause infection.Hepatitis B virus can be spread by:
unprotected sex injecting drug use during birth from mother to child contact with blood or open sores of an infected person human bites sharing a household with an infected person sharing items such as razors, toothbrushes, or washcloths pre-chewing food for babies or sharing chewing gum
using unsterilized needles in ear or body piercing, tattooing,or
acupuncture - so check needles are always taken out ofsterile packages in front of you
using the same immunisation needle on more than oneperson - insist on a clean needle every time
Hepatitis B virus IS NOT spread by: casual contact like holding hands eating food prepared by a carrier
kissing on the cheek or dry lip kissing
sharing silverware, plates, or cups visiting an infected person's home playing with a child who is a carrier sneezing or coughing
sumber:http://www.expat.or.id/medical/hepatitis.html.
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