Ep125: Hepatitis (video episode)

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Podcast Transcription

Okay. When we talk about hepatitis, it’s important to understand that not every case of hepatitis is going to be contagious. Okay? We have viral hepatitis on the one side, but then we also have alcoholic, we have autoimmune, conditions that are going to cause hepatitis, as well. You have viral hepatitis and that’s a big concern, that’s where we’re going to be tested about the most, but we also have patients that can develop hepatitis due to alcoholism or it might be an autoimmune response.

Basically, when we talk hepatitis, we’re talking inflammation of the liver. Again, the severity varies from very mild cases that are self-limiting with the liver cell regeneration. Again, that’s self-limiting so you develop this liver inflammation but then the liver cells self-regenerate and you’re fine. Okay? They can also range to very severe cases with hepatic necrosis and cell death within a very short time. Viral hepatitis is going to be the most common cause of hepatitis. We also have acute versus chronic. Okay? The chronic can develop over years and it can be very severe, and the acute would be much less severe to maybe self-limiting. Okay?

Let’s talk quickly, though. Before we do that, though, again, I just really want you to understand that you have the alcoholics and the autoimmune causes, but there’s also going to be the viral. What we’ll talk about mostly is going to be viral because that’s what we’re going to see being tested about, and that’s what’s going to be most commonly tested, and those are the types that can affect us as health workers, but there are these other cases that you will see a lot of in the hospital, especially you’ll see a lot of alcoholics hepatitis. Okay? Alcoholics that develop this hepatitis and it can take years and years of slow progression until they start to see symptoms.

Hepatitis A, HAV, it’s important to talk about hepatitis A because health care workers are at risk. Okay? One of the most common, well the transmission of this is going to be fecal oral. Okay? I remember what you’re going to be tested about a lot of times with this are going to be food workers. Okay? Not washing their hands after going to the bathroom, in a restaurant setting or something like that where there’s food handling would be a way that hepatitis A can be transmitted. Person to person, and like I said, poor hand hygiene or not washing utensils well after being touched by someone who has it, et cetera, fecal oral route, it doesn’t mean that you’re necessarily personally going to be touching the poop or anything like that, but if a food worker who may have hepatitis doesn’t wash their hands well, and then spreads it through there, you could end up being contracting it.

It’s most contagious, it takes 10 to 14 days prior to onset of symptoms, and that’s what can be hard about it is that you may not notice that you contracted it for 10 to 14 days. Okay? It is self-limiting, so best prevention with this is going to be strict hand hygiene and then there actually is hepatitis A vaccine. The hepatitis vaccine can help protect against a couple of kinds of hepatitis A and B, but it’s not going to help against every kind of hepatitis, so that’s why it’s important to understand that it can help, but it’s not going to prevent every form of hepatitis. Hepatitis B, on the other hand, is going to be transmitted blood and body fluids, sexual contact, IV drugs.

Healthcare workers are definitely at risk for this. The reason is we’re coming in contact with blood and body fluids all the time as healthcare workers. Okay? When you have the patient who has hepatitis, it’s important to know that if they’re hepatitis, you need to take extreme precaution when dealing with the patient’s blood. You’re drawing blood, you’re starting IVs, you’re giving medications, the patient’s throwing up, whatever, we’re in so much close contact with patients’ blood and body fluids that it’s important to understand that hepatitis B is transmitted via this route.

Again, the best thing you can do is going to be hand hygiene and the HBV vaccine. As healthcare workers, we need to exercise extreme precaution with needles and we need to screen. If we have a needle stick with a patient who is hep B positive, then we would need to get screened for that, and then safe sex practices, of course, because it is body fluids transmitted.