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Friday, February 28, 2020  Spokane, Washington  Est. May 19, 1883
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House call: Here’s the 411 on hepatitis A, B and C

UPDATED: Thu., Nov. 28, 2019

Spokane Regional Health District nurse Kira Lewis prepares hepatitis vaccinations on Aug. 6 at the House of Charity. (Dan Pelle / The Spokesman-Review)
Spokane Regional Health District nurse Kira Lewis prepares hepatitis vaccinations on Aug. 6 at the House of Charity. (Dan Pelle / The Spokesman-Review)
By Dr. Bob Riggs For The Spokesman-Review

According to the Spokane Regional Health District, Spokane is currently experiencing an outbreak of hepatitis A. Although this outbreak is primarily affecting people who are experiencing homelessness, it is still a good idea to be aware of how this infection is spread and its symptoms.

It’s also a good time to talk about all the forms of viral hepatitis and how to prevent infection. Hepatitis A is mostly spread when undetectable amounts of the feces from an infected person contaminate objects, food or drinks and then get swallowed.

It is easy to infect others living in the same household. Close personal contact, such as sex or caring for a person who is infected, can expose you to infection, too. Hepatitis B is more often spread by sex or contact with blood, and hepatitis C is mostly spread now through contaminated needles that are used in drug abuse and home done tattoos.

The symptoms of acute viral hepatitis – A, B or C – can include jaundice (a yellow discoloration of the skin and whites of the eyes), pasty clay-colored stools, dark urine, abdominal pain, fever, fatigue, loss of appetite, nausea, vomiting, diarrhea and joint pain. Once you recover from hepatitis A, you are immune for life and are no longer contagious.

Complicating things is that a substantial number of infected people have few or no symptoms but are still contagious. This is especially true of hepatitis C. In some cases, acute infection can cause liver failure and death, so it is important to seek medical treatment if you think you have been infected with any of the hepatitis viruses.

The most effective way to prevent hepatitis A is by vaccination. There are two vaccines available. One covers only hepatitis A and the other covers hepatitis A and B. Both require more than one injection over time to provide long-term protection against infection. There is no vaccine for hepatitis C yet.

If you have hepatitis thoroughly wash your hands after using the toilet and before preparing food or eating to prevent spreading the infection to others. Even if you don’t have hepatitis you should wash your hands after pooping or peeing; of course, you know that.

Thoroughly disinfecting surfaces that are touched often (especially in places that a lot of people frequent) can help prevent the spread of hepatitis A. Not all cleaning products kill the virus, so if you are concerned, check labels for “effective against hepatitis A.”

A gallon of water freshly mixed with 3/4 cup chlorine bleach is effective for disinfecting surfaces for hepatitis A, B and C. Our local health district has several helpful resources about hepatitis A at

In addition to the acute symptoms, hepatitis B and C can cause chronic disease, as well. The younger a person is infected with hepatitis B, the more likely he or she is to develop chronic hepatitis B. According to the World Health Organization, for infected infants, 80% to 90% will go on to develop a chronic hepatitis.

For children ages 1 to 5, it’s 30% to 50%, and for adults 19 years and older, it’s less than 5%. That is why we routinely vaccinate all newborns to hepatitis B. About 55% to 85% of people with acute hepatitis C go on to develop chronic hepatitis.

Chronic hepatitis B and C can cause ongoing acute symptoms or no symptoms whatsoever for as long as 20 or 30 years. It also can cause liver scarring (cirrhosis) and liver cancer, which affects 15% to 25% of people infected with chronic hepatitis B or C.

Cirrhosis and liver cancer may not cause symptoms until disease is advanced. There are now treatments for hepatitis B and C that are effective, but prevention is the better choice.

Editor’s note: This story was changed on Thursday, Nov. 29, 2019, to correct which form of hepatitis newborns are vaccinated for.

Bob Riggs is a family medicine physician at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.

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