What is Hepatitis?

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer.


There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Hepatitis A and E are typically caused by ingestion of contaminated food or water.

Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

The five types of hepatitis viruses all cause liver disease but they vary in important ways.

Hepatitis A virus is present in the feces of infected persons and is most often transmitted through consumption of contaminated water or food. Infections are in many cases mild, with most people making a full recovery and remaining immune from further infections of Hepatitis A. There are safe and effective vaccines to prevent Hepatitis A.

Hepatitis B is transmitted through exposure to infective blood, semen, and other body fluids. It can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of contaminated blood and blood products, contaminated injections during medical procedures, and through inject drug use. There are safe and effective vaccines available to prevent Hepatitis B.

Hepatitis C is mostly transmitted through exposure to infective blood. This may happen through transfusions of contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. There is no vaccine for Hepatitis C, but new and better treatments are being developed to treat Hepatitis C that can get rid of the virus in up to approximately 4-6  out of 10 people.

Hepatitis C is emerging as a major public health issue in Washington. The infection is chronic and lifelong for up to 85% of individuals who get the virus and of those chronically infected, 70% will develop liver disease. Hepatitis C takes a long time to damage the liver and many people may never exhibit symptoms. An estimated 110,000 people are reported to have Hepatitis C in our state. This year we have had 15 reports of Hepatitis C in San Juan County alone.

Hepatitis D virus inf mostly transmitted through consumption of contaminated water or food. It is a common cause of hepatitis outbreaks in developing parts of the world. Outbreaks and sporadic cases occur in many countries especially areas with inadequate environmental sanitation.

After Hepatitis A, Hepatitis E is the second most common cause of food/waterborne transmitted viral hepatitis worldwide.

There have been four cases of Hepatitis E in Washington State in the past five years, all with travel to Asia or the Middle East. San Juan County recently had a confirmed case of Hepatitis E in a person who travelled to an underdeveloped African country. This individual is now past the period of communicability and is doing well.

Here are ways to protect yourself from food and waterborne illness:

-Talk to your provider about the Hepatitis A vaccine, especially if you do a lot of travelling.

-Cook food well and eat it while it’s hot. Avoid raw shellfish and raw meat.

-ALWAYS wash your hands with soap and water after using the toilet, changing a baby’s diaper, and before preparation of food or eating.

-Peel fruit and vegetables, wash salads in clean water.

-Always drink safe water.

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