COVID-19

Background
COVID-19 is a disease caused by Severe Acute Respiratory Syndrome Coronavirus-
2" (acronym SARS-CoV-2). Coronaviruses (CoVs) enclosed positive-sense RNA
viruses are distinguished by club-like spikes extending from their surface, an
exceptionally large genome of RNA, and a special mechanism for replication.
Coronaviruses are associated with a broad variety of human and other animal
diseases spanning from enteritis in cattle and pigs and upper chicken respiratory
disease to extremely lethal human respiratory infections
A novel coronavirus (termed 2019-nCoV) was reported in December 2019 from
genomic screening of clinical samples from patients with viral pneumonia in
Wuhan, China. These patients were found to be epidemiologically linked to the
Huanan seafood market in Wuhan City, Hubei Province, China. The World Health
Organisation (WHO) declared the novel coronavirus outbreak a Public Health
Emergency of International Concern (PHEIC) on January 30, 2020. On February 11,
2020, the novel coronavirus was officially renamed COVID-19 (Coronavirus
disease 2019) and the causal virus was named “severe acute respiratory
syndrome-related Coronavirus 2” or SARS-CoV-2.
The first case of COVID-19 was confirmed in Nigeria on 27th February 2020 and
the response to the COVID-19 pandemic is led by the National Emergency
Operation Center in NCDC in close coordination with the States Public Health
Emergency Operations Centres. Over 200,000 people have tested positive for the
disease and over 3000 deaths have been recorded
Since December 2020, SARS-CoV-2 variants with multiple substitutions in the
spike protein that confers enhanced transmissibility have emerged in the United
Kingdom (B.1.1.7, also called Alpha), South Africa (B.1.351, also called Beta), Brazil
(B.1.1.28, also called P1 or Gamma), United States (B.1.427/B.1.429, also called
Epsilon), India (B.1.617, also called Delta) and South Africa (B.1.1.529) also called
Omicron.

Transmission
There are three main ways that COVID-19 can be spread:
- Breathing in the air when close to an infected person who is exhaling small
droplets and particles that contain the virus
- Having small droplets and particles that contain the virus land on the eyes, nose
or mouth - especially through splashes and sprays like a cough or sneeze
- Touching the eyes, nose or mouth with hands that have the virus on them
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Symptoms
People with COVID-19 have had a wide range of symptoms reported – ranging
from mild symptoms to severe illness. Symptoms may appear 2-14 days after
exposure to the virus. Anyone can have mild to severe symptoms. People with
these symptoms may have COVID-19:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- Loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhoea

Diagnosis/Testing
SUSPECTED CASE: Any person who meets the clinical AND epidemiological
criteria:
Clinical criteria: Acute onset of ANY TWO OR MORE of the following signs or
symptoms: fever, cough, runny nose, sore throat/ pharyngitis, headache, difficulty
breathing /dyspnea, nausea, loss of taste, loss of smell, general weakness/fatigue,
diarrhoea, chest pain, vomiting, chills/sweating, muscle pain/myalgia, wheezing,
abdominal pain, altered mental status
Epidemiological criteria:
1. Residing or working in a setting with a high risk of transmission of the virus: for
example, closed residential settings and humanitarian settings, such as camp and
camp-like settings for displaced persons, any time within the 14 days before
symptom onset.
OR
2. Residing in or travelling to a country, state, or LGA with community
transmission as classified by the NCDC, anytime within the 14 days before
symptom onset

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OR
3. Working in a health setting, including within health facilities anytime within the
14 days before symptom onset.
4. A patient with severe acute respiratory illness (SARI: acute respiratory infection
with history of fever or measured fever of ≥ 38 C°; and cough; with onset within
the last 10 days; and who requires hospitalisation) or with chest imaging showing
findings suggestive of COVID-19 disease
5. A person not meeting epidemiological criteria with a positive SARS-CoV-2
antigen-detecting rapid diagnostic test (Ag-RDT), irrespective of any symptoms
6. Close contact with a confirmed case, irrespective of any symptoms
PROBABLE CASE:
A suspected case who dies prior to the collection of a valid sample
CONFIRMED CASE:
Any person with laboratory PCR confirmation of SARS-CoV-2 infection with or
without signs and symptoms
CONTACT:
A contact is a person who experienced any one of the following exposures during
the 2 days before and the 14 days after the onset of symptoms of a probable or
confirmed case:
1. Face-to-face contact with a probable or confirmed case within 1 metre and for
more than 15 minutes
2. Direct physical contact with a probable or confirmed case
3. Direct care for a patient with probable or confirmed COVID-19 disease without
proper use of personal protective equipment (PPE)
OR
4. Other situations as indicated by local risk assessments.
Vulnerable Populations
Current COVID-19 cases and prior coronavirus infections predominantly occur in
adults and advanced age or immunocompromised or those having underlying
medical comorbidities like Cardiovascular disease (CVD), diabetes mellitus,
hypertension and chronic lung disease are at risk of severe infection

Treatment
Treatment

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People who are infected with the virus are kept in isolation at home (mild to
moderate cases) or in hospitals (severe cases). Treatment is supportive depending
on the presentation, they are provided with complete bed rest, paying attention
to their water-electrolyte balance, multivitamins, and other treatments are given
based on their symptoms. Respiratory and circulatory support is given to severe
cases.
Infection Prevention and Control
Safe and effective vaccines are a great tool for the prevention of COVID-19 but it
is also important to continue other preventive actions, such as wearing masks,
hand hygiene and cough etiquette generally termed as Non-pharmaceutical
Interventions (NPI) or Public Health Safety Measures (PHSM) especially as new
COVID-19 strains emerge coupled with children not targeted for vaccination and
low vaccination coverage in some countries.
While adhering to the COVID-19 NPIs, it is important to note the following:
1. Wear face masks that:
Have two or more layers of washable, breathable fabric
Completely cover the nose and mouth
Fit snugly against the sides of the face and not have gaps
Have a nose wire to prevent air from leaking out of the top of the mask
2. Stay at least 2 meters or further, away from anyone showing symptoms of
respiratory illness
3. Avoid crowded spaces and spaces with poor ventilation
4. Perform hand hygiene
5. Regularly disinfect high-contact surfaces
6. Monitor symptoms and visit a health care facility when ill

CHOLERA

Background
Cholera is an acute diarrhoeal disease caused by Vibrio cholerae; a gram negative
rod-shaped bacterium. It is a potentially life-threatening, primarily waterborne
disease. There are many serogroups of V. cholerae, but only two (O1 and O139)
cause outbreaks. There have been seven pandemics of cholera worldwide, the
last of which began in Indonesia in 1961, with an estimate of between 1.3 to 4.0
million cases and 21,000 to 143,000 deaths globally due to cholera every year.
The World Health Organization has estimated that officially reported cases

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represent only 5-10% of actual cases. This “tip `of the iceberg reporting” is likely
due to poor surveillance systems and inadequate disease notification systems in
low and middle-income countries which are disproportionately affected by the
disease.
Cholera can be both endemic and epidemic. A cholera-endemic area is an area
where confirmed cholera cases were detected during 3 out of the last 5 years
with evidence of local transmission. A cholera outbreak/epidemic can occur in
both endemic countries and in countries where cholera does not regularly occur.
A cholera hotspot is a geographically limited area where environmental, cultural
and/or socioeconomic conditions facilitate the transmission of the disease and
where cholera persists or re-appears regularly. Hotspots play a central role in the
spread of the disease to other regions or areas.
In Nigeria, cholera is an endemic and seasonal disease, occurring annually mostly
during the rainy season and more often in areas with poor sanitation, with the
first series of cholera outbreaks reported between 1970 and 1990. Major
epidemics also occurred in 1992, 1995-1996, and 1997. The Federal Ministry of
Health reported 37,289 cases and 1,434 deaths between January and October
2010, while a total of 22,797 cases of cholera with 728 deaths and case-fatality
rate of 3.2% were recorded in 2011. Outbreaks were also recorded in 2018 with
the Nigeria Centre for Disease Control (NCDC) reporting 42,466 suspected cases
including 830 deaths with a case fatality rate of 1.95% from 20 out of 36 States
from the beginning of 2018 to October 2018.
Cholera is an epidemic prone disease for immediate notification on the Integrated
Disease Surveillance and Response (IDSR) platform in Nigeria.

Transmission
Humans are the main reservoir of Vibrio cholerae but water, mollusc, fish and
aquatic plants are potential reservoirs.
The bacteria are transmitted mainly through the faeco-oral route via ingestion of
contaminated food or water. Cholera transmission is closely linked to inadequate
access to clean water and sanitation facilities. Typical at-risk areas include peri-
urban slums, where basic infrastructure is not available, as well as camps for
internally displaced persons or refugees. Humanitarian crises and the attendant
displacement of populations to inadequate and overcrowded camps can increase
the risk of cholera transmission.

Symptoms
Cholera has an incubation period of between two hours and five days, and is
asymptomatic or mild in 80% of cases, with only about one in 10 infected people

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developing the typical signs and symptoms of cholera disease, usually within a
few days of infection. Cholera is characterised by rapid onset of profuse watery
diarrhoea (rice water stools), with or without vomiting. It is usually not associated
with fever and is highly contagious. Severe cases can lead to death within hours
due to dehydration. Case fatality ratios can be up to 50% especially in people
without access to treatment but this drops to 1% with adequate treatment.
People with low immunity – such as malnourished children or people living with
HIV – are at a greater risk of death if infected.
The Technical Guidelines for IDSR in Nigeria gives the following standard case
definitions:
Suspected case:
In a patient aged 5 years or more, severe dehydration or death from acute watery
diarrhea.
If there is a cholera epidemic, a suspected case is any person age 5 years or more
with acute watery diarrhoea, with or without vomiting.
Confirmed case:
A suspected case in which Vibrio cholerae O1 or O139 has been isolated in the
stool.
NCDC also developed additional case definitions in September 2017 for the
community as well as for health workers as follows:
Community case definition:
Any person 2years and above with lots of watery diarrhea
Suspected case:
Any patient aged ≥2 years presenting with acute watery diarrhoea and severe
dehydration or dying from acute watery diarrhoea with or without vomiting.
In areas where a cholera outbreak is declared, any person presenting with or
dying from acute watery diarrhea with or without vomiting.

Diagnosis/Testing
Stool samples should be collected once the patient presents and before
antibiotics have been administered. The gold standard is culture of V. cholerae,
for example on selective media such as thiosulfate citrate bile sucrose (TCBS)
agar, with serogrouping and serotyping by antibody agglutination to confirm an
outbreak strain. This also allows for antimicrobial susceptibility testing and advice
on appropriate antibiotic administration. Stool samples can be enriched in

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alkaline peptone water to help with recovery, and field samples can be sent in
Cary-Blair transport media.
Rapid diagnostic tests (RDT) can be used for screening before confirmation in the
laboratory, and there any several lateral flow devices available, however their low
specificity (and sometimes low sensitivity) can limit their utility. Darkfield
microscopy of fresh rice-water stools can also be used to identify the motile V.
cholerae bacteria.

Treatment
The majority of affected people can be treated successfully through prompt
administration of oral rehydration solution (ORS). Severely dehydrated patients
are at risk of shock and require the rapid administration of intravenous fluids.
Such patients should also be given appropriate antibiotics to diminish the
duration of diarrhoea, reduce the volume of rehydration fluids needed, and
shorten the amount and duration of V. cholerae excretion in their stool. Rapid
access to treatment is essential during a cholera outbreak. Antibiotics may also
shorten the duration and severity of symptoms and are a useful adjunctive
therapy, the choice includes macrolides, fluoroquinolones, and tetracyclines
depending on resistance profile.
Infection Prevention and Control (IPC)
Good personal hygiene should be emphasised, as well as proper disposal of
sewage and refuse, good hand washing practices and consumption of safe water
and food. Enhanced epidemiological and laboratory surveillance to identify
endemic areas and detect, confirm, and quickly respond to outbreaks help in
control of infection. Community engagement for behavioral changes and
improved hygiene practices, as well as quick access to treatment are essential.
Immunisation with Oral Cholera Vaccine (OCV) can play an important role in
outbreak prevention and control, and in the long-term control of cholera. The
vaccines should always be used in conjunction with other cholera prevention and
control strategies in areas with endemic cholera, in humanitarian crises with high
risk of cholera, and during cholera outbreaks.
Nigeria References

LASSA FEVER
First Published: 2019-04-09 12:50:04 | Last updated: 2019-04-09 08:51:57

Background
Lassa fever (LF) is an acute viral illness and a viral haemorrhagic fever (VHF). The
causative agent is a single-stranded RNA virus in the family Arenaviridae, the

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Lassa virus. This zoonotic disease is associated with high morbidity and mortality,
and it has both economic and health security consequences. The illness was first
reported in Lassa community in Borno State, Nigeria, when two missionary nurses
died from an unusual febrile illness. Since then cases and outbreaks continue to
be reported in Nigeria and the diseases is increasingly recognised to be endemic
in many parts of West Africa, including Nigeria, Benin, Ghana, Mali and the Mano
River region (Sierra Leone, Liberia and Guinea), with the disease probably existing
in other West African countries as well. An estimated 300,000-500,000 cases and
5,000 related deaths occur annually in West Africa. In 2018, NCDC reported the
largest ever number of cases in Nigeria, with over 600 confirmed cases and over
170 deaths. The increase is not thought to be due to any new virus strains, and
may at least be partially explained by increasing surveillance capacity.
Lassa fever (LF) is an epidemic prone disease for immediate notification on the
IDSR platform in Nigeria. The actual incidence rate in Nigeria is unknown, but case
fatality rates range from 3% to 42% (and over the last two years has remained
between 20% and 25%). Historically, outbreaks occur during the dry season
(November to April), however, in recent years, cases have also occurred during
the rainy season. Lassa fever importation into non-endemic countries has
occurred in the UK, USA, and Germany, amongst others.

Transmission
The Lassa virus is transmitted to man by infected multi-mammate rats, the
mastomys natalensis species complex which is the reservoir host. Humans
become infected from direct contact with the urine and faeces of the rat which
contains the virus, through touching soiled objects, eating contaminated food, or
exposure to open cuts or sores. Secondary transmission from person to person
can occur following exposure to the virus in the blood, tissue, urine, faeces or
other bodily secretions of an infected individual. Hospital-acquired (nosocomial)
transmission from person to person are not uncommon, and importantly can
occur if appropriate Personal Protective Equipment (PPE) is not worn when
managing suspected cases.

Symptoms
Lassa fever presents with symptoms and signs similar to those of many febrile
illnesses, thus making it difficult to diagnose clinically. The incubation period is
between 6-21 days. It causes a syndrome characterised by fever, muscle aches,
sore throat, nausea, vomiting, chest and abdominal pain. Although fever is not a
constant presenting symptom, Lassa fever should be suspected in patients with
fever (≥380C) not responding adequately to regular antimalarials and antibiotics.
It should also be suspected in any outbreak setting with patients presenting with a

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compatible syndrome. It also likely has a wide spectrum of disease presentation,
from relatively mild illness to severe haemorrhagic manifestations. Case
definitions can guide diagnosis

Diagnosis/Testing
A high index of suspicion aids diagnosis, especially in endemic areas like Nigeria,
or in patients returning from other endemic areas in West Africa. Diagnosis is
based on clinical features (guided by case definitions above) and laboratory
confirmation. Laboratory diagnosis is by viral amplification from blood samples
using Reverse-Transcription Polymerase Chain Reaction (RT-PCR).
Case Definitions
The Technical Guidelines for Integrated Disease Surveillance and Response (IDSR)
in Nigeria gives the following standard case definitions:
Suspected case of Lassa Fever:
Illness with gradual onset with one or more of the following: malaise, fever,
headache, sore throat, cough, nausea, vomiting, diarrhoea, myalgia, chest pain
hearing loss and a history of contact with excreta of rodents or with a case of
Lassa Fever
Confirmed case of Lassa Fever:
A suspected case that is laboratory confirmed (positive IgM antibody, PCR or virus
isolation) or epidemiologically linked to a laboratory confirmed case.
There are also additional case definitions for clinical decision making to guide
management of Lassa fever cases in health facilities, developed by NCDC in
November 2018. These include:
Alert case
Any person who has an unexplained fever (i.e. malaria and other common causes
of fever have been ruled out), with or without bleeding OR Any person who died
after an unexplained severe illness with fever and bleeding.
Suspected case
Patient with fever for 3-21 days with a measured temperature of 38OC or more
with one or more of the following: vomiting, diarrhoea, sore throat, myalgia
(muscle pain), generalised body weakness, abnormal bleeding, abdominal pain OR
in Neonates: Maternal Lassa fever +/- signs and symptoms.
Any of the following scenarios should raise the index of suspicion:
a. Patient has not responded to standard anti-malaria treatment and treatment
for other common infectious causes of fever within 48-72 hours.

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b. History of recent contact with a probable or confirmed case of Lassa fever
within 21 days of onset of fever.
c. Patient with history of fever and history of travel to high risk/burden area of
Lassa fever.
d. Contact with body fluids or tissues of a dead patient with a febrile illness,
symptoms and signs highly suggestive of Lassa fever leading to death.
Probable case
A suspected case who has one or more of the following complications:
a. Hearing loss
b. Facial or neck swelling
c. Seizures
d. Restlessness
e. Confusion
f. Hypotension (SBP< 90mmHg in adults and

Treatment
Treatment should be carried out in designated isolation centres by trained staff.
Standard infection prevention and control (IPC) measures for LF must be in place.
The drug of choice is Ribavirin, an antiviral agent, administered orally or
parenterally. Prognosis is best if this treatment is commenced early, usually
within six days of onset of symptoms. High quality supportive treatment should
also be instituted based on clinical assessment of patients, which improves
patient outcomes.
Infection Prevention and Control (IPC)
Prompt diagnosis of Lassa fever is key. There is currently no vaccine that protects
against Lassa fever. The collaboration of government agencies working with
development partners has increased the recognition of Lassa Fever and the need
for deployment of enhanced IPC measures. Other prevention and control
measures include:
• Continued advocacy and sensitisation of communities, States, their leaders and
other stakeholders.
• Strengthening of the surveillance system for early detection, isolation and
confirmation of cases.
• Promoting good environmental and personal hygiene. This is to discourage
rodents from entering homes and having access to food stuff. Effective measures

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include storing grain and other foodstuff in rodent-proof containers, disposing of
garbage far from the home, and maintaining clean households.
• Reminding care givers to be careful and maintain standard precautions to avoid
contact with blood and body fluids while taking care of an infected person.
• Avoiding nosocomial transmission of infections in health-care settings, with
health care workers observing all necessary IPC precautions when caring for
patients, regardless of their presumed diagnosis.
• Ensuring staff in Lassa fever treatment centres apply extra infection control
measures to prevent contact with the patient’s blood and body fluids and
contaminated surfaces or materials.
• Following safe injection practices at every stage.
• Training health care workers in the laboratories in appropriate specimen receipt
and handling, and ensuring all patient samples are properly labelled on collection
with appropriate details included such as haemorrhagic manifestations.
• Ensuring safe burial practices are adhered to for anybody that died (or is
suspected to have died) of Lassa fever.
Hepatitis is an inflammation of the liver. It may be caused by viral infection,
alcohol consumption, several health conditions, or even some medications.
Treatment varies based on the type and underlying cause.

Hepatitis refers to an inflammatory condition of the liver. It is commonly the

result of a viral infection, but there are other possible causes of hepatitis.

These include autoimmune hepatitis and hepatitis that occurs as a secondary

result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a
disease that occurs when your body makes antibodies against your liver tissue.

The five main viral classifications of hepatitis are hepatitis A, B, C, D, and E. A

different virus is responsible for each type of viral hepatitis.

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The World Health Organization (WHO) estimates that 354 millionTrusted Source
people currently live with chronic hepatitis B and C globally.

Hepatitis A

Hepatitis A is the result of an infection with the hepatitis A virus (HAV). This type
of hepatitis is an acute, short-term disease.

Hepatitis B

The hepatitis B virus (HBV) causes hepatitis B. This is often an ongoing, chronic
condition. The Centers for Disease Control and Prevention (CDC) estimates that
around 826,000Trusted Source people are living with chronic hepatitis B in the
United States and around 257 million people worldwide.

Hepatitis C

Hepatitis C comes from the hepatitis C virus (HCV). HCV is among the most
common bloodborne viral infections in the United States and typically presents as
a long-term condition.

According to the CDC, approximately 2.4 million AmericansTrusted Source are

currently living with a chronic form of this infection.

Hepatitis D

This is a rare form of hepatitis that only occurs in conjunction with hepatitis B
infection. The hepatitis D virus (HDV) causes liver inflammation like other strains,
but a person cannot contract HDV without an existing hepatitis B infection.

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Globally, HDV affects almost 5 percentTrusted Source of people with chronic
hepatitis B.

Hepatitis E

Hepatitis E is a waterborne disease that results from exposure to the hepatitis E

virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and typically
results from ingesting fecal matter that contaminates the water supply.

This disease is uncommonTrusted Source in the United States, according to the

CDC.

Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

Causes of hepatitis

Type of hepatitis Common route of transmission

hepatitis A exposure to HAV in food or water

hepatitis B contact with HBV in body fluids, such as blood, vaginal secretions, or
semen

hepatitis C contact with HCV in body fluids, such as blood, vaginal secretions, or
semen

hepatitis D contact with blood containing HDV

hepatitis E exposure to HEV in food or water

Causes of noninfectious hepatitis

Although hepatitis is most commonly the result of an infection, other factors can
cause the condition.

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Alcohol and other toxins

Excess alcohol consumption can cause liver damage and inflammation. This may
also be referred to as alcoholic hepatitis.

The alcohol directly injures the cells of your liver. Over time, it can cause
permanent damage and lead to thickening or scarring of liver tissue (cirrhosis)
and liver failure.

Other toxic causes of hepatitis include misuse of medications and exposure to

toxins.

Autoimmune system response

In some cases, the immune system mistakes the liver as harmful and attacks it.
This causes ongoing inflammation that can range from mild to severe, often
hindering liver function. It’s three times more common in women than in men.

Common symptoms of hepatitis

If you are living with a chronic form of hepatitis, like hepatitis B and C, you may
not show symptoms until the damage affects liver function. By contrast, people
with acute hepatitis may present with symptoms shortly after contracting a
hepatitis virus.

Common symptoms of infectious hepatitis include:

fatigue

flu-like symptoms

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dark urine

pale stool

abdominal pain

loss of appetite

unexplained weight loss

yellow skin and eyes, which may be signs of jaundice

How hepatitis is diagnosed

It is crucial to understand what is causing hepatitis in order to treat it correctly.

Doctors will progress through a series of tests to accurately diagnose your
condition.

History and physical exam

To diagnose all forms of hepatitis, your doctor will first take your history to
determine any risk factors you may have.

During a physical examination, your doctor may press down gently on your
abdomen to see if there’s pain or tenderness. Your doctor may also check for any
swelling of the liver and any yellow discoloration in your eyes or skin.

If you need help finding a primary care doctor, then check out our FindCare tool
here.

Liver function tests

Liver function tests use blood samples to determine how efficiently your liver
works.

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Abnormal results of these tests may be the first indication that there is a problem,
especially if you don’t show any signs on a physical exam of liver disease. High
liver enzyme levels may indicate that your liver is stressed, damaged, or not
functioning correctly.

Other blood tests

If your liver function tests are abnormal, your doctor will likely order other blood
tests to detect the source of the problem.

These tests can determineTrusted Source if you have infectious hepatitis by

checking for the presence of hepatitis viruses or antibodies your body produces to
combat them.

Doctors may also use blood tests to check for any signs of autoimmune hepatitis.

Liver biopsy

When diagnosing hepatitis, doctors will also assess your liver for potential
damageTrusted Source. A liver biopsy is a procedure that involves taking a sample
of tissue from your liver.

A medical professional may take this sample through your skin with a needle,
meaning there is no need for surgery. They will typically use an ultrasound scan
for guidance during this procedure.

This test allows your doctor to determine how infection or inflammation has
affected your liver.

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Ultrasound

An abdominal ultrasound uses ultrasound waves to create an image of the organs

within your abdomen. This test allows your doctor to take a close look at your
liver and nearby organs. It can reveal:

fluid in your abdomen

liver damage or enlargement

liver tumors

abnormalities of your gallbladder

Sometimes the pancreas shows up on ultrasound images as well. This can be a

useful test in determining the cause of your abnormal liver function.

How hepatitis is treated

Treatment options will vary by the type of hepatitis you have and whether the
infection is acute or chronic.

Hepatitis A

Hepatitis A is a short-term illness and may not require treatment. However, if

symptoms cause a great deal of discomfort, bed rest may be necessary. In
addition, if you experience vomiting or diarrhea, your doctor may recommend a
dietary program to maintain your hydration and nutrition.

Hepatitis B

There is no specific treatment program for acute hepatitis B.

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However, if you have chronic hepatitis B, you will requireTrusted Source antiviral
medications. This form of treatment can be costly, as you may have to continue it
for several months or years.

Treatment for chronic hepatitis B also requires regular medical evaluations and
monitoring to determine if the virus is responding to treatment.

Hepatitis C

Antiviral medications can treat both acute and chronic forms of hepatitis C.

Typically, people who develop chronic hepatitis C will use a combination of

antiviral drug therapies. They may also need further testing to determine the best
form of treatment.

People who develop cirrhosis or liver disease due to chronic hepatitis C may be
candidates for a liver transplant.

Hepatitis D

The WHOTrusted Source lists pegylated interferon alpha as a treatment for

hepatitis D. However, this medication can have severe side effects. As a result, it’s
not recommended for people with cirrhosis liver damage, those with psychiatric
conditions, and people with autoimmune diseases.

Hepatitis E

Currently, no specific medical therapies are availableTrusted Source to treat

hepatitis E. Because the infection is often acute, it typically resolves on its own.

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Doctors will typically advise people with this infection to get adequate rest, drink
plenty of fluids, get enough nutrients, and avoid alcohol. However, pregnant
women who develop this infection require close monitoring and care.

Autoimmune hepatitis

Corticosteroids, like prednisone or budesonide, are extremely important in the

early treatment of autoimmune hepatitis. They’re effective in about 80 percent of
people with this condition.

Azathioprine (Imuran), a drug that suppresses the immune system, may also be a
part of treatment programs. People may use this with or without steroids.

Other immune-suppressing drugs like mycophenolate (CellCept), tacrolimus

(Prograf), and cyclosporine (Neoral) can also replace azathioprine in treatment.

Tips to prevent hepatitis

There are vaccines that can help protect against many hepatitis viruses.
Minimizing your risk of exposure to substances containing these viruses can also
be an important preventive measure.

Vaccines

A vaccine for hepatitis A is available and can help prevent the contraction of HAV.
The hepatitis A vaccine is a series of two doses and most children begin
vaccination at age 12 to 23 monthsTrusted Source. This is also available for adults
and can also include the hepatitis B vaccine.

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The CDCTrusted Source recommends hepatitis B vaccinations for all newborns.
Doctors typically administer the series of three vaccines over the first 6 months of
childhood.

The CDC also recommends the vaccine for all healthcare and medical personnel.
Vaccination against hepatitis B can also prevent hepatitis D.

There are currently no vaccines for hepatitis C or E.

Reducing exposure

Hepatitis viruses can transmit from person to person through contact with bodily
fluids, water, and foods containing infectious agents. Minimizing your risk of
contact with these substances can help to prevent contracting hepatitis viruses.

Practicing effective hygiene is one way to avoid contracting hepatitis A and E. The
viruses that cause these conditions can be presentTrusted Source in water. If
you’re traveling to a country where there is a high prevalence of hepatitis, you
should avoid:

local water

ice

raw or undercooked shellfish and oysters

raw fruit and vegetables

The hepatitis B, C, and D viruses can transmit through contact with bodily fluids
containing these infectious agents.

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You can reduce your riskTrusted Source of coming into contact with fluids
containing these viruses by:

not sharing needles

not sharing razors

not using someone else’s toothbrush

not touching spilled blood

Hepatitis B and C can carry through sexual intercourse and sexual contact. Using
barrier methods, such as condoms and dental dams, during sexual activity can
help decrease the risk of infection.

Complications of hepatitis

Chronic hepatitis B or C can lead to more severe health problems. Because the
virus affects the liver, people with chronic hepatitis B or C are at risk of:

chronic liver disease

cirrhosis

liver cancer

When your liver stops functioning normally, liver failure can occur. Complications
of liver failure include:

bleeding disorders

a buildup of fluid in your abdomen, known as ascites

increased blood pressure in portal veins that enter your liver, known as portal
hypertension

kidney failure

21
hepatic encephalopathy, which can involve fatigue, memory loss, and diminished
mental abilities

hepatocellular carcinoma, which is a form of liver cancer

death

People with chronic hepatitis B and C should avoid alcohol as it can accelerate
liver disease and failure. Certain supplements and medications can also affect
liver function. If you have chronic hepatitis B or C, check with your doctor before
taking any new medications.

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