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Hepatitis A
Infection
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Hepatitis A is highly contagious and is transmitted through
food, drinks or objects having had contact with infected stools.
It is not transmitted through sex contrary to Hepatitis B.
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Chances of getting infected
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Prevalence is low in Middle and Northern Europe, Australia/NZ
and the USA. It is intermediate in Southern and Eastern Europe
and high in the other countries.
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If you travel with a backpack and don't mind eating in cheap
restaurants, it's easy to catch Hepatitis A. Chances of getting
infected range from 1/300 to 1/50 per month depending on your
standard of travelling. It's not dangerous, but you will
be sick for some weeks.
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Vaccination
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There is a good vaccination for Hepatitis A nowadays, so ask
your doctor. You need 2 shots (used to be 3 shots) at 0 and
6 months, although if you can it's even better to postpone the
second shot till after 12 months. Best is to get your first
shot 2 weeks before departure, but a "last-minute shot"
is always possible. They are expensive, but they protect you
for 10 years.
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Another possibility is to get an injection wth immunoglobulines.
However, I advise against this because it's less effective (85%),
and you need a new shot each time you go on holidays since it
stops working after 3 to 6 months depending on the dose you've
taken.
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Who should get a vaccination ?
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Everyone travelling in bad hygienical circumstances and everyone
travelling regularly to countries where hepatitis A is endemic
even when hygienical circumstances are good.
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Who should NOT get a vaccination ?
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Everyone who has already had hepatits A is protected for life
and does not need the vaccination anymore.
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For persons having lived longer then 1 year in the tropics,
it might be worthwile to get your blood tested on hepatitis
A IgG antibodies (NOT IgM). If they are postive, you've already
had the infection and you don't need the vaccination anymore.
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Side effects
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The vaccine is extremely well tolerated. It is a dead vaccine
and can be given to pregnant women, also in combination with
other vaccines or malarial drugs if necessary.
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Hepatitis B
Infection
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You can only get this through sex, blood transfusion or contaminated
needles.
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Contrary to Hepatitis A, this is a dangerous infection, sine
about 5 to 10% of patients will get a chronic hepatitis giving
liver cirrhosis in the long run, and sometimes even liver cancer.
In 0,1 to 1% of patients the disease can be fatal immediately
after infection.
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Chances of getting infected
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The risk of getting infected depends of course entirely upon
the fact whether you have sex with an infected person, or whether
you get infected bloodtransfusion or a shot with an infected
needle.
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Prevalence of the disease is distributed as follows:
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< 2% in Central and Northern Europe, USA, Canada (except
in the upper North and Alaska), Central America (except
Guatemala and Honduras), Argentina, Chili, Uruguay, Paraguay
and most of Bolivia.
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2-7%: Southern Brasil, Guatemala, Honduras, North Africa,
Southern and Eastern Europe and Russia, India, Pakistan,
Iran and the Middle East.
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> 8%: The rest of the world, meaning most of Africa,
SE Asia but also Northern Canada and Alaska.
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Vaccination
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There are 2 schemes:
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Get your shots at 0, 1 and 6 months, protection will start
from 6 months onwards.
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If you need earlier protection, take an accelerated scheme:
0, 1, 2 months with a recall after 1 year. This scheme
offers protection from 2 months onwards.
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It is effective in 90 to 95% of patients.
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It can be used in combination with any other vaccination.
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They are equally expensive as hepatitis A.
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Who should get a vaccination ?
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Anyone who will engage in risky behaviour:
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Medical personnel
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People going to high risk areas for longer then 6 months
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Travellers who will engage in sexual activity with locals
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"Accident-prone" travellers like motorcyclists,
but also IV drug abusers
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Children living for longer periods in high risk areas.
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Hepatitis C
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Hepatitis C is spread like hepatitis B. It is also dangerous
giving rise to liver cirrhosis and cancer in some patients.
However, untill now there's no vaccine available yet.
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Although
we have done our very best to provide reliable info, we cannot be
held responsible for any loss you might suffer after following advice
giving on this site.
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