Hepatitis is a general term that means inflammation of the liver. Hepatitis A and E are two of five viruses in the hepatitis group that also includes hepatitis B, C, and D. Like the other hepatitis viruses, hepatitis A and E cause inflammation of the liver by entering and destroying liver cells. Hepatitis A and E are transmitted through the fecal oral route. Water or food contaminated with hepatitis A or E can cause disease if ingested. Hepatitis B, C, and D are transmitted through exposure to blood and body fluids of someone infected with these viruses. They are not transmitted by water or food.

How may I be exposed to hepatitis A or E?

Hepatitis A and E viruses are present in the feces of infected humans and other primates. Surface waters such as streams, rivers, and lakes may be contaminated with the virus. The virus can also be transmitted through food washed in contaminated water and eaten raw, and food and drinking water handled by an infected person. Person to person transmission of hepatitis A can occur but is rare for hepatitis E. Both hepatitis A and E viruses need to be ingested in order to cause an illness. Hepatitis A occurs in all parts of the world, but hepatitis E infections usually occur in parts of Asia, Central America, and Africa. Once infected, most people develop a long term immunity to both viruses. People at high risk for hepatitis A and E include the following groups:

• Household and sexual contacts of people who are infected
• Injection and other drug users
• International travelers to countries where water treatment infrastructure is poor
• Males who have sex with men
• People who live in areas where the virus is common

What are the symptoms of hepatitis A and E infections?

Initial symptoms of both viruses are similar. They can include fever, decrease in appetite, nausea, vomiting, diarrhea, and abdominal pain. These are often followed by jaundice (a yellowing of the skin and the whites of the eyes). The severity of the symptoms generally increases with age. Children may become infected and not show any evidence of illness. Symptoms usually occur between fifteen to fifty days after swallowing the virus. Hepatitis E can cause a more serious infection in pregnant women. If you suspect that you have hepatitis A, E, or any other form of hepatitis, you should contact a doctor.

What is the treatment for hepatitis A and E infections?

There is no cure for hepatitis A or E. Symptoms usually last for two to three weeks. In rare cases symptoms can come and go for up to six months. Most people recover completely. Fluid and electrolyte replacement may be given to replace fluids lost to vomiting and diarrhea.

How can hepatitis A and E infections be prevented?

If someone in your household has hepatitis A, you can protect yourself and other members of the household by getting a short term immunization against the virus within 2 weeks of exposure. There is currently no vaccine available for hepatitis E. People who are at high risk for hepatitis A or for complications from hepatitis A should also get the long lasting vaccine. People who should get vaccinated include people in the following groups:

• Household and sexual contacts of people who are infected
• Injection and other drug users
• International travelers to countries where water treatment infrastructure is poor
• Males who have sex with men
• People who live in areas where the virus is common
• People with liver disease and clotting disorders

Hepatitis A and E are contracted by ingestion of the virus. The following precautions can lower the risk of getting an infection:

• If someone in your house or someone you have had sex with has been diagnosed with hepatitis A ask your doctor for an immunization
• Wash your hands with soap and warm water after using the toilet, changing diapers, cleaning up after pets, or gardening
• Wash your hands before eating
• Rinse vegetables and fruit before eating
• Do not drink or swallow untreated water directly from rivers, lakes, streams, pools, or spas
• When traveling to areas with poor water sanitation avoid tap water, uncooked food, and street vendors
• Wash all bedding and clothing that has come in contact with vomit or feces in hot soapy water

If you have hepatitis A or E you can take the following precautions to avoid spreading the disease to others:

• Wash your hands with soap and warm water after using the toilet
• Avoid preparing or serving food for other people
• Tell members of your household and sexual contacts to get an immunization
• Wash all bedding and clothing that has come in contact with vomit or feces in hot soapy water

 

The original norovirus, Norwalk virus, was first identified during an outbreak of gastrointestinal illness in Norwalk, Ohio in 1968. Norovirus is a generic term for a group of viruses that are similar to and include Norwalk virus. These viruses are also sometimes referred to as small round structured viruses. The viruses in the norovirus group have similar modes of transmission and symptoms. They are usually spread through the fecal oral route and can cause diarrhea, nausea, and vomiting.

How may I be exposed to norovirus?

Noroviruses are present in the feces and vomit of infected humans and are generally transmitted through the fecal oral route. They are very infectious. It can take only a few virus particles to cause illness in a person. The virus can be transmitted through food washed in contaminated water and eaten raw, food and drinking water handled by an infected person, through contamination of surfaces and objects, or from person to person. Surface waters such as streams, rivers, and lakes may be contaminated with the virus. However, food borne outbreaks of norovirus are more common than drinking water outbreaks. Noroviruses need to be ingested in order to cause an illness. They are common in all geographical areas and affect all groups of people. Infection with these viruses does not provide long term immunity. In the U.S. some foods and settings are more likely to cause transmission of norovirus.

Foods associated with norovirus:

1. Oysters and shellfish harvested in waters that have been contaminated with sewage

2. Foods generally eaten cold such as fruit, uncooked vegetables, salads, sandwiches, salad dressings and cake frosting

     1. Institutional settings such as nursing homes, daycare centers, and  
         hospitals
     2. Cruise ships

     3. Restaurants

What are the symptoms of norovirus infection?

Infection with norovirus usually causes nausea, vomiting, watery diarrhea, stomach cramps, and occasionally fever, chills and headache. Some infections can occur without symptoms. Symptoms usually start between 24 and 48 hours after ingesting the virus and last for one to three days.

What is the treatment for norovirus infection?

There is no specific treatment for the infection, however, most people recover on their own. Fluid and electrolyte replacements may be administered to treat dehydration resulting from diarrhea and vomiting.

How can norovirus infection be prevented?

Norovirus is spread through ingestion of the virus. The following precautions can lower the risk of getting an infection:

• Wash your hands with soap and warm water after using the toilet and changing diapers
• Wash your hands with soap and warm water before eating
• Rinse vegetables and fruit before eating
• Do not drink or swallow water directly from rivers, lakes, streams, pools, or spas
• When traveling to areas with poor water sanitation avoid tap water, uncooked food, and street vendors

If you have norovirus infection you can take the following precautions to avoid spreading the disease to others:

• Wash your hands with soap and warm water after using the toilet
• Avoid preparing or serving food for other people
• Wash all bedding and clothing that has come in contact with vomit or feces in hot soapy water

 

Rotavirus is a very common cause of diarrhea. It occurs in all areas of the world. In temperate climates rotavirus infections are more common in the winter than summer. Rotavirus is usually spread through the fecal oral route and can cause diarrhea, nausea, and vomiting.

How may I be exposed to rotavirus?

Infection with rotavirus occurs through the fecal oral route. The virus is usually transmitted person to person but can also be transmitted through food washed in contaminated water and eaten raw, food and drinking water handled by an infected person, and through contamination of surfaces and objects. Surface waters such as streams, rivers, and lakes may be contaminated with the virus. However, drinking water outbreaks of rotavirus are quite rare. Rotavirus needs to be ingested in order to cause an illness. It is common in all geographical areas. Young children, the elderly, and immunocompromised individuals are more likely to have more severe symptoms. An infection with rotavirus does not cause complete immunity.

What are symptoms of rotavirus infection?

Symptoms usually start between 19 and 48 hours after ingesting the virus and last for one to eight days. Infection with rotavirus usually causes nausea, vomiting, diarrhea, stomach cramps, and occasionally fever.

What is the treatment for rotavirus?

There is no specific treatment for the infection, however, most people recover on their own. Fluid and electrolyte replacements may be administered to treat dehydration resulting from diarrhea and vomiting.

Rotavirus is spread through ingestion of the virus. A vaccine to prevent rotavirus infection has been developed. The CDC does not recommend the rotavirus vaccine because some children who received the vaccine developed bowel obstruction. The following precautions can lower the risk of getting an infection:

• Wash your hands with soap and warm water after using the toilet and changing diapers
• Wash your hands with soap and warm water before eating
• Rinse vegetables and fruit before eating
• Do not drink or swallow water directly from rivers, lakes, streams, pools, or spas
• When traveling to areas with poor water sanitation avoid tap water, uncooked food, and street vendors

If you have rotavirus infection you can take the following precautions to avoid spreading the disease to others:

• Wash your hands with soap and warm water after using the toilet
• Avoid preparing or serving food for other people
• Wash all bedding and clothing that has come in contact with vomit or feces in hot soapy water