1. Hepatitis A (formerly known as infectious hepatitis ) is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). Tens of millions of individuals worldwide are estimated to become infected with HAV each year.

3. Hepatitis A is transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person.

4. Hepatitis A can be prevented by vaccination , good hygiene and sanitation . The vaccine protects against HAV in more than 95% of cases for longer than 20 years. It contains inactivated hepatitis A virus providing active immunity against a future infection. The vaccine was first phased in 1996 for children in high-risk areas. The vaccine is given by injection. An initial dose provides protection starting two to four weeks after vaccination; the second booster dose, given six to twelve months later, provides protection for over twenty years.

5. There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated. Pharmacotherapeutic goals are to reduce the morbidity and prevent complications involved in infection. The therapy is given by the agents like 1. Analgesics -to reduce the abdominal pain; usually Acetaminophen is given. Acetaminophen also acts as an antipyretic , to reduce the fever 2. Antiemetics -to suppress vomiting and nausea; usually Metoclopramide is given 3. Immune globulins usually BayGam 15-18% IG is given through intramuscular route

6. Hepatitis C is an infectious disease affecting the liver , caused by the hepatitis C virus (HCV). The infection is often asymptomatic , but once established, chronic infection can progress to scarring of the liver ( fibrosis ), and advanced scarring ( cirrhosis ) which is generally apparent after many years. In some cases, those with cirrhosis will go on to develop liver failure or other complications of cirrhosis, including liver cancer .

7. SIGNS AND SYMPTOMS Acute hepatitis C refers to the first 6 months after infection with HCV although symptoms may appear within a day if infection was caused by any method of intravenous injection. Between 60% and 70% of people infected develop no symptoms during the acute phase unless infection was caused by direct access to the blood stream as crossing the blood brain barrier is then made up to 100 times easier. Main symptoms consist of general cold and flu like symptoms with increased loss of senses. Chronic hepatitis C is defined as infection with the hepatitis C virus persisting for more than six months. Clinically, it is often asymptomatic, and it is mostly discovered accidentally (e.g. usual checkup).

8. Shared personal care items Personal care items such as razors, toothbrushes, cuticle scissors, and other manicuring or pedicuring equipment can easily be contaminated with blood. Tattooing dyes, ink pots, stylets, and piercing implements can transmit HCV-infected blood from one person to another if proper sterilization techniques are not followed. Blood exposure Medical and dental personnel, first responders (e.g., firefighters , paramedics , emergency medical technicians , law enforcement officers ), and military combat personnel can be exposed to HCV through accidental exposure to blood through needle sticks or blood spatter to the eyes or open wounds. Universal precautions to protect against such accidental exposures significantly reduce the risk of exposure to HCV

9. Vertical transmission refers to the transmission of a communicable disease from an infected mother to her child during the birth process. Injection drug use Those who currently use or have used drug injection as their delivery route for drugs are at increased risk for getting hepatitis C because they may be sharing needles or other drug paraphernalia (includes cookers, cotton, spoons, water, etc.), which may be contaminated with HCV-infected blood. Blood products Blood transfusion , blood products, or organ transplantation prior to implementation of HCV screening (in the U.S., this would refer to procedures prior to 1992) are all risk factors for hepatitis C.

10. Strategies such as the provision of new needles and syringes, and education about safer drug injection procedures, greatly decrease the risk of hepatitis C spreading between injecting drug users. No vaccine protects against contracting hepatitis C, or helps to treat it. Vaccines are under development and some have shown encouraging results.

11. The hepatitis C virus induces chronic infection in 50%-80% of infected persons. Approximately 50% of these do not respond to therapy. There is a very small chance of clearing the virus spontaneously in chronic HCV carriers (0.5% to 0.74% per year). However, the majority of patients with chronic hepatitis C will not clear it without treatment.

12. Hepatitis E is a viral hepatitis (liver inflammation) caused by infection with a virus called hepatitis E virus ( HEV ). HEV is a positive-sense single-stranded RNA icosahedral virus with a 7.5 kilobase genome. HEV has a fecal-oral transmission route. Infection with this virus was first documented in 1955 during an outbreak in New Delhi , India.

13. The incidence of hepatitis E is highest in juveniles and adults between the ages of 15 and 40. Though children often contract this infection as well, they less frequently become symptomatic. Mortality rates are generally low, for Hepatitis E is a “self-limiting” disease, in that it usually goes away by itself and the patient recovers. However, during the duration of the infection (usually several weeks), the disease severely impairs a person’s ability to work, care for family members, and obtain food. Hepatitis E occasionally develops into an acute severe liver disease, and is fatal

14. SIGNS AND SYMPTOMS The list of signs and symptoms mentioned in various sources for Hepatitis E includes the 11 symptoms listed below: Flu-like symptoms Fever Fatigue Nausea Vomiting Loss of appetite Abdominal pain Diarrhea Jaundice Yellow eyes

15. Domestic animals have been reported as a reservoir for the hepatitis E virus, with some surveys showing infection rates exceeding 95% among domestic pigs. Transmission after consumption of wild boar meat and uncooked deer meat has been reported as well. The rate of transmission to humans by this route and the public health importance of this are however still unclear.

16. Improving sanitation is the most important measure, which consists of proper treatment and disposal of human waste, higher standards for public water supplies, improved personal hygiene procedures and sanitary food preparation. Thus, prevention strategies of this disease are similar to those of many others that plague developing nations, and they require large-scale international financing of water supply and water treatment projects. A vaccine based on recombinant viral proteins has been developed and recently tested in a high-risk population (military personnel of a developing country). The vaccine appeared to be effective and safe, but further studies are needed to assess the long-term protection and the cost-effectiveness of hepatitis E vaccination.