How is viral hepatitis spread?

• Hepatitis A: HAV is typically contracted from ingested food or liquid (water) that is contaminated with infected faecal matter. The infection spreads to the liver through the bloodstream once ingested and causes swelling and inflammation. An infected person can transmit the disease through close personal contact with others. Hepatitis A then becomes contagious to others through eating foodstuffs and drinking fluids handled by an infected person (who may not have strict hygiene habits after using the toilet), having unprotected sex with someone with the virus, having direct contact with infected faecal matter or eating sewage-contaminated foods (such as raw or undercooked seafood) or those washed with untreated tap water. An infected person will likely be contagious for a period of at least 2 weeks (often before obvious symptoms even develop) and until at least 1 week after noticeable signs develop. Those handling children in nursery care centres or frail care centres for the aged will need to take care if handling nappies (diapers) of young children and elderly residents. Hygiene habits (regular hand-washing) are essential to curb the spread of potential infections.
• Hepatitis B: HBV is highly contagious and transmitted through direct contact with infected bodily fluids (fresh or dried). The virus is detectable in saliva, but is not easily transmitted through contact with the substance (sharing utensils or kissing an infected individual). HBV is also not easily spread through coughing, sneezing and even breastfeeding. Symptoms may develop over a period of 3 months (incubation period) but once evident can last for between 2 and 12 weeks. An infected person is still highly contagious even without the presence of symptoms. HBV is easily contracted through direct handling of infected blood (health care workers are at risk of infection through cuts in the skin or exposed contact in the eyes or mouth), intimate relations (unprotected oral, vaginal or anal sex), sharing a razor or other personal items containing remnants of infected bodily fluids (particularly blood), sharing needles or cottons, spoons or water used for injecting illicit drugs or during a tattoo or body piercing process, and through childbirth (during which a baby comes into contact with an infected mother’s bodily fluids). Blood transfusions and organ transplants can also be high risk for spreading hepatitis B (this is less common – since approximately 1992 - if all donated blood and organs are carefully screened). Acute infections are short-lived (less than 6 months) and the body (immune system) typically clears HBV with a full recovery. An acute infection can become chronic, however, if the immune system produces an antibody to help fight the condition, the infected person won’t likely be contagious after the incubation period. A chronic infection lasts beyond 6 months when the immune system is unable to produce antibodies to fight off an acute case of HBV. Chronic cases can last a lifetime and lead to long-term damage of the liver. For as long as they have an active infection, long-term sufferers can spread the virus. Chronic infections are highest among newborns and young children under 5 years of age. This is because very young children do not typically clear infections as effectively as adults do.
• Hepatitis C: HCV is highly contagious once transmitted through direct contact with contaminated blood. The disease is less commonly spread through sexual contact (but this can happen if you have multiple partners). Common transmission means include the sharing of personal care items that may have remnants of infected blood (such as razors and even toothbrushes or nail clippers), direct contact with contaminated blood (including during organ transplants and blood transfusions, particular before 1992 when blood wasn’t typically screened for hepatitis C), sharing of needles used for illicit drug use, tattooing or body piercing and childbirth. Other high risk factors for transmission include those who have received haemodialysis treatment (a renal replacement therapy) or clotting factor concentrates and similar blood products (more common before 1987). Contracting the virus is less common from casual contact (sneezing, coughing, sharing foodstuffs and water, or kissing an infected person). Blood contact is the primary means of transmission for HCV.
• Hepatitis D: Direct contact with the bodily fluids (vaginal fluids, semen, urine and blood) of an infected person transmits the disease. Childbirth is another way HDV is transmitted. Hepatitis D typically develops once a person has contracted the hepatitis B virus. As with the other viral variations of the disease, an infected person is contagious even before symptoms develop.
• Hepatitis E: Poor sanitation combined with overcrowded living conditions (typical of developing countries) easily contributes to the spread of hepatitis E infections. Ingested water and foodstuffs contaminated through exposure to faecal matter is the primary cause of HEV. It is rare, but it can happen that HEV is transmitted by consuming products from an infected animal or blood transfusions. Transmission has also been noted from mother to child during childbirth. Most HEV infections clear up on their own within a few weeks. If an infection is not able to clear, it can worsen, causing further damage to the liver and can ultimately cause total failure.