Dr. Sebastian Ruhs– Let’s think about your liver

Baltimore health authorities are urging local gay and bisexual men to get vaccinated against hepatitis A following reports of outbreaks of the disease among LGBT communities in other cities nationwide. A highly contagious disease, hep A causes a variety of symptoms which can last a few weeks in mild cases, to a few months in more severe cases. It can be prevented through a widely available vaccination. We asked Dr. Sebastian Ruhs, director of Chase Brexton’s Infectious Diseases Center of Excellence, to provide some details on hep A and how to get vaccinated.

What is hepatitis A?

Hepatitis A is an infectious disease caused by the hepatitis A virus. The virus infects the liver and can cause a flu-like illness with fever and fatigue, as well as nausea, vomiting, diarrhea, and jaundice. The incubation period – the period between the time of infection and the time when symptoms occur – is usually between two to six weeks. Symptoms can sometimes last up to eight weeks or even longer. Unlike other types of viral hepatitis such as hepatitis B or C, the hepatitis A virus never causes chronic or lifelong disease.

How is it transmitted, and who is at higher risk of contracting it?

The virus is almost always transmitted when a person unknowingly ingests it from objects, food or drinks contaminated by small amounts of stool from an infected person. There are multiple different ways the virus can be ingested. Often, the feces of someone infected with the virus somehow get into food or water. This is a common route of transmission in developing countries, which suffer from poor sanitary conditions and overcrowded living situations. Typical foods that can carry the virus are undercooked seafood, poorly washed salads, or plain water. Another route of transmission is certain sexual practices, such as rimming.

How can I protect myself?

There is a vaccine against the hepatitis A virus, and it is almost 100 percent protective. Everyone at risk of being in contact with the virus should be vaccinated. Not everyone in the US needs to be vaccinated. At risk are people who travel into areas where HAV is regularly causing infections, people who use illegal drugs, people who are infected with hepatitis B and C, as well as men who have sex with men. If you fall in either of these categories please contact your doctor and ask about the vaccine.

Have there been hep A cases reported in Baltimore? Is an outbreak possible?

The hepatitis A virus does not regularly cause infections in most parts of the US, including Baltimore. Food-borne outbreaks are rare, but small outbreaks happen from time to time in some states, including Maryland. Those cases are usually linked to contaminated food brought to Maryland from out of state or even out of the country.

However, there have been outbreaks of hepatitis A among men who have sex with men in urban areas across in the US. Those outbreaks have been linked to sexual practices, such as rimming. To prevent further outbreaks, it is recommended that all men who have sex with men be vaccinated against the virus.

Where can I go for more information?

Chase Brexton’s infectious disease care team is ready to provide more information and vaccinations for hep A. Learn more at Chasebrexton.org/hepatitis or by calling 410-837-2050 to make an appointment.

In addition, the CDC has a great website about hepatitis A at Tinyurl.com/CDChepatitis. Also, the Maryland Department of Health offers a good source of information at Tinyurl.com/BaltimoreHepA and will also report regional outbreaks.

The LGBT Health Resource Center of Chase Brexton Health Care is to provide LGBTQ individuals and their families with welcoming access to expert health information and resources that will enhance wellness and quality of life. For more info, visit ResourceCenter.lgbt.

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