Hepatitis a in History

Hepatitis is the inflammation of the liver, usually caused by a viral infection. Of the five main types of viral hepatitis, the most common is hepatitis A which has been with us for a long time.

Hippocrates, the Greek father of medicine, is believed to be the first to describe the disease in the 5th century B.C. Viral hepatitis was probably the reason why the whole nation of Israel became ill after dining on contaminated quail eggs as Numbers 11:32-33 tells us. Twenty-seven hepatitis A outbreaks have been reported in 17th and 18th century Europe and even Napoleon’s army proved to be no match to the disease which hit his troops in 1799.

Although hepatitis A is found mainly in developing countries where poverty, overcrowding, and inadequate access to clean water and food are common, industrialized nations are not spared from this problem. Epidemics have occurred in the United States as early as 1812 and in Sweden, Australia, and the United Kingdom.

In America, hepatitis A is responsible for over 143,000 infections and 80 deaths yearly. The disease costs the American public over $200 million annually. In other countries, the number of those with hepatitis A infection ranges from 10 to 50 per 100,000 people yearly.

In Eastern European countries, there are about 50 to 300 cases per 100,000 each year. The worldwide incidence of hepatitis A exceeds 1.4 million cases and costs $1.5 to $3 billion annually.

Although hepatitis A has been with us since ancient times, the virus responsible for the disease was not identified until 1973. During the 19th century, it was thought that the disease was caused by a biliary obstruction.

In 1908, scientists hypothesized that an infectious agent was involved. As more epidemics occurred in World War I, one army doctor suggested that contaminated food and water could be the means of transmitting the disease. That observation eventually proved correct.

Further studies of human volunteers during World War II showed that the infecting agent was confined to feces. Three decades later, Drs. Robert Purcell, Albert Kapikian, and Stephen Feinstone of the US National Institute of Allergy and Infectious Diseases saw the hepatitis A virus for the first time.

People get hepatitis A by ingesting food or water contaminated with the stools of an infected person. Transmission through saliva and oro-pharyngeal secretions, although rare, have been reported.

Once inside the body, the hepatitis A virus (HAV) attacks liver cells. But even before any of its symptoms appear, the infected person may transmit the disease to others.

“Food or drinks contaminated with fecal material that contain the virus will give you hepatitis A. The person with hepatitis A passes out the virus in his stools and spreads the disease to others,” explained Dr. Nina G. Barzaga of the Department of Medical Microbiology, College of Public Health, University of the Philippines.

“If you have hepatitis A, the virus will be in your stools, blood and bile from two to three weeks before any symptoms develop. The virus disappears once jaundice develops within two to three weeks afterwards. Thus, anyone who comes into contact with your blood or feces, even before you have symptoms, may become infected with the virus,” added Dr. David E. Larson, editor-in-chief of the Mayo Clinic Family Health Book.

In others, it may take from 40 days to two months before the signs of hepatitis A appear. These include flu-like symptoms such as fever, sore throat, loss of appetite, muscle and joint pains. Nausea, vomiting, and diarrhea or constipation may follow together with chills, weight loss, and distaste for smoking.

As the infected liver is unable to filter bilirubin (bile pigment) from the blood, jaundice sets in and urine becomes tea-colored. (Next: Jaundice not always a sign of hepatitis A.)

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