Saturday, July 26, 2008

Who needs a Hepatitis A Vaccine?

Fecal fingers.

Yucko. But that's what they're called, the 'fomites' (vectors or vehicles of infection) that bring you hepatitis A. That occasional, unclean digit of the unwell worker who forgot to read the sign you've seen posted in restaurant restrooms, namely "Employees are required by law to wash their hands before returning to work." I'm sure the majority of kitchen- and wait-staff are law-abiding citizens, but what if they're stomach's upset AND they're in a bit of a hurry.

There are worse things than having hepatitis A (like having hepatitis B or C). Unfortunately, however, this disease which was formerly known as infectious hepatitis can take a chunk of days from your life and a chunk of points from your sense of well-being. While children can contract the disease with few or no symptoms, adults are generally nauseated, yellowish, and too exhausted to care, and may remain thus for weeks. Fortunately, hepatitis A virus (HAV), unlike B or C, cannot set up permanent housekeeping in your liver in a chronic sort of way and only rarely causes liver failure.

We have shots, a series of two to be exact spaced at least 6 months apart, that can raise your immunity to fecal fingers at least in a HAV sort of way.* As you ponder whether or not this shot's for you, consider that 1) I haven't seen a case of hep A for years (and I do check liver functions in persons with persistent nausea and GI upset), and 2) If you happen to have eaten in an establishment subsequently found to be the source of a HAV outbreak, we can administer hepatitis A immune globulin (IG) to you. This drug contains preformed antibodies to HAV and is 85% effective in preventing a hep A infection in persons exposed to the disease. Protection from an IG shot lasts for 3 months. It is made from blood products from paid donors, and while there are no reported cases of hepatitis B or AIDS from hep A immune globulin, this blood products from paid donors thing may seem a little unsavory.

The vaccination is made from HAV raised in cultures, then inactivated with formalin. You can't get hep A from the shot. Several different brands are available, and none are preserved with the controversial, mercury-based preservative thiomerisol. The shot is highly immunogenic meaning that nearly everyone who gets it quickly develops protective levels of antibodies within one month of the first dose. So if you've put off getting the hep A vaccine,and you are planning travel to a country known to be high-risk for HAV infection, chances are good that even a last-minute shot will afford you some protection. The shot is considered very safe.

Many school systems require the two-dose hep A series for children entering school. Remember that 85% of children do not develop symptoms of hep A, so an unvaccinated child who contracts the infection while traveling out of the country can bring the disease back to more vulnerable personal contacts at home. The incubation period for the disease is 2-6 weeks. Adults in high-risk groups for infections (say those who are in institutions or immuno-suppressed) or persons who work with high-risk groups, and anyone traveling to a high-risk country should consider receiving vaccination against HAV.
*There are other infections leaping from the fecal fomites such as salmonella and shigella.


Mauigirl said...

Eeew. Fecal fingers...

I had to have a Hep A shot (gamma globulin) back in college. I'd been in the infirmary with flu for 4 days and it turned out one of the other girls there had had Hep A. So back to the infirmary I went for a big shot in the rump!

Ruth said...

The thought of Hep A is another reason I stay away from most fast food resturants, but unwashed hands can be found anywhere. I visit Mexico often and perhaps should get one for that reason.

Cilicious said...

Back in 1983, the Fecal Finger of Fate prodded both my brother in law and sister in law--they had put their daughter in a terrible daycare center that I had warned against, but I guess these things can happen any old place, really. Anyway, they were sick as dogs with Hep A for a long time, turned yellow and the whole 9 yards--and we got shots in the butt.

Steph said...

I'm in need of a tetanus vaccine. Is there any place in the metro area, downtown or up north, that you can obtain tetanus or other vaccines at a low cost. My doctor's office wants over 100 dollars for my tetanus and we just can't afford that. Any suggestions would be very helpful. (We're not low income but in that very grey area between it and middle class where you don't have enough insurance to cover out of pocket and you're not poor enough to qualify for government assistance.) Thanks.

Roel Bobis said...

Thanks for the info about Hepatitis A vaccine