Hepatitis

Hepatitis is primarily caused by viruses, with the most common types being hepatitis A, B, C, D, and E. These viral infections can range from mild conditions to chronic, severe diseases that can lead to cirrhosis, liver cancer, or liver failure. Especially in post-acute and long-term care (PALTC) settings, an understanding of hepatitis, its modes of transmission, and management strategies is crucial, given the potential for outbreaks and the serious implications for older adults with comorbidities.

Key Considerations for Hepatitis in PALTC

• Epidemiology and Transmission: While hepatitis A and E are primarily transmitted through contaminated food and water, hepatitis B, C, and D spread through contact with infected body fluids. Awareness of transmission routes is pivotal in PALTC to implement preventative measures, especially in environments where shared amenities or close quarters can facilitate spread.
• Clinical Presentation: The acute phase of hepatitis may manifest with jaundice, fatigue, abdominal pain, and general malaise. However, older adults may present atypically or with milder symptoms, making vigilance essential for early detection.
• Diagnostic Modalities: Hepatic function tests, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST), can indicate liver inflammation. Confirmatory diagnoses often require serological tests, identifying specific viral antigens or antibodies.
• Management Strategies: While hepatitis A and E are self-limiting without specific antiviral treatments, hepatitis B and C have targeted antiviral therapies. Hepatitis D only occurs with a hepatitis B co-infection, complicating its management.
• Vaccination: One of the key preventative measures for hepatitis, particularly in PALTC settings, is vaccination. Vaccines are available for hepatitis A and B. Regular vaccination campaigns and ensuring up-to-date immunization for both residents and healthcare workers can mitigate outbreak risks.
• Infection Control: Given the potential for transmission, especially of hepatitis B and C, strict adherence to infection control protocols, including safe injection practices, disposal of sharps, and personal protective equipment, is paramount.
• Educational Initiatives: Regular training sessions for staff on the modes of transmission, early symptoms, and protective measures can prevent potential outbreaks and ensure timely interventions.
• Screening and Monitoring: Especially for hepatitis B and C, which can become chronic, regular monitoring of liver function, viral loads, and potential complications is key.