Outbreaks of hepatitis A continue in five regions of Ukraine. The story lasts a month and does not subside. What kind of infection is this and what does this development of events indicate?
Recently, 32 cases of hepatitis A were recorded in the Dnepropetrovsk region. This is the first time the infection has been detected in eastern Ukraine.
5 regions in all regions of the country are already involved
It all started with a large outbreak of hepatitis A in the Vinnytsia region, more than 200 cases were recorded there. Chief Sanitary Doctor of Ukraine Igor Kuzin On October 30, he described the outbreak as a regional emergency.
But a day later, on November 1, the first cases of hospitalization with hepatitis A were recorded in the Ivano-Frankivsk region, and then more patients began to appear in the neighboring Transcarpathian and Ternopil regions. As Andrei Pashinny, head of the immunization department of the public health center of the Ministry of Health, said on November 3, the source of infection is still unknown.
What does this development of events indicate? What forecast can be given in this situation?
“Hepatitis A is a phenomenon atypical for our time”
“Outbreaks of hepatitis A are an atypical phenomenon for our time,” says aif.ru hepatologist, doctor of medical sciences, professor of the First Moscow State Medical University named after. I. M. Sechenova, leading researcher at MONIKI named after. M. F. Vladimirsky Alexey Bueverov. — Their risk is higher, the worse the hygienic situation. And therefore, in countries with high hygiene standards, they are rare. The second most important factor is the existence of an immune layer in society. The fact is that most people get this infection in childhood, and often in a latent form, acquiring lifelong immunity.
They usually become infected in children’s groups, especially in kindergartens, or during after-school activities at school, when they play together. Most often due to the fact that toys contaminated by one of the children with a latent form of infection are put into the mouth. In this case, you need to understand two things. In children, hepatitis A is usually asymptomatic and the infection often goes unrecognized. And secondly, the only route of transmission of the hepatitis A virus is fecal-oral. And therefore, its transmission is possible primarily by young children, since they do not observe basic hygiene rules.
The older the person, the more severe hepatitis A is. In adults, an obvious form with jaundice occurs in 40-50% of cases, and in people over 40 years old, already in 70-80% (the popular name for the infection is jaundice, which is derived from this form of the disease). note aif.ru). Against the background of chronic liver diseases, especially in older people, the so-called fulminant (fulminant) form of hepatitis A is possible, leading to acute liver failure and even death. But this happens extremely rarely, in one case in 1000-10000 diseases. Usually, outbreaks of this infection die out on their own, since the immune layer in society is significant. Therefore, there are no large epidemics of hepatitis A.
The main route of infection during hepatitis A outbreaks is water, when people become infected from one source – a well, a bathhouse, and sometimes a water supply system. Less common, but the food route of infection occurs; this happens in catering, when one of the patients worked in the kitchen. The route of infection of children, which we described above, is called household contact.
Epidemiologists in Ukraine need to look for sources of infection. Given that the outbreaks occurred in different areas, there are most likely several of them. The hepatitis A virus is quite persistent. It can be stored in water for several months and survives even at temperatures of minus 20 °C. Plus, since it does not have a lipid membrane, it is not easily destroyed by detergents and detergents. All this suggests that cases of infection may recur.