Hepatitis A,B,C,D,E

Students name:

1- Sara Mohammed Al- yahya 442803259

2- Waad Ali Al-ahmari 442803258
3- Amerah Abdullah Ali Ali- shawaf 442803262
4- Maha Ali Al-Asmari 441812021
5- Raghad Hassan Al-thawaby 442803322
6- Sara Mohammed Gamesh 442803311
7- Bashaier khaled Damri 441804154
8- Lamis Ali Al-awaji 442803244
9- Renad mohammed Al hoban 442803241
10- Elaf Abdullah Hefdi 442803255
11- Rawan Mohammed Al-meidil 442803319

 Outline:
1. Introduction

2. Signs and symptoms

3. How is it spread?
4. chain of infection.
5. Lab investigations
6. Treatment including vaccines
7. How to prevent
8. Complication
9. summary
10. Reference

 Introduction
The liver is a vital organ that processes nutrients, filters the blood, and fights infections.
When the liver is inflamed or damaged, its function can be affected.
Heavy alcohol use, toxins, some medications, and certain medical conditions can cause
hepatitis.

hepatitis is often caused by a virus. In the United States, the most common types of viral
hepatitis are hepatitis A, hepatitis B, hepatitis C. also hepatitisD , hepatitisE

Many people with hepatitis do not have symptoms and do not know they are infected. If
symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6
months after exposure. Symptoms of chronic viral hepatitis can take decades to
develop.
 Hepatitis A
is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV).

HAV is found in the stool and blood of people who are infected. And it is very

contagious

Causative organism:
hepatitis B virus (HBV).
 Signs and symptoms
fever
malaise
loss of appetite
diarrhoea
nausea
abdominal discomfort
dark-coloured urine
jaundice (a yellowing of the eyes and skin). Not
everyone who is infected will have all the
symptoms.
 How it is spread
Hepatitis A is usually spread through:
household contact with an infected person
sexual contact with an infected person
eating or drinking contaminated food or water
sharing eating utensils that are contaminated
touching contaminated surfaces and then placing your hands near or in the mouth

Incubation period:
approximately 28 days (range 15 to 50

days).

when is the person highly contagious?

Hepatitis A is very contagious. It is spread when someone unknowingly ingests the
virus — even in microscopic amounts — through close personal contact with an
infected person or through eating contaminated food or drink
 Chain of infection
1-presence of microbiological agent
Hepatitis A virus (HAV), a hepatovirus from the Picornaviridae family, is the causative agent, primarily
through the faecal–oral route.
2-presence of reservoir
The gastrointestinal tracts of humans (and possibly certain primates including chimpanzees)
3-portal of entry
Eating contaminated food or drink.
Contamination of food and water happens more often in countries where hepatitis A is
common.
4-mode of transmission
Hepatitis A can be spread from close, personal contact with an
infected person, such as through certain types of sexual contact
caring for someone who is ill, or using drugs with others. Hepatitis
A is very contagious, and people can even spread the virus before
they feel sick.
5-portal of exit
The hepatitis A virus is transmitted primarily by the faecal-oral route; that is
when an uninfected person ingests food or water that has been contaminated
with the faeces of an infected person. In families, this may happen though dirty
hands when an infected person prepares food for family members.
6-presence of susceptible host
Humans are the only natural host, although several nonhuman primates have
been infected in laboratory conditions. Depending on conditions, HAV can be
stable in the environment for months.
 Lab investigation
by the detection of HAV-specific immunoglobulin G (IgM) antibodies in the blood.
Additional tests include reverse transcriptase polymerase chain reaction (RT-PCR) to
detect the hepatitis A virus RNA and may require specialized laboratory facilities.
treatment :No specific treatment exists for hepatitis A. Your body
will clear the hepatitis A virus on its own. In most cases of
hepatitis A, the liver heals within six months with no lasting
damage.

how to prevention
The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. To get the full benefit of the hepatitis A vaccine, more than one
shot is needed. The number and timing of these shots depends on the type of vaccine you are given. Practicing good hand hygiene — including
thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food — plays an important role in preventing
the spread of hepatitis A.

complication
cholestatic hepatitis, relapsing hepatitis, and autoimmune hepatitis. Rarely, hepatitis
A can progress to acute liver failure.
 Hepatitis B
Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is
passed from person to person through blood, semen or other body fluids. It
does not spread by sneezing or coughing.

Causitive organism :

HBV.
Signs and symptoms:

Fever
Fatigue
Loss of appetite
Nausea
vomiting
Abdominal pain
Dark urine
Clay-colored bowel movement
joint pain
Jaundice
Hepatomegaly
How is it spread ?
HIV usually speard by vaginal , or oral sex with someone who has the virus . It is most
commonly spread during vaginal or anal sex .

Incubation period:

. If symptoms occur , they beging an average of 90 days ( range :60-150days) after exposure to HBV

when is the person highly contagious?

Two days before and three days after they develop symptoms .
 Chain of infection

1- presense of Microbilogical agent :

This is disease - causing organism . For many illnesses and diseases this is a virus or bacterium Hepatitis B
is a liver infection caused by HBV .
2- The Reservoir :
This is the second process . This is the natural enviroment that the pathogen required for survival .
Reservoirs can be a person or animals . Hepatitis B virus can survive outside the body at least 7days .
During that time , the virus can still cause infection if it enters the body of a person who is not infected .
3- Portal of exit :
This is needed for the pathogen to leave the resevoir . If the reservoir is a human , then the portal of exit
may be saliva , feces , blood , or nose or throat discharges . As for HBV , it can exit the body through the
urethra , mouth , nose , or cut on the skin .
 Chain of infection

4- Mode of Transmission :
The pathogen can be transmitted either directly or indirectly .
Hepatitis B isn’t transmitted causally . It can’t be speard through sneezing. . Coughing , hugging or eating food prepared by
someone who is infected whith hepatitis B . Every is at some risk for a hepatitis B infection , but some are at higher risk
because of thier occupation or life choices .
5-portal of entry
Entry of the pathogen can take place in one of three ways :
penetrating , inhalation , or ingestion . The portal of entry for HBV is any opening in the body that a fluid containing the virus
could get into such as open wounds . This can also be transmitted sexually .

6- Presence of susceptible Host:

Although anyone can get hepatitis B, these people are at greater risk: Infants born to mothers with hepatitis B. People who
.inject drugs or share needles, syringes, and other types of drug equipment. Sex partners of people with hepatitis B

Lab investigation:

blood test: can detect signs of the hepatitis B virus in your body and tell your
provider whether it's acute or chronic
Liver ultrasound: special ultrasound called transient elastography can show
the amount of liver damage.
Liver biopsy: During this test, your provider inserts a thin needle through your
skin and into your liver and removes a tissue sample for laboratory analysis
Treatment:

If it is acute::
not need treatment. Instead, your provider might recommend rest, proper nutrition, plenty of fluids and
close monitoring while your body fights the infection.

if it’s chronic:

Antiviral medications: can help fight the virus and slow its ability to damage your
liver
Interferon injections.
Liver transplant: If your liver has been severely damaged, a liver transplant may
be an option.

 Prevention:

Hepatitis B vaccine is available for all age groups. The hepatitis B vaccine is recommended for all
infants, all children or adolescents younger than 19 years of age who have not been vaccinated, all adults
age 19 through 59 years, and adults age 60 years or older with risk factors for hepatitis B infection. Adults
who are 60 years or older without known risk factors for hepatitis B may also receive hepatitis B vaccine.

Complications::
Scarring of the liver (cirrhosis)
Liver cancer.
Liver failure
Reactivation of the hepatitis B virus

 Hepatitis c
Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV).
Hepatitis C is spread through contact with the blood of an infected person.
Today, most people become infected with the hepatitis C virus by sharing
needles or other equipment used to prepare and inject drugs, non-sterile
medical equipment, and blood transfusions.

Causative organism:
hepatitis C virus (HCV).

 Incubation period

The incubation period for hepatitis C ranges from 2 weeks to 6 months (14- 180 days)

Following the initial infection, about 80% of people infected do not develop any symptoms.

Symptoms
Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a
"silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of
liver disease.
Signs and symptoms include:
Bleeding easily
Bruising easily
Fatigue
Poor appetite
Yellow discoloration of the skin and eyes (jaundice)
Dark-colored urine
Itchy skin
Fluid buildup in your abdomen (ascites)
Swelling in your legs
Weight loss
Confusion, drowsiness and slurred speech (hepatic encephalopathy)
Spiderlike blood vessels on your skin (spider angiomas)
 Hepatitis C chain of infection
Susceptible host
have a history of injecting drugs
received donated blood or
organs before 1992
were born to mothers with the
infection
work in healthcare and have had
needlestick injuries
have HIV or AIDS
Portal of entry
Contact with infected blood or
body fluids containing blood
from a pregnant woman to her
Agent
Infectious agent of hepatitis
C
Hepatitis C virus (HCV) is a Reservoir of hepatitis C virus
small RNA virus that is closely Humans are the reservoir.
related to the flaviviruses and
animal pestiviruses.
Mode of transmission of
hepatitis C virus
sharing unsterilised needles –
Portal of exit
particularly needles used to
-Blood
inject recreational drugs
-Body fluids
sharing razors or toothbrushes
like saliva or semen, but this is
rare.
unborn baby
through unprotected sex –
although this is very rare


Lap investigation
HCV antibody test
-non-reactive or negative
antibody test means that
you are not currently
infected with the hepatitis C
virus.
-reactive or positive
antibody test means you
have been infected with the
hepatitis C virus at some
point in time.
Hepatitis c
Treatment &
Prevention Complications
vaccine
Until recently, most not sharing any drug-
injecting equipment with Scarring of the
people would have
taken 2 main other people – including liver (cirrhosis)..
needles and other Liver cancer..
medicines called
equipment, such as
pegylated interferon Liver failure..
syringes, spoons and
(a weekly injection)
filters
and ribavirin (a
capsule or tablet). not sharing razors or
There's no vaccine for toothbrushes that might
hepatitis C, be contaminated with
blood
 Hepatitis D
Hepatitis D is a liver infection you can get if you have hepatitis B. It can cause serious

symptoms that can lead to lifelong liver damage and even death.
The hepatitis D virus causes hepatitis D

"Hepatitis D Symptoms"
The signs of HDV can include:
•Yellow skin and eyes (jaundice) • Stomach upse.
•Pain in your belly •Throwing up
•Fatigue •Not feeling hungry

•Joint pain •Dark urine

•Light-colored stool

 How is it spread ?
You can get hepatitis D only after coming into contact with the blood or other body fluids of

someone who has it. This can happen if you:

•Have sex with someone who has the virus
•Share needles used to inject drugs
•Touch the open sores of someone who has the virus

Incubation period
The incubation period for Hepatitis D superinfection is approximately two to eight weeks.

When HBV and HDV viruses infect simultaneously, the incubation period is similar to that of

HBV, 45-160 days with an average of 90 days.

 Agents
Hapeitis D :is liver infection
Susceptible host caused by hepatitis D virus
HDV
Reservoir

anyone can get

Humans are the only reservoir
hepatitis D

Chain of infection
HDV
Portal of entry Portal of exit
*Penetrating Modes of vomiting, diarrhea, saliva
sexual contact.
*Inhalation transmission secretions from coughing,
*Ingestion exposure to infected blood sneezing, or talking.
*transmitted sexually and serous body fluids. open wounds.
and contaminated needles,

syringes

 Lab investigations
The diagnosis of hepatitis D is made by the detection of HDV RNA in

circulation, with RT-PCR

How to prevention, vaccine 💉

No vaccine can prevent HDV. The best way to avoid it is to cut your risk

of getting hepatitis B. Talk to your doctor about getting an HBV vaccine.

Avoid contact with blood or other body fluids of someone with hepatitis.
 Treatment :
interferon alpha is the generally recommended treatment for hepatitis D

virus infection. Treatment should last for at least 48 weeks irrespective of

the patient’s response

Complication
cirrhosis, which is scarring of the liver , liver failure , liver cancer
Symptoms of these complications can include:
•easily bleeding or bruising
•swollen legs or ankles due to water retention
•yellowing of the skin or eyes
 Hepatitis E
Hepatitis E virus (HEV) is a single-stranded positive-sense
RNA virus an emerging zoonotic pathogen transmitting both
human to human via the fecal oral route and from animals to
humans through feces, direct contact, and consumption of
contaminated meat products
Hepatitis E is a liver infection caused by the *hepatitis E virus (HEV)*
 sings & symptoms of Hepatitis E 2 stages :

prodromal phase Icteric phase

Nausea And vomiting Jaundice and dark urine

Myalgia and Arthralgia Light coloured stools

Fever and Anorexia Pruritus 50%

weight loss and dehydration Rash and diarrhea

Right upper quadrant pain that increase with physical activity Malaise

How to spread ? HEV is usually spread by the fecal-oral route

The incubation period: range from 15 to 60 days
when is person highly contagious? *from 1 week before symptoms start to 4 weeks afterward
 susceptible host
anyone can AGENTS
Portal of entry
get hepatitis E
drinking water contaminated by hepatitis E virus
feces from people who are
infected or (HEV)*
eating raw or undercooked
pork, venison, wild boar meat,
or shellfish

HEV CHAIN OF INFECTION

Reservoir
-carry by animals
zoonotic such as pig
Modes of Transmission -Environmental reservoirs
- Vehicle borne by food contaminated water or
(raw meat )and Portal of exit food
Contaminated water by feces from people who
are infected and
with HEV
raw or undercooked pork,

venison, wild boar meat
 Diagnosis Anti-HEV antibodies HEV-RNA in serum

second treatment option is

administeration of pegylated -
interferon a with Ribavirin
Treatment 1- reductionof immuno suppression medication
No vaccine for hepatitis E is
currently available

Prevention General measures as hepatitis A

In rare cases, acute hepatitis E can be severe and

result in fulminant hepatitis (acute liver failure). These
patients are at risk of death. Pregnant women with
Complications hepatitis E, particularly those in the second or third
trimester, are at increased risk of acute liver failure,
fetal loss and mortality

 Summary

Hepatitis is inflammation of the liver. It can be caused by viruses,

alcohol or substance use, exposure to toxins, and certain diseases.
Viral hepatitis refers to liver inflammation caused by one of several
types of viruses that attack the liver.

There are different ways to prevent or lower your risk for

hepatitis, depending on the type of hepatitis. There are vaccines
to prevent hepatitis A and B.
 References:

infectious disease book Samir S. Shah, MD, MSCE

https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
https://prezi.com/ju7isxv0epk0/chain-of-infection-hepatitis-b/
pubmed
https://www.webmd.com/hepatitis/hepatitis-d-overview
https://www.floridahealth.gov/diseases-and-conditions/disease-reporting-and-

management/disease-reporting-and-surveillance/_documents/gsi-hepatitis-

d.pdf
https://www.who.int/news-room/fact-sheets/detail/hepatitis-d