1. + By: Sydney Freedman

2. + General Background 1895: Germany, smallpox outbreak Led to Jaundice Liver doesn’t destroy blood cells properly 1942: United States, WWII, vaccinated against yellow fever Jaundice Vaccines used to prevent viral diseases caused another All infect and damage the liver Means “liver inflammation” Different strains

3. + What is Hepatitis A? Serious liver disease caused by HAV Found in stool Causes inflammation of liver and affects ability to function Acute virus Recovery=complete elimination (no damage) Mildest form 1-2 months

4. + Transmission of Hepatitis A Spread orally when contaminated food or water is ingested Disease of feces and filth sewage disposal/unclean conditions  thrive Come in contact w/ blood or stool of infected individual Individual doesn’t properly wash hands and then touches objects or food

5. + Signs, Symptoms and Diagnosis Show up after 2-6 weeks Signs and Symptoms: dark urine, fatigue, itching, loss of appetite, low-grade fever, nausea/vomiting, pale or clay colored stools, yellow skin (jaundice) Diagnosis: Noticed in physical exam (enlarged/ tender liver) Blood tests show: raised IgM and IgG antibodies and elevated liver enzymes

6. + Treatment and Prevention Rest, avoid alcohol and other substances that are toxic to the liver (Tylenol), avoid fatty foods Vaccines are available (4 weeks) Booster is necessary Wash hands thoroughly after using the bathroom Avoid unclean food and water

7. + What is Hepatitis B? Serious liver disease caused by HBV Irritation and swelling of the liver Infects 5% of the world’s population with a lifelong chronic infection Destruction of liver cells  cirrhosis Causes 5 million liver cancer cases a year More common in areas of Southeast Asia, tropical Africa, gay men and intravenous drug users

8. + Transmission of Hepatitis B Transmission occurs through sexual contact and contact with contaminated blood and bodily fluids Blood transfusions Direct contact with blood in health care settings Tattoo or acupuncture with unclean needles or instruments Shared needles during drug use Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person

9. + Signs, Symptoms and Diagnosis May not appear for up to 6 months Signs and Symptoms: Appetite loss, fatigue, low- grade fever, muscle and joint aches, nausea and vomiting, yellow skin and dark urine due to jaundice Diagnosis: Tests: antibody to HBsAg, Hepatitis B core antigen, Hepatitis B surface antigen, Hepatitis E surface antigen Identify/Monitor Liver Damage: albumin level, liver function tests and prothrombin time Need ongoing blood tests

10. + Treatment and Prevention Monitor liver and other bodily functions Liver failure  liver transplant Rare Antiviral medications Decrease/remove HBV from blood and reduce risk of cirrhosis and cancer Vaccines are available Only 1 percent receive vaccines Avoid sexual contact with a person who has hepatitis Avoid sharing personal items, such as razors or toothbrushes Do not share drug needles or other drug equipment First dose of the hepatitis B vaccine at birth  complete the series of three shots by 6 months old

11. + What is Hepatitis C? Caused by HCV viral disease that leads to swelling of the liver Not as globally common as B, but much higher percentage of individuals become chronically ill More cases of cirrhosis and liver cancer

12. + Transmission of Hepatitis C Transmitted through bodily fluids like B Sexual contact with a person who has hepatitis C Inject street drugs or share a needle with someone who has hepatitis C Received a blood transfusion before July 1992 Received a tattoo or acupuncture with contaminated instruments Blood, blood products, or solid organs from a donor who has hepatitis C Share personal items such as toothbrushes and razors with someone who has hepatitis C Was born to a hepatitis C-infected mother

13. + Signs, Symptoms and Diagnosis Not as common for symptoms to develop…may not be noticed until cirrhosis has developed and liver is permanently scarred Possible Signs and Symptoms: Abdominal pain, abdominal swelling, clay-colored or pale stools, dark urine, fatigue, fever, itching, jaundice, loss of appetite, nausea and vomiting Diagnosis: Blood tests Genetic testing for the hepatitis C genotype Identify and monitor liver damage: Albumin level, liver function tests, prothrombin time and liver biopsies

14. + Treatment and Prevention Given an antiviral medication that is taken 3 times a week for 6 to 12 months Effective if started within 2 to 3 months of infection No vaccine Avoid contact with blood Do not share needles with anyone Tattoos and piercings

15. + There is more? Strands go all the way up to G D, delta virus, is only found with B Symptoms become more severe E is different strand than A, but is also spread through fecal contamination Large outbreaks in Asia and South America Later two new strands were isolated  F&G

16. + Works Cited http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001323/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001324/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001329/ http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep- a.pdf http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep- a.pdf Killer Germs By: Barry and David Zimmerman Google Images