• Ingesting food or drinks prepared by a person with HAV virus
• Oral or Anal sex with a person HAV
• Contact with fecal substance while changing a diaper or on public toilets
• Consuming contaminated water

A fly can be a vector when it touches the food or drink, then the individual will ingest it not knowing that the fly had carried the virus into the food contents. Hepatitis A develops around after 2 months of exposure to the virus. Its incubation period is 15 to 50 days.

Signs and Symptoms:

1. It may occur without symptoms
2. It may show flu-like symptoms
3. Pre-icteric phase – headache, malaise, fatigue, anorexia and fever
4. Icteric phase – dark urine, jaundice, tender liver

Diagnostic Evaluation:

1. Only confirmed by a blood test (IgM anti-HAV)
2. Serum electrolytes might be imbalanced

Prevention:

1. Hepatitis A vaccine are given before the occurrence of the disease. This is given for people who are traveling frequently.
2. Practice proper hand washing before and after using the toilet.
3. Avoid eating raw or uncooked foods in places with poor sanitation.
4. Clean the area suspected with contamination with bleach.
5. Heat food or water to 185°F or 85°C to kill the virus.

Medical Management:

1. Dehydration is the priority management at this time.
2. Intravenous fluid and medications are given to control nausea and vomiting as well as further dehydration.

Nursing Management:

1. Instruct folks and patient to do proper hand washing before and after eating, using the toilet or having in contact with soiled items of body fluids or stool.
2. Encourage the family to provide screen or cover for foods or drinks so that flies won’t be in contact with them.
3. Teach them to cook their food properly and as much as possible avoid eating in food establishments with poor sanitation.
4. Encourage more fluid intake to prevent dehydration.
5. Provide a high calorie, low fat diet in small frequent feedings as to compensate with the weakness being felt by the body.

Photo credits: www.health.allrefer.com