Hepatitis A
Clinical Manifestations
A viral inflammation of the liver that generally presents with malaise, loss of appetite, low grade fever, nausea, abdominal pain, gastrointestinal upset, dark urine and in some cases, jaundice and light-colored stools. The onset is usually abrupt. Hepatitis A varies from a subacute or mild illness to a severely disabling disease lasting several months. Transmission is usually person-to-person through the fecal-oral route. Occasionally, food can become contaminated by an infected food handler and serve as a vehicle for transmission.
Incubation Period
From 15-50 days; average of 25-30 days.
Period of Communicability
The risk of transmission is greatest during the two weeks preceding the onset of jaundice (evidenced by yellow skin and eyes) through one week after jaundice onset. The risk is minimal after one week following jaundice onset.
Applicable Laws For Indiana Schools
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Infected children shall be excluded from schools and day care centers, and adults from employment involving food handling or direct care of children, during the infectious period. (410 IAC 1-2.3-72(2))
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If a day care center admits children in diapers, immune globulin (IG) should be given to all children and staff in the center. If a food handler is diagnosed with Hepatitis A, IG should be administered to other food handlers (unless employee is immune due to vaccination or past infection). Any susceptible food handler who refuses IG prophylaxis is to be restricted from working with exposed food, clean equipment, utensils, and unwrapped single-service and single-use articles for fifty (50) days. (410 IAC 1-2.3-72(5))
School Nursing Implications
- Hand washing is critical to control spread of disease.
- Watch for additional cases.
- Call caregiver of child.
- Consider sending letter to caregivers of classmates.
- IG should not be routinely given to contacts in the usual school situation.
Related Sites/Additional Information
www.cdc.gov/ncidod/diseases/hepatitis/a/index.htm
http://www.nih.gov/health/InformationIndex/HealthIndex/Pubincov.htm
ISDH Hepatitis A Quick Facts
http://www.cfsan.fda.gov/~mow/intro.html
www.cdc.gov/nip/publications/pink/hepa.pdf
www.immunize.org/catg.d/p2021.htm
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