Hepatitis A (Botkin’s disease) is a viral liver damage that occurs as a result of a violation of personal hygiene, eating contaminated food or water. This infection belongs to the category of “dirty hands disease”. Most common in hot countries.
Botkin’s disease is widespread in Asia and Africa, including the traditionally tourist states – Tunisia, Egypt, Turkey, India. Most often, children under 5–6 years of age are ill, many suffer from a mild form of hepatitis.
Outbreaks are frequent in children’s groups, after the disease remains a lifelong immunity.
Botkin’s disease causes a virus that is transmitted through water, food, and dirty hands.
When viruses enter the intestine, they are absorbed and through the blood into the liver. The development of infection occurs in the liver cells, damaging them and causing the main symptoms of the disease. The inflammatory process has an immune mechanism, the body recognizes the damaged cells and destroys them.
Who is at risk for getting sick
There is a high risk of becoming ill with Botkin’s disease when:
- close contact with patients violation of hygiene rules;
- with kisses, sex;
- when going abroad to countries with a high incidence of disease;
- when using drugs.
How to find out about infection
If you suspect a Botkin’s disease or when determining the presence of immunity, blood is tested to detect antibodies to the anti-HAV IgG virus.
If they are in the blood, it means that there was already contact with the virus (as a result of vaccination or illness). In this case, re-infection is impossible, vaccination is not necessary.
If there is no antibody, it means that there is no immunity to Botkin’s disease and it is necessary to carry out planned or emergency vaccination, administration of immunoglobulin (it can prevent infection or stop the infection for two weeks).
All family members of the sick person and contact persons, if it is a child, are subject to examination.
Botkin’s disease occurs in stages, the incubation period from the time of infection lasts from 15 to 50 days.
Upon its completion, the stage of prodromal phenomena (i.e. common symptoms) begins – symptoms of general intoxication of the organism appear:
- nausea and vomiting;
- appetite disturbances;
- heaviness in the stomach;
- pain in the right side;
- weakness, sleep disorders .
At the height of the Botkin’s disease appear:
- frothy and dark urine;
- jaundice on the skin, mucous membranes and whites of the eyes;
- discoloration of the chair.
Against the background of jaundice, the general well-being of the patient is improving. Yellowness lasts about a month, gradually decreasing in intensity.
Depending on the age and state of the immune system, the disease lasts from 30 to 40 days; in weakened patients, it can turn into a chronic form that lasts up to six months.
Most cases of Botkin’s disease lead to full recovery, without the formation of any consequences.
The diagnosis is made by an infectious disease doctor.
In order to make a diagnosis, it is important to indicate contact with a carrier of Botkin’s disease or stay in countries at risk of infection. A detailed examination with the determination of the size of the liver and spleen, a series of tests.
- general blood and urine analysis;
- blood test for bilirubin and liver enzymes (liver tests);
- blood chemistry;
- blood for antibodies to hepatitis;
- blood clotting.
The criterion for the acute form of Botkin’s disease is the detection of M-class antibodies in the blood; in chronic course or immunity, G-class antibodies appear.
Due to the active work of the immune system against viruses, recovery occurs even without treatment. The use of therapy methods is aimed at alleviating the condition and relieving the symptoms of intoxication.
- at the time of the acute period, the “hepatic” diet (table No. 5);
- creation of peace, isolation of the patient;
- removal of intoxication by introducing solutions of glucose and sodium chloride;
- the introduction of vitamins to maintain immunity and liver function;
- the introduction of drugs that protect the liver cells from destruction.
In the diet table number 5 includes boiled or stewed vegetarian table, dairy, cereal dishes, lean meat. Prohibited fatty, fried, spicy dishes, spices and excess salt. It is important to eat often, at least five times, in small portions.
Antiviral therapy is not carried out, as it has no effectiveness. When antibodies are detected in the blood of contact persons, they are administered anti-hepatitis immunoglobulin to prevent infection.
Botkin’s disease is severe in children under the age of one year and in the elderly. In adults, hepatitis A is accompanied by severe intoxication.
There may be cases of anicteric lung disease, such a person is a source of infection, especially dangerous for children.
With defects in the immune system or an early age of up to six months, there is a severe course of Botkin’s disease with the development of liver damage, or even death.
Hepatitis A is in many ways similar to other hepatitis, so any cases of jaundice require examination.
Prevention of Botkin’s disease is vaccination. Today, it is not included in the calendar of compulsory vaccinations, but it is highly recommended for children attending kindergartens, people going on holiday and people who are at high risk of contact.
The vaccine is administered twice, with an interval of 6 months, while a full-fledged immunity is formed for up to 10 years. Vaccination is given to children from three years of age, adults who have not been ill with hepatitis A, and people from risk groups.