DIAGNOSE UND EPIDEMIOLOGIE DER HEPATITIS A UNTER BERUCKSICHTIGUNG NOSOKOMIALER INFEKTIONEN

The hepatitis A virus (HAV) responsible for infectious hepatitis could be clearly characterized in recent years, and allowed the investigation of its pathogenesis and epidemiology. HAV is a picornavirus with many of the properties of enteroviruses. It is relatively stable in the environment. HAV is demonstrable in the stool up to 3 weeks after onset of illness; carriers of the virus are unknown. As infections with HAV are transmitted fecally-orally, local epidemics can occur in kindergartens, schools, etc., by the direct fecal-oral route or contaminated food if hygienic measures are not strictly followed. In the GFR the prevalence of HAV was reduced considerably within the last two decades. The peak of infections today is among the 20-35 yr olds, who in 60% of the cases were infected during trips to southern countries. Nosocomial infections occur occasionally in psychiatric clinics, where hygienic measures cannot be observed with the usual thoroughness. In pediatric departments or in department of internal medicine infections can be caused by inapparently infected patients or patients in the incubation phase of the disease. A prophylactic effect can be achieved by applying general hygienic measures and by donation of immunoglobulin to persons before or immediately after exposition.