Vaccination
The prophylaxis of hepatitis A is based, besides on the respect of determined hygienic and behavioral norms, on the vaccination and on the passive immunization through standard gammaglobuline (antibodies).
In addition to giving a long-lasting immunity, the anti-hepatitis A serum proves to be particularly effective, so as to cover almost 100% of the vaccinated.
The vaccine, injected intramuscularly, usually in the deltoid region, requires a booster after 6 or 12 months. Side effects are scarce and mostly local: pain at the injection site, rarely headache, malaise, nausea and loss of appetite.
Vaccine: Who is it for?
The vaccination is indicated for drug addicts, active homosexuals, travelers who go to regions at risk, patients suffering from chronic viral hepatitis and subjects with chronic liver diseases or those requiring transfusions (haemophilia).
Vaccine or passive immunization?
Compared to the vaccine, immunoglobulins are preferred when rapid immunization is required. The vaccine, in fact, requires two to four weeks to provide the desired protection, while the immunoglobulins are active immediately, with a coverage of 85% (against 97% of the vaccination).
The same antibodies can be used to prevent or mitigate the disease in the healthy person who has come into contact with the virus; in this case, however, the treatment must be undertaken promptly, within two weeks of infection.
Immunoglobulins are also often given to people who live in the same home as those with confirmed hepatitis; their use is not contraindicated in pregnancy and lactation.
While the vaccine protects the subject from hepatitis A for at least a decade, the effect of exogenous immunoglobulins is exhausted over 3-6 months.
Finally, it should be noted that people recovered from a previous hepatitis A infection have a set of antibodies in their blood that will protect them from disease for the rest of their lives. It should also be remembered that hepatitis A vaccines, as well as acquired immunity after passing the disease, can do nothing against other forms of hepatitis (B, C, D, E, G).
Prevention
Beyond the preventive vaccination or passive immunization, the traveler who goes to high-risk countries should respect some simple rules, such as the fact of rinsing abundantly the vegetables and the fruit, and peel the latter before consumption. Furthermore, it is very important to eat meat and fish (especially molluscs) only after a generous cooking.
Another important vehicle of hepatitis A infection is water; that taken from the tap or from common sources should always be boiled for at least 5-10 minutes, while the bottled one can be consumed with greater tranquility, as long as it is uncorked before your eyes. Also pay attention to ice cubes, which should never be consumed directly or added to beverages, and to water used for brushing teeth: it should also be safe, then bottle. Likewise, when bathing in rivers and seas, care should be taken that no water enters the mouth.
The individual prevention of hepatitis A is completed with the common rules of personal hygiene, such as the accurate and frequent washing of hands, especially after having been to the toilet and before handling food. Items such as toothbrushes, cutlery, glasses and towels should be used strictly for personal use.
The countless possible routes of infection described up to this point up the importance of active (vaccine) or passive immunization (gammaglobulins) before departure, for travel or work, in areas at risk.
The general prevention of hepatitis A, which is very effective in industrialized countries, is implemented by providing homes with an adequate sewerage system and an effective waste collection and treatment system; all with the aim of avoiding contamination of the aquifers. Attention, therefore, when you go to countries or regions where the waste is piled up along the roads instead of in special dumps.
