Patient's question:
Loss of appetite, nausea, even vomiting, abdominal distension, went out to eat on 12.20Doctor's answer:
After infection with the hepatitis A virus, it first replicates in the digestive tract. During a brief viremic phase, the virus can continue to replicate in blood leukocytes before entering the liver, where it replicates within hepatocytes. One to two weeks before the onset of symptoms, the hepatitis A virus is transported from the Golgi apparatus of hepatocytes to the bile canaliculi and then through the bile ducts into the intestinal lumen, where it is excreted in the feces. The peak excretion of the virus occurs during the late incubation period of hepatitis A and a few days before jaundice appears. Patients in this period, especially asymptomatic subclinical infections, are the most dangerous sources of transmission. Their feces, urine, and vomit, if not properly disinfected, can contaminate the surrounding environment, food, water sources, or the hands of healthy individuals. Additionally, the hands of infected individuals (such as cooks during the incubation period) and virus-carrying flies can also contaminate food, drinking water, and utensils. Once susceptible individuals consume food contaminated with hepatitis A virus or unpasteurized or uncooked contaminated water and food, or eat raw vegetables, strawberries, fruits, etc., that have been fertilized with feces, they can develop hepatitis A, leading to outbreaks or sporadic infections. Poor personal hygiene habits, crowded living conditions, high population density, and poor environmental sanitation in schools, factories, rural areas, childcare institutions, or households make it easier for hepatitis A infections to occur and cause highly localized outbreaks. If water sources become contaminated, it can lead to large-scale outbreaks. In 1950, Sweden and 1978, China both experienced hepatitis A outbreaks due to the consumption of clams. In 1979, Shanghai had a due to the consumption of crab, and in 1988, a massive outbreak occurred due to the consumption of hepatitis A virus-contaminated mussels, all of which were examples of fecal-oral transmission. In recent years, reports from abroad have indicated that intravenous drug abuse and homosexual populations have high levels of hepatitis A virus antibodies and detection rates. In these populations, the primary transmission routes of hepatitis A virus are anal-oral contact or contaminated injection equipment. Literature reports suggest that if women become infected with the hepatitis A virus during pregnancy, they can transmit it to the fetus through the placenta or during childbirth, although this is extremely rare. Hepatitis A virus infection does not involve mother-to-child transmission, and it has no adverse effects on the fetus. Studies have shown that in cases of pregnancy complicated by hepatitis A, there is no evidence of the hepatitis A virus spreading through the placenta, nor has there been any observed fetal malformation.