Hepatitis

From Wikipedia, the free encyclopedia

Hepatitis
Classification and external resources

Alcoholic hepatitis evident by fatty change,

cellnecrosis, Mallory bodies
ICD-10

K75.9

ICD-9

573.3

DiseasesDB

20061

MedlinePlus

001154

MeSH

D006505

Hepatitis (plural: hepatitides) is a medical condition defined by the inflammation of the liver and
characterized by the presence ofinflammatory cells in the tissue of the organ. Hepatitis may occur
with limited or no symptoms, but often leads to yellow discoloration of the skin, mucus membranes,
and conjunctivae, poor appetite and malaise. Hepatitis is acute when it lasts less than six months
and chronic when it persists longer. The condition can be self-limiting (healing on its own) or can
progress to fibrosis (scarring) andcirrhosis.
Worldwide, sexually transmitted hepatitis viruses are the most common cause of the condition.
[1]
Other causes include autoimmune diseases and ingestion of toxic substances (notably alcohol,
certain medications (such as paracetamol), some industrial organic solvents, and plants).
The term is derived from the Greek hpar (), meaning "liver," and the suffix -itis (-), meaning
"inflammation" (c. 1727).[2]

Contents

1 Signs and symptoms

o

1.1 Acute

1.2 Chronic

2 Causes
o

2.1 Viral hepatitis

2.2 Alcoholic hepatitis

2.3 Toxic and drug-induced hepatitis

2.4 Autoimmune

2.5 Non-alcoholic fatty liver disease

2.6 Ischemic hepatitis

2.7 Giant cell hepatitis

3 Mechanism

4 Diagnosis
o

4.1 Viral hepatitis

4.2 Differential diagnosis

4.3 Pathology

5 Prognosis

6 Prevention
o

6.1 Vaccines

7 See also

8 References

9 External links

Signs and symptoms[edit]

A person with jaundice

Acute[edit]
Initial features are of nonspecific flu-like symptoms, common to almost all acute viral infections and
may include malaise, muscle and joint aches, fever, nausea or vomiting, diarrhea, and headache.
More specific symptoms, which can be present in acute hepatitis from any cause, are: profound loss
of appetite, aversion to smoking among smokers, dark urine, yellowing of the eyes and skin, and
abdominal discomfort. Phys 17b9 ical findings are usually minimal, apart from yellowing of the skin
and conjunctivae, tender enlargement of the liver,enlarged lymph nodes in 5%, and enlargement of
the spleen. Acute viral hepatitis is more likely to be asymptomatic in children. Symptomatic
individuals may present after a convalescent stage of 7 to 10 days, with the total illness lasting
weeks.[3]
A small proportion of people with acute hepatitis progress to acute liver failure, in which the liver is
unable to remove harmful substances from the blood (leading to confusion and coma due to hepatic
encephalopathy) and produce blood proteins (leading to peripheral edemaand bleeding).[3]

Chronic[edit]
Chronic hepatitis may cause nonspecific symptoms such as malaise, tiredness and weakness, and
often leads to no symptoms at all. It is commonly identified on blood tests performed either
for screening or to evaluate nonspecific symptoms. The presence of jaundiceindicates advanced
liver damage. On physical examination there may be enlargement of the liver.[4]
Extensive damage to and scarring of liver (i.e. cirrhosis) leads to weight loss, easy bruising and
bleeding, peripheral edema (swelling of the legs) and accumulation of ascites(fluid in the abdomen).
Eventually, cirrhosis may lead to various complications: esophageal varices (enlarged veins in the
wall of the esophagus that can cause life-threatening bleeding), hepatic encephalopathy (confusion
and coma) and hepatorenal syndrome (kidney dysfunction).
Acne, abnormal menstruation, lung scarring, inflammation of the thyroid gland and kidneys may be
present in women with autoimmune hepatitis.[4]

Causes[edit]

Viral hepatitis is the most common cause of hepatitis worldwide.[5] Other common causes of non-viral
hepatitis include toxic and drug-induced, alcoholic, autoimmune, fatty liver, and metabolic disorders.
[6]
Less commonly some bacterial, parasitic, fungal, mycobacterial and protozoal infections can cause
hepatitis.[7][8] Additionally, certain complications of pregnancy and decreased blood flow to the liver
can induce hepatitis.[7][9] Cholestasis (obstruction of bile flow) due to hepatocellular dysfunction
18f6 , biliary tract obstruction, orbiliary atresia can result in liver damage and hepatitis.[10][11]

Viral hepatitis[edit]
The most common causes of viral hepatitis are the five unrelated hepatotropic viruses hepatitis
A, hepatitis B, hepatitis C, hepatitis D (which requires hepatitis B to cause disease), and hepatitis E.
Hepatitis B, which causes between one and two million deaths per year, is most often transmitted
sexually. The disease does not affect the sexual organs, but is highly contagious in its early stages,
especially from sexual intimacy, and even kissing. A vaccine is routinely given in the developed
world.[12]

Alcoholic hepatitis[edit]
Main article: Alcoholic hepatitis
Excessive alcohol consumption is a significant cause of hepatitis and liver damage (cirrhosis).
Alcoholic hepatitis usually develops over years-long exposure to alcohol. Alcohol intake in excess of
80 grams of alcohol a day in men and 40 grams a day in women is associated with development of
alcoholic hepatitis. Alcoholic hepatitis can vary from mild asymptomatic disease to severe liver
inflammation and liver failure. Symptoms and physical exam findings are similar to other causes of
hepatitis. Laboratory findings are significant for elevated transaminases, usually with elevation
of aspartate transaminase (AST) in a 2:1 ratio to alanine transaminase (ALT).[13][14]
Alcoholic hepatitis may lead to cirrhosis and is more common in patients with long-term alcohol
consumption and those infected with hepatitis C.[15] Patients who drink alcohol to excess are also
more often than others found to have hepatitis C.[16] The combination of hepatitis C and alcohol
consumption accelerates the development of cirrhosis.[17]

Toxic and drug-induced hepatitis[edit]

Main article: Hepatotoxicity
A large number of medications and other chemical agents can cause hepatitis. In the United
States acetaminophen, antibiotics, and central nervous system medications are among the most
common causes of drug-induced hepatitis. Acetaminophen, also known as paracetamol, is the
leading cause of acute liver failure in the United States.[18] Herbal remedies and dietary supplements
may also cause hepatitis, and these are the most common causes of drug-induced hepatitis in
Korea.[19] Risk factors for drug-induced hepatitis include: increasing age, female sex, and previous
drug-induced hepatitis. Genetic variability is increasingly understood as a key predisposing risk
factor to drug-induced hepatitis.[20][21]
Toxins and medications can cause liver injury through a variety of mechanisms, including direct cell
damage, disrupting cell metabolism, and inducing structural changes.[22]Some medications, like
acetaminophen, cause predictable dose-related 1c18 liver damage, whereas others
cause idiosyncratic reactions that vary among individuals.[21]
Exposure to other hepatotoxins can occur accidentally or intentionally through ingestion, inhalation,
and skin absorption. Occupational exposure may occur in many work fields and can present acutely
or insidiously.[23] Mushroom poisoning is a common toxic exposure that may result in hepatitis.[24]

Autoimmune[edit]
Main article: Autoimmune hepatitis

Autoimmune hepatitis is a chronic disease caused by an abnormal immune response against liver
cells.[25] The disease is thought to have a genetic predisposition as it is associated with
certain human leukocyte antigens.[26] The symptoms of autoimmune hepatitis are similar to other
hepatitides and may have a fluctuating course from mild to very severe. Women with the disease
may have abnormal menstruation or become amenorrheic. The disease occurs in people of all ages
but most commonly in young women. Many people with autoimmune hepatitis have
other autoimmune diseases.[27]

Non-alcoholic fatty liver disease[edit]

Main article: Non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease (NAFLD) is the occurrence of fatty liver in people who have little or
no history of alcohol use. In the early stage there are usually no symptoms, as the disease
progresses symptoms typical of chronic hepatitis may develop. [28] NAFLD is associated
with metabolic syndrome, obesity, diabetes, and hyperlipidemia.[29] Severe NAFLD leads to
inflammation, fibrosis, and cirrhosis, a state referred to as non-alcoholic steatohepatitis (NASH).
Diagnosis requires excluding other causes of hepatitis, including excessive alcohol intake.
[30]
While imaging can show fatty liver, only liver biopsy can demonstrate inflammation and fibrosis
characteristic of NASH.[31] NASH is recognized as the third most common cause of liver disease in
the United States.[28]

Ischemic hepatitis[edit]
Main article: Ischemic hepatitis
Injury to liver cells due to insufficient blood or oxygen results in ischemic hepatitis (or liver shock).
[32]
The condition is most often associated with heart failure but can also be caused
by shock or sepsis. Blood testing of a person with ischemic hepatitis will show very high levels
of transaminase enzymes (AST and ALT). The condition usually resolves if the underlying cause is
treated successfully. Ischemic hepatitis rarely causes permanent liver damage. [33]

Giant cell hepatitis[edit]

Giant cell hepatitis is a rare form of hepatitis that predominantly occurs in newborns and children.
Diagnosis is made on the basis of the presence of multinucleated hepatocytegiant cells on liver
biopsy.[34] The cause of giant cell hepatitis is unknown but the condition is associated with viral
infection, autoimmune disorders, and drug toxicity.[35][36]

Mechanism[edit]
The specific mechanism varies and depends on the underlying cause for the condition. In viral
hepatitis, the presence of the virus in the liver cells causes the immune system to attack the liver,
resulting in inflammation and impaired function.[37] In autoimmune hepatitis, the immune system
attacks the liver due to the autoimmune disease.[38] Some hepatitis, often including hepatitis caused
by alcoholism, fat deposits accumulate in the liver, resulting in fatty liver disease, also
called steatohepatitis.[39]

Diagnosis[edit]
Diagnosis is made by assessing an individual's symptoms, physical exam, and medical history, in
conjunction with blood tests, liver biopsy, and imaging. Blood testing includesblood chemistry, liver
enzymes, serology and nucleic acid testing. Abnormalities in blood chemistry and enzyme results
may be indicative of certain causes or stages of hepatitis.[40][41] Imaging can identify steatosis of the
liver but liver biopsy is required to demonstrate fibrosis and cirrhosis.[31] A biopsy is unnecessary if
the clinical, laboratory, and radiologic data suggests cirrhosis. Furthermore, there is a small but

significant risk to liver biopsy, and cirrhosis itself predisposes for complications caused by liver
biopsy.[42]

Liver chemistry test

Clinical implication of abnormality

Alanine transaminase (ALT)

Hepatocellular damage

Aspartate transaminase (AST)

Hepatocellular damage

Bilirubin

Cholestasis

Alkaline phosphatase

Cholestasis

Prothrombin time

Impaired synthetic function

Albumin (ALB)

Impaired synthetic function

Gamma-glutamyl transpeptidase (GGT)

Cholestasis

Bile acids

Cholestasis

Lactate dehydrogenase

Hepatocellular damage

Viral hepatitis[edit]
Main article: viral hepatitis
Viral hepatitis is mostly diagnosed through clinical laboratory testing. Some of these tests react with
the virus or parts of the virus, such as the Hepatitis B surface antigen test ornucleic acid tests.[43]
[44]
Many of the tests are serological tests that react to the antibodies formed by the immune system.
For some major causes of viral hepatitis, such as Hepatitis B, there are multiple serological tests
used that provide additional information for diagnosis. [45]

Differential diagnosis[edit]
Several diseases can present with signs, symptoms, and/or liver function test abnormalities similar
to 1488 hepatitis. In severe cases of alpha 1-antitrypsin deficiency (A1AD), excess protein in liver
cells causes inflammation and cirrhosis.[46] Some metabolic disorders cause damage to the liver
through a variety of mechanisms. In hemochromatosis andWilson's disease toxic accumulation
of dietary minerals results in inflammation and cirrhosis.[47]

Pathology[edit]
The liver, like all organs, responds to injury in a limited number of ways and a number of patterns
have been identified. Liver biopsies are rarely performed for acute hepatitis and because of this the
histology of chronic hepatitis is better known than that of acute hepatitis.

Acute[edit]
In acute hepatitis the lesions (areas of abnormal tissue) predominantly contain diffuse sinusoidal and
portal mononuclear infiltrates (lymphocytes, plasma cells, Kupffer cells) and swollen hepatocytes.
Acidophilic cells (Councilman bodies) are common. Hepatocyte regeneration and cholestasis
(canalicular bile plugs) typically are present. Bridging hepaticnecrosis (areas of necrosis connecting
two or more portal tracts) may also occur. There may be some lobular disarray. Although aggregates
of lymphocytes in portal zones may occur these are usually neither common nor prominent. The
normal architecture is preserved. There is no evidence of fibrosis or cirrhosis (fibrosis plus
regenerative nodules). In severe cases prominent hepatocellular necrosis around the central vein
(zone 3) may be seen.
In submassive necrosis a rare presentation of acute hepatitis there is widespread hepatocellular
necrosis beginning in the centrizonal distribution and progressing towardsportal tracts. The degree
of parenchymal inflammation is variable and is proportional to duration of disease.[48][49] Two distinct
patterns of necrosis have been recognised: (1) zonal coagulative necrosis or (2) panlobular
(nonzonal) necrosis.[50] Numerous macrophages and lymphocytes are present. Necrosis and
inflammation of the biliary tree occurs.[51] Hyperplasia of the surviving biliary tract cells may be
present. Stromal haemorrhage is common.
The histology may show some correlation with the cause:

Zone 1 (periportal) occurs in phosphorus poisoning or eclampsia.

Zone 2 (midzonal) rare is seen in yellow fever.

Zone 3 (centrilobular) occurs with ischemic injury, toxic effects, carbon tetrachloride
exposure or chloroform ingestion. Drugs such as acetaminophen may be metabolized in zone 1
to toxic compounds that cause necrosis in zone 3.

Where patients have recovered from this condition, biopsies commonly show multiacinar
regenerative nodules (previously known as adenomatous hyperplasia). [52]
Massive hepatic necrosis is also known and is usually rapidly fatal. The pathology resembles that of
submassive necrosis but is more markered in both degree and extent.

Chronic[edit]
Chronic hepatitis has been better studied and several conditions have been described.
Chronic hepatitis with piecemeal (periportal) necrosis (or interface hepatitis) with or without
fibrosis[53] (formerly chronic active hepatitis) is any case of hepatitis occurring for more than 6 months
with portal based inflammation, fibrosis, disruption of the terminal plate, and piecemeal necrosis.
This term has now been replaced by the diagnosis of 'chronic hepatitis'.
Chronic hepatitis without piecemeal necrosis (formerly called chronic persistent hepatitis) has no
significant periportal necrosis or regeneration with a fairly dense mononuclear portal infiltrate.
Councilman bodies are frequently seen within the lobule. Instead it includes persistent parenchymal
focal hepatocyte necrosis (apoptosis) with mononuclear sinusoidal infiltrates.
The older terms have been deprecated because the conditions are now understood as being able to
alter over time so that what might have been regarded as a relatively benign lesion could still

progress to cirrhosis. The simpler term chronic hepatitis is now preferred in association with the
causative agent (when known) and a grade based on the degree of inflammation, piecemeal or
bridging necrosis (interface hepatitis) and the stage of fibrosis. Several grading systems have been
proposed but none have been adopted universally.
Cirrhosis is a diffuse process characterized by regenerative nodules that are separated from one
another by bands of fibrosis. It is the end stage for many chronic liver diseases. The
pathophysiological process that results in cirrhosis is as follows: hepatocytes are lost through a
gradual process of hepatocellular injury and inflammation. This injury stimulates a regenerative
response in the remaining hepatocytes. The fibrotic scars limit the extent to which the normal
architecture can be reestablished as the scars isolate groups of hepatocytes. This results in nodules
formation. Angiogenisis (new vessel formation) accompanies scar production which results in the
formation of abnormal channels between the central hepatic veins and the portal vessels. This in
turn causes shunting of blood around the regenerating parenchyma. Normal vascular structures
including the sinusoidal channels may be obliterated by fibrotic tissue leading to portal hypertension.
The overall reduction in hepatocyte mass, in conjunction with the portal blood shunting, prevents the
liver from accomplishing its usual functions the filtering of blood from the gastrointestinal tract and
serum protein production. These changes give rise to the clinical manifestations of cirrhosis.

Specific causes[edit]
Most of the causes of hepatitis cannot be distinguished on the basis of the pathology but some do
have particular features that are suggestive of a particular diagnosis.
The presence of micronodular cirrhosis, Mallory bodies and fatty change within a single biopsy are
highly suggestive of alcoholic injury.[54] Perivenular, pericellular fibrosis (known as 'chicken wire
fibrosis' because of its appearance on trichrome or van Gieson stains) with partial or complete
obliteration of the central vein is also very suggestive of alcohol ab 10e8 use.
Cardiac, ischemic and venous outflow obstruction all cause similar patterns. [55] The sinusoids are
often dilated and filled with erythrocytes. The liver cell plates may be compressed. Coagulative
necrosis of the hepatocytes can occur around the central vein. Hemosiderin and lipochrome
laden macrophages and inflammatory cells may be found. At the edge of the fibrotic zone
cholestasis may be present. The portal tracts are rarely significantly involved until late in the course.
Biliary tract disease including primary biliary cirrhosis, sclerosing cholangitis, inflammatory changes
associated with idiopathic inflammatory bowel disease and duct obstruction have similar histology in
their early stages. Although these diseases tend to primarily involve the biliary tract they may also be
associated with chronic inflammation within the liver and difficult to distinguish on histological
grounds alone. The fibrotic changes associated with these disease principally involve the portal
tracts with cholangiole proliferation, portal tract inflammation with neutrophils surrounding the
cholangioles, disruption of the terminal plate by mononuclear inflammatory cells and occasional
hepatocyte necrosis. The central veins are either not involved in the fibrotic process or become
involved only late in the course of the disease. Consequently the centralportal relationships are
minimally distorted. Where cirrhosis is present it tends to be in the form of a portalportal bridging
fibrosis.
Hepatitis E causes different histological patterns that depend on the host's background. [56] In
immunocompetent patients the typical pattern is of severe intralobular necrosis and acute cholangitis
in the portal tract with numerous neutrophils. This normally resolves without sequelae. Disease is
more severe in those with preexisting liver disease such as cirrhosis. In the immunocompromised
patients chronic infection may result with rapid progression to cirrhosis. The histology is similar to
that found in hepatitis C virus with dense lymphocytic portal infiltrate, constant piecemeal necrosis
and fibrosis.

Prognosis[edit]

The outcome of hepatitis depends heavily on the disease or condition that is causing the symptoms.
For some causes, such as subclinical Hepatitis A infection, the person may not experience any
symptoms and will recover without any long term effects. For other causes hepatitis can result in
irreparable damage to the liver and require a liver transplant.[3] A subset referred to in a 1993
classification as "hyperacute" liver failure can happen in less than a week. [57]
The liver can regenerate damaged cells.[58] Chronic damage to the liver can result in the formation of
scar tissue 1672 called fibrosis and can result in nodules that block the liver from functioning
properly; this condition is called cirrhosis and is not reversible.[59] Cirrhosis may indicate a liver
transplant is necessary. Another complication of chronic hepatitis is liver cancer,
specifically hepatocellular carcinoma.[60]

Prevention[edit]
Vaccines[edit]

Global distribution of hepatitis B

Vaccines are available to prevent hepatitis A and B. Hepatitis A immunity is achieved in 99-100% of
persons receiving the two-dose inactivated virus vaccine. The hepatitis A vaccine is not approved for
children under one year of age.[61] Vaccines to prevent hepatitis Bhave been available since 1986
and have been incorporated into at least 177 national immunization programs for children. Immunity
is achieved in greater than 95% of children and young adults receiving the three-dose recombinant
virus vaccine. Vaccination within 24 hours of birth can prevent transmission from an infected mother.
Adults over 40 years of age have decreased immune response to the vaccine. The World Health
Organization recommends vaccination of all children, particularly newborns in countries where
hepatitis B is common to prevent transmission from the mother to child.[62]

Hepatitis
Also called: Viral hepatitis

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and
remove poisons. Hepatitis is an inflammation of the liver.
Viruses cause most cases 5b4 of hepatitis. The type of hepatitis is named for the virus that
causes it; for example, hepatitis A, hepatitis B or hepatitis C. Drug or alcohol use can also cause
hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.
Some people who have hepatitis have no symptoms. Others may have
Loss of appetite

 Nausea and vomiting

Diarrhea
Dark-colored urine and pale bowel movements
Stomach pain
Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring,
called cirrhosis, or to liver cancer.
Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes
hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

The word hepatitis comes from the Ancient Greek word hepar (root word hepat) meaning 'liver',
and the Latin itis meaning inflammation. Hepatitis means injury to the liver with inflammation of
the liver cells.

Fast facts on hepatitis

Here are some key points about hepatitis. More detail and supporting information is in
the main article.

The five main types of hepatitis are caused by viruses.

Globally, around 250 million people are affected by hepatitis C and 300 million
people are estimated to be hepatitis B carriers.
Hepatitis A is caused by consuming contaminated food or water.

Hepatitis B is a sexually transmitted disease.

Hepatitis C is commonly spread via direct contact with the blood of f31 a person
who has the disease.

A person can only become infected with hepatitis D if they are already infected
with hepatitis B.

Person can become infected with the hepatitis E virus (HEV) by drinking
contaminated water.

Hepatitis that cannot be attributed to one of the viral forms of the disease is
called hepatitis X.

Hepatitis G is another type of hepatitis caused by a specific virus (HGV).

The initial symptoms of hepatitis are similar to those of flu.

What is the liver?

The liver is the largest gland in the human body. It weighs approximately 3 lb (1.36 kg). It is
reddish brown in color and is divided into four lobes of different sizes and lengths. It is also the
largest internal organ (the largest organ is the skin). It is below the diaphragm on the right in the
thoracic region of the abdomen. Blood reaches the liver through the hepatic artery and the portal
vein. The portal vein carries blood containing digested food from the small intestine, while the
hepatic artery carries oxygen-rich blood from the aorta.

Most liver damage is caused by 3 hepatitis viruses, called hepatitis A, B and C.

The liver is made up of thousands of lobules, each lobule consists of many hepatic cells - hepatic
cells are the basic metabolic cells of the liver.
The liver has a wide range of functions, including:

Detoxification (filters harmful substances form the blood, such as alcohol)

Stores vitamins A, D, K and B12 (also stores minerals)

Protein synthesis (makes certain amino acids - the building blocks of proteins)

The production of biochemicals needed for digestion, such as bile

Maintains proper levels of glucose in the blood

Produces 80% of your body's cholesterol (cholesterol is vital)

The storage glycogen (also converts glucose to glycogen)

Decomposing red blood cells

Synthesizing plasma protein

The production of hormones

Produces urea (the main substance of urine).

Hepatitis can heal on its own with no significant consequence, or it can progress to scarring of
the liver. Acute hepatitis lasts under six months, while chronic hepatitis lasts longer.
Most liver damage is caused by 3 hepatitis viruses, called hepatitis A, B and C. However,
hepatitis can also be caused by alcohol and some other toxins and infections, as well as from our
own autoimmune process (the body attacks itself).
About 250 million people globally are thought to be affected by hepatitis C, while 300 million
people are thought to be carriers of hepatitis B.
Not all forms of hepatitis are infectious. Alcohol, medicines, and chemical may be bad for the
liver and cause inflammation. A person may have a genetic problem, a metabolic disorder, or an
immune related injury. Obesitycan be a cause of liver damage which can lead to inflammation.
These are known as non-infectious, because they cannot spread form person-to-person.

Types of hepatitis
There are five main types of hepatitis 10ea that are caused by a virus, A, B, C, D, and E - plus
types X and G.

Hepatitis A

This is caused by eating infected food or water. The food or water is infected with a virus called
HAV (hepatitis A virus). Anal-oral contact during sex can also be a cause. Nearly everyone who
develops Hepatitis A makes a full recovery - it does not lead to chronic disease.

Hepatitis B
This is an STD (sexually transmitted disease). It is caused by the virus HBV (hepatitis B virus)
and is spread by contact with infected blood, semen, and some other body fluids. You get
hepatitis B by:

Unprotected sexual intercourse with an infected person (unprotected sex means without
using a condom) Using a syringe that was previously used by an infected person (most
commonly happens with drug addicts and people who inject steroids).

Having your skin perforated with unsterilized needles, as might be the case when getting
a tattoo, or being accidentally pricked. People who work in health care risk becoming infected
by accident in this way. Sharing personal items, such as a toothbrush or razor, with an
infected person.

A baby can become infected through his mother's milk if she is infected.

Being bitten by someone who is infected.

The liver of a person infected with hepatitis B swells. The patient can suffer serious liver damage
due to infection, resulting in cancer. For some patients the hepatitis becomes chronic (very longterm or lifelong). Donated blood is always tested for hepatitis B.

Hepatitis C
Hepatitis C is usually spread through direct contact with the blood of a person who has the
disease. It is caused by the virus HCV (hepatitis C Virus). The liver can swell and become
damaged. In hepatitis C, unlike hepatitis B, liver cancer risk is only increased in people
with cirrhosis and only 20% of hep C patients get cirrhosis. Feces is never a route of
transmission in hepatitis C. Donated blood is also tested for hepatitis C.
Misuse of anesthesia can result in the transmission of hepatitis B and hepatitis C viruses,
researchers reported in the journal Gastroenterology. The cause of infection tends to be from
anesthesia contamination, and not endoscopy contamination. Experts say that more effort is

needed to better educate the health care community about the importance of strict sterile
techniques when using any type of anesthesia.

Hepatitis D
Only a person who is already infected with hepatitis B can become infected with hepatitis D. It is
caused by the virus HDV (Hepatitis D Virus). Infection is through contact with infected blood,
unprotected sex, and perforation of the skin with infected needles. The liver of a person with
Hepatitis D swells.

Hepatitis E
A person can become infected by drinking water that contains HEV (hepatitis E virus). The liver
swells but there is no long-term consequence. Infection is also possible through anal-oral sex.

Hepatitis X
If a hepatitis cannot be attributed to the viruses of hepatitis A, B, C, D, or E, it is called hepatitis
X. In other words, hepatitis of an unknown virus.

Hepatitis G
This is a type of hepatitis caused by the hepatitis G virus (HGV). Usually there are no symptoms.
When there are symptoms, they are very mild.

Recent developments on hepatitis causes from MNT news

Frozen fruit blend linked to hepatitis A outbreak
The "Townsend Farms Organic Antioxidant Berry Blend" sold under the Harris Teeter brand,
could be the cause of a recent outbreak of hepatitis A.
Smoking results in lower immune system responses after transplants
According to a study published in Liver Transplantation, 1216 liver transplant recipients who
continue to smoke or have smoked in the past are more likely to acquire viral hepatitis
reinfection after the procedure.

Signs and symptoms

Many people with hepatitis experience either mild symptoms or none at all. Remember that an
infected person's feces are always infectious to other people. When symptoms appear, they
usually do so about 15 to 180 days after the person has become infected.

The acute phase of hepatitis - symptoms

The initial phase of hepatitis is called the acute phase. The symptoms are like a mild flu, and
may include:

Diarrhea

Fatigue

Loss of appetite

Mild fever
Muscle or joint aches

Nausea

Slight abdominal pain

Vomiting

Weight loss.

The acute phase is not usually dangerous, unless it develops into the fulminant or rapidly
progressing form, which can lead to death.
As the patient gets worse, these symptoms may follow:

Circulation problems (only toxic/drug-induced hepatitis)

Dark urine

Dizziness (only toxic/drug-induced hepatitis)

Drowsiness (only toxic/drug-induced hepatitis)

Enlarged spleen (only alcoholic hepatitis)

Headache (only toxic/drug-induced hepatitis)

Hives
Itchy skin

Light colored feces, the feces may contain pus

Yellow skin, whites of eyes, tongue (jaundice).

Patient outcomes after the acute phase depend on various factors, especially the type of hepatitis.

Recent developments on hepatitis diagnosis from MNT news

Baby boomers should be tested for hepatitis C, says panel
The U.S. Preventive Services Task Force has just issued new screening recommendations for
adults, specifically baby boomers, at risk of hepatitis C virus infection.
Only half of hepatitis C patients get needed follow-up tests
Only half of all patients who have tested positive for hepatitis C have had follow-up testing to
see if they are still infected, according to a new report by the CDC (Centers for Disease Control
and Prevention).

How is it treated?

There are five main types of hepatitis that are caused by a virus, A, B, C, D, and E - plus types X and G.

Hepatitis A
There is no treatment specifically for hepatitis A. The doctor will advise the patient to abstain
from alcohol and drugs during the recovery. The vast majority of patients with hepatitis A will
recover spontaneously.

Hepatitis B
A patient with hepatitis B needs to rest. He will require a diet that is high in protein
and carbohydrate - this is to repair damaged liver cells, as well as to protect the liver. If this is
not enough, the doctor may prescribe interferon. Interferon is an antiviral agent.

Hepatitis C
A patient with hepatitis C will be prescribed pegylated interferon and ribavirin.
Patients with chronic hepatitis C who are receiving standard HCV treatment may benefit
significantly by taking vitamin B12 supplements, researchers reported in the journal Gut. The
authors explained that by adding vitamin B12 to standard treatment, the body's ability to fight the
virus is greatly improved. According to their study results, patients who are difficult to treat
effectively benefit especially well.
Interferon-free therapy for hepatitis C 'cured' 90% of patients, A new study found that an
interferon-free combination of drugs was safe, well tolerated and cured over 90% of 380 trial
patients with liver cirrhosis in 12 weeks. The research was published in the New England
Journal of Medicine in April 2014.

Hepatitis D or E
So far, there is no effective treatment for either hepatitis D or E.

Non-viral hepatitis

If the patient has non-viral hepatitis, the doctor needs to remove the harmful substance. It will be
flushed out of the stomach by hyperventilation or induced vomiting. Patients with drug-induced
hepatitis may be prescribed corticosteroids.

Recent developments on hepatitis treatment from MNT news

Interferon-free therapy for hepatitis C 'cured' 90% of patients
Currently, doctors treating hepatitis C patients with cirrhosis (liver scarring) can only offer
treatments that rely on the drug interferon, which unfortunately, only works for less than half of
patients. Now, a new study found that an interferon-free combination of drugs was safe, well
tolerated and cured over 90% of 380 trial patients with liver cirrhosis in 12 weeks.
New hepatitis C drug shows promising results in phase II trials
Trial shows 79% of patients adding danoprevir to their treatment regimen (peginterferon alfa2a/ribavirin) showed early response and were eligible for a shorter treatment schedule.
Hepatitis C vaccine shows promise in early clinical trial
Researchers reveal how a vaccine has shown promise against hepatitis C infection a phase 1
clinical trial. In their study, published in the journal Science Translational Medicine, the
researchers reveal how they developed a two-tier vaccine approach that triggers and enhances an
immune response to HCV, protecting against infection.

Preventing hepatitis
How to prevent hepatitis A

Wash your hands with soap after going to the toilet

Only consume food that has just been cooked

Only drink commercially bottled water, or boiled water if you're unsure of local
sanitation

Only eat fruits that you can peel if you are somewhere where sanitation is unreliable

Only eat raw vegetables if you are sure they have been cleaned/disinfected thoroughly

Get a vaccine for hepatitis A if you travel to places where hepatitis may be endemic.

How to prevent hepatitis B

Tell the partner if you are a carrier or try to find out whether he/she is a carrier

Practice safe sex

Only use clean syringes that have not been used by anyone else

Do not share toothbrushes, razors, or manicure instruments

Have a hepatitis B series of shots if you are at risk

Only allow well sterilized skin perforating equipment (tattoo, acupuncture, etc.).

How to prevent hepatitis C

If you are infected do not let others share your toothbrush, razor, manicure equipment

If you are infected cover open wounds

Do not share needles, toothbrushes, or manicure equipment

If your skin is to be pierced, make sure equipment is well sterilized (tattoo, etc.)

Go easy on the alcohol 17c2

Do not share drug equipment.

How to prevent hepatitis D

Use the same guidelines as for hepatitis B. Only a person who is infected with hepatitis B
can become infected with hepatitis D.

How to prevent hepatitis E

Do the same as you would to protect yourself from hepatitis A infection.

How to prevent alcoholic hepatitis

Go easy on the alcohol, or abstain from consuming alcohol.

How to prevent toxic/drug induced hepatitis

Make sure you know about the lethal contents of all chemicals

Make sure the spray is not pointing at you

Make sure you wear protective gear if you have to.

Overview
What is hepatitis?
Hepatitis means inflammation of the liver. Toxins, certain drugs, some diseases, heavy
alcohol use, and bacterial and viral infections can all cause hepatitis. Hepatitis is also
the name of a family of viral infections that affect the liver; the most common types are
Hepatitis A, Hepatitis B, and Hepatitis C.

What is the difference between Hepatitis A, Hepatitis B, and

Hepatitis C?
Hepatitis A, Hepatitis B, and Hepatitis C are diseases caused by three different viruses.
Although each can cause similar symptoms, they have different modes of transmission
and can affect the liver differently. Hepatitis A appears only as an acute or newly
occurring infection and does not become chronic. People with Hepatitis A usually
improve without treatment. Hepatitis B and Hepatitis C can also begin as acute
infections, but in some people, the virus remains in the body, resulting in chronic
disease and long-term liver problems. There are vaccines to prevent Hepatitis A and B;
however, there is not one for Hepatitis C. If a person has had one type of viral hepatitis
in the past, it is still possible to get the other types.

What is Hepatitis C?

Hepatitis C is a contagious liver disease that ranges in severity from a mild illness
lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from
infection with the Hepatitis C virus (HCV), which is spread primarily through contact
with the blood of an infected person. Hepatitis C can be either acute or chronic.
Acute Hepatitis C virus infection is a short-term illness that occurs 133a within the
first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute
infection leads to chronic infection.
Chronic Hepatitis C virus infection is a long-term illness that occurs when the
Hepatitis C virus remains in a persons body. Hepatitis C virus infection can last a
lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or
liver cancer.

Statistics
How common is acute Hepatitis C in the United States?

In 2009, there were an estimated 16,000 acute Hepatitis C virus infections reported in
the United States.

How common is chronic Hepatitis C in the United States?

An estimated 3.2 million persons in the United States have chronic Hepatitis C virus
infection. Most people do not know they are infected because they dont look or feel
sick.

How likely is it that acute Hepatitis C will become chronic?

Approximately 75%85% of people who become infected with Hepatitis C virus develop
chronic infection.

Transmission / Exposure
How is Hepatitis C spread?
Hepatitis C is usually spread when blood from a person infected with the Hepatitis C
virus enters the body of someone who is not infected. Today, most people become
infected with the Hepatitis C virus by sharing needles or other equipment to inject
drugs. Before 1992, when widespread screening of the blood supply began in the United
States, Hepatitis C was also commonly spread through blood transfusions and organ
transplants.
People can become infected with the Hepatitis C virus during such activities as

Sharing needles, syringes, or other equipment to inject drugs

Needlestick injuries in health care settings

Being born to a mother who has Hepatitis C

Less commonly, a person can also get Hepatitis C virus infection through

Sharing personal care items that may have come in contact with another
persons blood, such as razors or toothbrushes

Having sexual contact with a person infected with the Hepatitis C virus

Can Hepatitis C be spread through sexual contact?

Yes, but the risk of transmission from sexual contact is believed to be low. The risk
increases for those who have multiple sex partners, have a sexually transmitted
disease, engage in rough sex, or are infected with HIV. More research is needed to
better understand how and when Hepatitis C can be spread through sexual contact.

Can you get Hepatitis C by getting a tattoo or piercing?

A few major research studies have not shown Hepatitis C to be spread through licensed,
commercial tattooing facilities. However, transmission of Hepatitis C (and other
infectious diseases) is possible when poor infection-control practices are used during

tattooing or piercing. Body art is becoming increasingly popular in the United States,
and unregulated tattooing and piercing are known to occur in prisons and other
informal or unregulated settings. Further research is needed to determine if these types
of settings and exposures are responsible for Hepatitis C virus transmission.

Can Hepatitis C be spread within a household?

Yes, but this does not occur very often. If Hepatitis C virus is spread within a
household, it is most likely a result of direct, through-the-skin exposure to the blood of
an infected household member.

How should blood spills be cleaned from surfaces to make sure

that Hepatitis C virus is gone?
Any blood spills including dried blood, which can still be infectious should be
cleaned using a dilution of one part household bleach to 10 parts water. Gloves should
be worn when cleaning up blood spills.

How long does the Hepatitis C virus survive outside the body?
The Hepatitis C virus can survive outside the body at room temperature, on
environmental surfaces, for at least 16 hours but no longer than 4 days.

What are ways Hepatitis C is not spread?

Hepatitis C virus is not spread by sharing eating utensils, breastfeeding, hugging,
kissing, holding hand 1600 s, coughing, or sneezing. It is also not spread through food
or water.

Who is at risk for Hepatitis C?

Some people are at increased risk for Hepatitis C, including

Current injection drug users (currently the most common way Hepatitis C virus is
spread in the United States)

Past injection drug users, including those who injected only one time or many
years ago

Recipients of donated blood, blood products, and organs (once a common means
of transmission but now rare in the United States since blood screening became
available in 1992)

People who received a blood product for clotting problems made before 1987

Hemodialysis patients or persons who spent many years on dialysis for kidney
failure

People who received body piercing or tattoos done with non-sterile instruments

People with known exposures to the Hepatitis C virus, such as

Health care workers injured by needlesticks

o
o

Recipients of blood or organs from a donor who tested positive for the
Hepatitis C virus

HIV-infected persons

Children born to mothers infected with the Hepatitis C virus

Less common risks include:

Having sexual contact with a person who is infected with the Hepatitis C virus
Sharing personal care items, such as razors or toothbrushes, that may have
come in contact with the blood of an infected person

What is the risk of a pregnant woman passing Hepatitis C to her

baby?
Hepatitis C is rarely passed from a pregnant woman to her baby. About 4 of every 100
infants born to mothers with Hepatitis C become infected with the virus. However, the
risk becomes greater if the mother has both HIV infection and Hepatitis C.

Can a person get Hepatitis C from a mosquito or other insect

bite?
Hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.

Can I donate blood, organs, or semen if I have Hepatitis C?

No, if you ever tested positive for the Hepatitis C virus (or Hepatitis B virus), experts
recommend never donating blood, organs, or semen because this can spread the
infection to the recipient.

Symptoms

What are the symptoms of acute Hepatitis C?

Approximately 70%80% of people with acute Hepatitis C do not have any symptoms.
Some people, however, can have mild to severe symptoms soon after being infected,
including

Fever

Fatigue

Loss of appetite

Nausea

Vomiting

Abdominal pain

Dark urine

Clay-colored bowel movements

Joint pain

Jaundice (yellow color in the skin or eyes)

How soon after exposure to Hepatitis C do symptoms appear?

If symptoms occur, the average time is 67 weeks after exposure, but this can range
from 2 weeks to 6 months. However, many people infected with the Hepatitis C virus do
not develop symptoms.

Can a person spread Hepatitis C without having symptoms?

Yes, even if a person with Hepatitis C has no symptoms, he or she can still spread the
virus to others.

Is it possible to have Hepatitis C and not know it?

Yes, many people who are infected with the Hepatitis C virus do not know they are
infected because they do not look or feel sick.

What are the symptoms of chronic Hepatitis C?

Most people with chronic Hepatitis C do not have any symptoms. However, if a person
has been infected for many years, his or her liver may be damaged. In many cases,
there are no symptoms of the disease until liver problems have developed. In persons
without symptoms, Hepatitis C is often detected during routine blood tests to measure
liver function and liver enzyme (protein produced by the liver) level.

How serious is chronic Hepatitis C?

Chronic Hepatitis C is a serious disease that can result in long-term health problems,
including liver damage, liver failure, liver cancer, or even death. It is the leading cause
of cirrhosis and liver cancer and the most common reason for liver transplantation in
the United States. Approximately 15,000 people die every year from Hepatitis C related
liver disease.

What are the long-term effects of Hepatitis C?

Of every 100 people infected with the Hepatitis C virus, about

7585 people will develop chronic Hepatitis C virus infection; of those,

o

6070 people will go on to develop chronic liver disease

520 people will go on to develop cirrhosis over a period of 2030 years

15 people will die from cirrhosis or 1376 liver cancer

Tests
Can a person have normal liver enzyme (e.g., ALT) results and
still have Hepatitis C?
Yes. It is common for persons with chronic Hepatitis C to have a liver enzyme level that
goes up and down, with periodic returns to normal or near normal. Some infected
persons have liver enzyme levels that are normal for over a year even though they
have chronic liver disease. If the liver enzyme level is normal, persons should have
their enzyme level re-checked several times over a 612 month period. If the liver
enzyme level remains normal, the doctor may check it less frequently, such as once a
year.

Who should get tested for Hepatitis C?

Talk to your doctor about being tested for Hepatitis C if any of the following are true:

You were born from 1945 through 1965

You are a current or former injection drug user, even if you injected only one
time or many years ago.

You were treated for a blood clotting problem before 1987.

You received a blood transfusion or organ transplant before July 1992.

You are on long-term hemodialysis treatment.

You have abnormal liver tests or liver disease.

You work in health care or public safety and were exposed to blood through a
needlestick or other sharp object injury.
You are infected with HIV.

If you are pregnant, should you be tested for Hepatitis C?

No, getting tested for Hepatitis C is not part of routine prenatal care. However, if a
pregnant woman hasrisk factors for Hepatitis C virus infection, she should speak with
her doctor about getting tested.

What blood tests are used to test for Hepatitis C?

Several different blood tests are used to test for Hepatitis C. A doctor may order just
one or a combination of these tests. Typically, a person will first get a screening test
that will show whether he or she has developed antibodies to the Hepatitis C virus. (An
antibody is a substance found in the blood that the body produces in response to a
virus.) Having a positive antibody test means that a person was exposed to the virus at
some time in his or her life. If the antibody test is positive, a doctor will most likely

order a second test to confirm whether the virus is still present in the person's
bloodstream.

Treatment

Can acute Hepatitis C be treated?

Yes, acute hepatitis C can be treated. Acute infection can clear on its own without
treatment in about 25% of people. If acute hepatitis C is diagnosed, treatment does
reduce the risk that acute hepatitis C will become a chronic infection. Acute hepatitis C
is treated with the same medications used to treat chronic Hepatitis C. However, the
optimal treatment and when it should be started remains uncertain.

Can chronic Hepatitis C be treated?

Yes. There are several medications available to treat chronic Hepatitis C, including new
treatments that appear to be more effective and have fewer side effects than previous
options. The Food and Drug Administration (FDA) maintains a complete list of approved
treatments for Hepatitis C.

Is it possible to get over Hepatitis C?

Yes, approximately 15%25% of people who get Hepatitis C will clear the virus from
their bodies without treatment and will not develop chronic infection. Experts do not
fully understand why this happens for some people.

What can a person with chronic Hepatitis C do to take care of

his or her liver?
People with chronic Hepatitis C should be monitored regularly by an experienced doctor.
They should avoid alcohol because it can cause additional liver damage. They also
should check with a health professional before taking any prescription pills,
supplements, or over-the-counter medications, as these can potentially damage the
liver. If liver damage is present, a person should check with his or her doctor about
getting vaccinated against Hepatitis A and Hepatitis B.

Vaccination
Is there a vaccine that can prevent 3275 Hepatitis C?
Not yet. Vaccines are available only for Hepatitis A and Hepatitis B. Research into the
development of a vaccine is under way.

Hepatitis C and Employment

Should a person infected with the Hepatitis C virus be

restricted from working in certain jobs or settings?
CDC's recommendations for prevention and control of the Hepatitis C virus infection
state that people should not be excluded from work, school, play, child care, or other
settings because they have Hepatitis C. There is no evidence that people can get
Hepatitis C from food handlers, teachers, or other service providers without blood-toblood contact.

Hepatitis C and Co-infection with HIV

What is HIV and Hepatitis C virus coinfection?

HIV and Hepatitis C virus coinfection refers to being infected with both HIV and the
Hepatitis C virus. Coinfection is more common in persons who inject drugs. In fact,
50%90% of HIV-infected persons who use injection drugs are also infected with the
Hepatitis C virus. To learn more about coinfection,
visit http://www.cdc.gov/hiv/resources/factsheets/hepatitis.htm.

Hepatitis is a term used to describe inflammation (swelling) of

the liver. It can occur as the result of a viral infection or
because the liver is exposed to harmful substances such as
alcohol.
Some types of hepatitis will pass without causing permanent
damage to the liver.
Other types can persist for many years and cause scarring of the
liver (cirrhosis). In the most serious cases, it may lead to loss of liver
function (liver failure) or liver cancer, which can both be fatal. These
types of long-lasting hepatitis are known as chronic hepatitis.
Initial symptoms of hepatitis caused by infection are similar to the
flu and include:

muscle and joint pain

a high temperature (fever) of 38C (100.4F) or above

feeling sick

being sick

headache

occasionally, yellowing of the eyes and skin (jaundice)

Symptoms of chronic hepatitis can include:

feeling unusually tired all the time

depression

jaundice

a general sense of feeling unwell

In many cases hepatitis causes no noticeable symptoms, so when

hepatitis is caused by a virus, many people are unaware they are
infected.
Similarly, many people with hepatitis caused by alcohol are unaware
that their drinking is harming their liver.

Types of hepatitis
The most common types of hepatitis are described below.
Hepatitis A
Hepatitis A, caused by the hepatitis A virus, is the most common
type of viral hepatitis. It occurs in the UK, but is more common in
countries where sanitation and sewage disposal are poor.
Around 350 cases are reported each year in England, with most
cases occurring in people who have travelled abroad.
Hepatitis A is usually caught by putting something in your mouth that
has been contaminated with the faeces of someone with hepatitis A.
It is usually a short-term (acute) infection and symptoms will pass
within three months. There is no specific treatment for hepatitis A
other than to relieve symptoms.
A vaccination can protect you against hepatitis A. Vaccination is
recommended if you are travelling to countries where the virus is
common, such as the Indian subcontinent, Africa, Central and South
America, the Far East and Eastern Europe.
Read more about hepatitis A.
Hepatitis B
Hepatitis B is caused by the hepatitis B virus. This can be found in
blood and body fluids, such as semen and vaginal fluids, so it can
be spread during unprotected sex, by sharing needles to inject
drugs, and from pregnant women to their babies.

Hepatitis B is uncommon in England and cases are largely confined

to certain groups, such as drug users. It is much more common in
other parts of the world, particularly East Asia and sub-Saharan
Africa.
Most people infected with hepatitis B are able to fight off the virus
and fully recover from the infection within a couple of months.
However, a small minority of people develop a long-term infection.
This is known as chronic hepatitis B. In some people, chronic
hepatitis B can cause cirrhosis and liver cancer.
Chronic hepatitis B is treatable with antiviral medication.
A vaccination is available for preventing hepatitis B, which is
recommended for people in high-risk groups, such as injecting drug
users or healthcare workers.
Read more about hepatitis B.
Hepatitis C
Hepatitis C is the most common type of viral hepatitis in England. It
is estimated that around 215,000 people in the UK have chronic
hepatitis C.
Hepatitis C is caused by the hepatitis C virus. This can be found in
the blood and, to a much lesser extent, the saliva and semen or
vaginal fluid of an infected person.
It is particularly concentrated in the blood, so it is usually transmitted
through blood-to-blood contact.
In England, it's most commonly spread through sharing needles to
inject drugs, which account for 9 out of 10 cases.
Hepatitis C often causes no noticeable symptoms, or symptoms that
are mistaken for the flu, so many people are unaware they are
infected.
Around one in four people will fight off the infection and will be free
of the virus. In the remaining three out of four people, the virus will
stay in their body for many years. This is known as chronic hepatitis
C. In some people, chronic hepatitis C can cause cirrhosis and liver
failure.
Chronic hepatitis C can be treated by taking antiviral medications,
although there can be unpleasant side effects.

There is currently no vaccination for hepatitis C.

Read more about hepatitis C.
Alcoholic hepatitis
Drinking excessive amounts of alcohol over the course of many
years can damage the liver, leading to hepatitis. This type of
hepatitis is known as alcoholic hepatitis.
It is estimated that as many as one in four moderate to heavy
drinkers has some degree of alcoholic hepatitis.
The condition does not usually cause any symptoms and is often
detected with a blood test.
If a person with alcoholic hepatitis continues to drink alcohol, there
is a real risk that they will go on to develop cirrhosis and possibly
liver failure.
Read more about alcoholic liver diseases and the health risks
associated with alcohol.

R 71e4 arer types of hepatitis

Hepatitis D
Hepatitis D, caused by the hepatitis D virus, is only present in
people already infected with hepatitis B (it needs the presence of
the hepatitis B virus to be able to survive in your body).
Chronic hepatitis D can increase the risk of cirrhosis developing.
Cirrhosis is more likely to develop in someone with chronic hepatitis
B becoming infected with hepatitis D (superinfection). It is much
rarer when both infections occur together (co-infection).
Infection rates in the UK are low.
Hepatitis E
Hepatitis E, caused by the hepatitis E virus, is very rare in the UK
and is generally a mild and short-term infection.
It is caught by putting something in your mouth that has been
contaminated with the faeces of someone with hepatitis E. Personto-person transmission is rare.
See the British Liver Trust website to find out more about hepatitis
E.

Autoimmune hepatitis
Autoimmune hepatitis is a very rare cause of chronic (long-term)
hepatitis. The white blood cells attack the liver, causing chronic
inflammation and damage. This can lead to more serious problems,
such as liver failure. The reason for this reaction is unknown.
There are an estimated 10 to 17 cases of autoimmune hepatitis for
every 100,000 people in Europe.
Between the ages of 15 and 25, women are around three to
four times more likely to be affected than men. However, in older
age groups, both men and women are similarly affected.
Symptoms include tiredness, pains in your abdomen, joint aches,
jaundice (yellow tinge to your skin and whites of your eyes)
and cirrhosis. See your GP immediately if you show any of these
symptoms so that tests can be carried out for an early diagnosis.
Treatment for autoimmune hepatitis involves medicines that help
suppress the immune system and reduce inflammation
(immunosuppressants). Steroid medication (prednisolone) can
gradually reduce the swelling over several weeks and can then be
used to control your symptoms.

Common cold
From Wikipedia, the free encyclopedia
1480
Jump to: navigation, search

Common cold
Classification and external resources

A representation of the molecular surface of one variant of

human rhinovirus.
ICD-10

J00

ICD-9

460

DiseasesDB

31088

MedlinePlus

000678

eMedicine

med/2339

Patient UK

Common cold

MeSH

D003139

The common cold (also known as nasopharyngitis, rhinopharyngitis, acute coryza,[1] head
cold, or simply a cold) is a viralinfectious disease of the upper respiratory tract which primarily
affects the nose.
Symptoms include coughing, sore throat, runny nose, sneezing, and fever which usually resolve in
seven to ten days, with some symptoms lasting up to three weeks. Well over 200 virus strains are
implicated in the cause of the common cold; the rhinoviruses are the most common.
Upper respiratory tract infections are loosely divided by the areas they affect, with the common cold
primarily affecting the nose, the throat (pharyngitis), and the sinuses (sinusitis), occasionally
involving either or both eyes via conjunctivitis. Symptoms are mostly due to the
body's immune response to the infection rather than to tissue destruction by the viruses themselves.
The primary method of prevention is by hand washing with some evidence to support the

effectiveness of wearing face masks. The common cold may occasionally lead to pneumonia,
either viral pneumonia or secondary bacterial pneumonia.
No cure for the common cold exists, but the symptoms can be treated. It is the most frequent
infectious disease in humans with the average adult getting two to three colds a year and the
average child getting between six and twelve. These infections have been with humanity since
antiquity.[2]

Contents

1 Signs and symptoms

o

1.1 Progression
2 Cause

2.1 Virology

2.2 Transmission

2.3 Weather

2.4 Other

3 Pathophysiology

4 Diagnosis

5 Prevention

6 Management
o

6.1 Symptomatic

6.2 Antibiotics and antivirals

6.3 Alternative medicine

7 Prognosis

8 Epidemiology

9 History

10 Society and culture

11 Research directions

12 References

13 External links

Signs and symptoms

The typical symptoms of a cold include a cough, a runny nose, nasal congestion and a sore throat,
sometimes accompanied by muscle ache, fatigue, headache, and loss of appetite.[3] A sore throat is
18d2 present in about 40% of the cases and a cough in about 50%, [4] while muscle ache occurs in
about half.[5] In adults, a fever is generally not present but it is common in infants and young children.
[5]
The cough is usually mild compared to that accompanying influenza.[5] While a cough and a fever
indicate a higher likelihood of influenza in adults, a great deal of similarity exists between these two
conditions.[6] A number of the viruses that cause the common cold may also result inasymptomatic
infections.[7][8] The color of the sputum or nasal secretion may vary from clear to yellow to green and
does not indicate the class of agent causing the infection. [9]

Progression
A cold usually begins with fatigue, a feeling of being chilled, sneezing and a headache, followed in a
couple of days by a runny nose and cough.[3] Symptoms may begin within 16 hours of
exposure[10] and typically peak two to four days after onset.[5][11] They usually resolve in seven to ten
days but some can last for up to three weeks.[12] The average duration of cough is 18 days[13] and in
some cases people develop a post-viral cough which can linger after the infection is gone.[14] In
children, the cough lasts for more than ten days in 3540% of the cases and continues for more than
25 days in 10%.[15]

Cause
Virology

Coronaviruses are a group of viruses known for causing the common cold. They have a halo, or
crown-like (corona) appearance when viewed under an electron microscope.
The common cold is a viral infection of the upper respiratory tract. The most commonly implicated
virus is a rhinovirus (3080%), a type of picornavirus with 99 knownserotypes.[16][17] Others
include: human coronavirus (~15%),[18][19] influenza viruses (10-15%),[20] adenoviruses (5%),[20] human
parainfluenza viruses, human respiratory syncytial virus, enteroviruses other than rhinoviruses,
and metapneumovirus.[21] F 1637 requently more than one virus is present.[22] In total over 200
different viral types are associated with colds.[5]

Transmission
The common cold virus is typically transmitted via airborne droplets (aerosols), direct contact with
infected nasal secretions, or fomites (contaminated objects).[4][23] Which of these routes is of primary
importance has not been determined; however, hand-to-hand and hand-to-surface-to-hand contact

seems of more importance than transmission via aerosols.[24] The viruses may survive for prolonged
periods in the environment (over 18 hours for rhinoviruses) and can be picked up by people's hands
and subsequently carried to their eyes or nose where infection occurs. [23] Transmission is common in
daycare and at school due to the proximity of many children with little immunity and frequently poor
hygiene.[25] These infections are then brought home to other members of the family.[25] There is no
evidence that recirculated air during commercial flight is a method of transmission. [23] However,
people sitting in close proximity appear at greater risk.[24] Rhinovirus-caused colds are most
infectious during the first three days of symptoms; they are much less infectious afterwards. [26]

Weather
The traditional folk theory is that a cold can be "caught" by prolonged exposure to cold weather such
as rain or winter conditions, which is how the disease got its name.[27] Some of the viruses that cause
the common colds are seasonal, occurring more frequently during cold or wet weather.[28] The reason
for the seasonality has not been conclusively determined. [29] This may occur due to cold induced
changes in the respiratory system,[30] decreased immune response,[31] and low humidity increasing
viral transmission rates, perhaps due to dry air allowing small viral droplets to disperse farther and
stay in the air longer.[32] It may be due to social factors, such as people spending more time indoors,
near an infected person,[30] and specifically children at school.[25][29] There is some controversy over
the role of low body temperature as a risk factor for the common cold; the majority of the evidence
suggests that it may result in greater susceptibility to infection.[31]

Other
Herd immunity, generated from previous exposure to cold viruses, plays an important role in limiting
viral spread, as seen with younger populations that have greater rates of respiratory infections.
[33]
Poor immune function is also a risk factor for disease.[33][34] Insufficient sleep and malnutrition have
been associated with a greater risk of developing infection following rhinovirus exposure; this is
believed to be due to their effects on immune function. [35][36] Breast feeding decreases the risk
of acute otitis media and lower respiratory tract infections among other diseases[37] and it is
recommended that breast feeding be continued when an infant has a cold. [38] In the developed world
breast feeding may not however be protective against the common cold in and of itself. [39]

Pathophysiology

The common cold is a disease of the upper respiratory tract.

The symptoms of the common cold are believed to be primarily related to the immune response to
the virus.[40] The mechanism of this immune response is virus specific. For example, the rhinovirus is
typically acquired by direct contact; it binds to human ICAM-1 receptors through unknown

mechanisms to trigger the release of inflammatory mediators.[40] These inflammatory mediators then
produce the symptoms.[40] It does not generally cause damage to the nasal epithelium.[5] The
respiratory syncytial virus (RSV) on the other hand is contracted by both direct contact and airborne
droplets. It then replicates in the nose and throat before frequently spreading to the lower respiratory
tract.[41]RSV does cause epithelium damage.[41] Human parainfluenza virus typically results in
inflammation of the nose, throat, and bronchi.[42] In young children when it affects thetrachea it may
produce the symptoms of croup due to the small size of their airway.[42]

Diagnosis
The distinction between different viral upper respiratory tract infections is loosely based on the
location of symptoms with the common cold affecting primarily the nose,pharyngitis the throat,
and bronchitis the lungs.[4] However there can be significant overlap and multiple areas can be
affected.[4] The common cold is frequently defined as nasal inflammation with varying amount of
throat inflammation.[43] Self-diagnosis is frequent.[5] Isolation of the actual viral agent involved is rarely
performed,[43] and it is generally not possible to identify the virus type through symptoms. [5]

Prevention
The only possibly useful ways to reduce the spread of cold viruses are physical measures [44] such
as hand washing and face masks; in the healthcare environment, gowns and disposable gloves are
also used.[44] Isolation, e.g. quarantine, is not possible as the disease is so widespread and
symptoms are non-specific. Vaccination 18f0 has proved difficult as there are so many viruses
involved and they mutate rapidly.[44] Creation of a broadly effective vaccine is thus highly improbable.
[45]

Regular hand washing appears to be effective in reducing the transmission of cold viruses,
especially among children.[46] Whether the addition of antivirals or antibacterials to normal hand
washing provides greater benefit is unknown.[46] Wearing face masks when around people who are
infected may be beneficial; however, there is insufficient evidence for maintaining a greater social
distance.[46] Zinc supplements may help to reduce the prevalence of colds.[47] Routine vitamin
C supplements do not reduce the risk or severity of the common cold, though they may reduce its
duration.[48]

Management

Poster encouraging citizens to "Consult your Physician" for treatment of the common cold
No medications or herbal remedies have been conclusively demonstrated to shorten the duration of
infection.[49] Treatment thus comprises symptomatic relief.[50] Getting plenty of rest, drinking fluids to
maintain hydration, and gargling with warm salt water, are reasonable conservative measures.
[21]
Much of the benefit from treatment is however attributed to the placebo effect.[51]

Symptomatic
Treatments that help alleviate symptoms include simple analgesics and antipyretics such
as ibuprofen[52] and acetaminophen/paracetamol.[53] Evidence does not show thatcough
medicines are any more effective than simple analgesics[54] and they are not recommended for use in
children due to a lack of evidence supporting effectiveness and the potential for harm. [55][56] In 2009,
Canada restricted the use of over-the-counter cough and cold medication in children six years and
under due to concerns regarding risks and unproven benefits.[55] In adults there is insufficient
evidence to support the use of cough medications. [57] The misuse of dextromethorphan (an over-thecounter cough medicine) has led to its ban in a number of countries. [58]
In adults the symptoms of a runny nose can be reduced by first-generation antihistamines; however,
these sometimes have adverse effects such as drowsiness.[50] Otherdecongestants such
as pseudoephedrine are also effective in adults.[59] Ipratropium nasal spray may reduce the
symptoms of a runny nose but has little effect on stuffiness.[60]Second-generation
antihistamines however do not appear to be effective.[61]
Due to lack of studies, it is not known whether increased fluid intake improves symptoms or shortens
respiratory illness[62] and a similar lack of data exists for the use of heated humidified air.[63] One study
has found chest vapor rub to provide some relief of nocturnal cough, congestion, and sleep difficulty.
[64]

Antibiotics and antivirals

Antibiotics have no effect against viral infections and thus have no effect against the viruses that
cause the common cold.[65] Due to their side effects, antibiotics cause overall harm, but are still
frequently prescribed.[65][66] Some of the reasons that antibiotics are so commonly prescribed include
people's expectations for them, physicians' desire to help, and the difficulty in excluding

complications that may be amenable to antibiotics.[67] There are no effective antiviral drugs for the
common cold even though some preliminary research has shown benefits. [50][68]

Alternative medicine
While there are many alternative treatments used for the common cold, there is insufficient scientific
evidence to support the use of most.[50] As of 2010 there is insufficient evidence to recommend for or
against either honey or nasal irrigation.[69][70] Zinc has been used to treat symptoms, with studies
suggesting that zinc, if taken within 24 hours of the onset of symptoms, reduces the duration and
severity of the common cold in otherwise healthy people.[47] Due to wide differences between the
studies, further research may be needed to determine how and when zinc may be effective.
[71]
Whereas the zinc lozenges may produce side effects, there is only a weak rationale for physicians
to recommend zinc for the treatment of the common cold. [72] Vitamin C's effect on the common cold,
while extensively researched, is disappointing, except in limited circumstances, specifically,
individuals exercising vigorously in cold environments. [48][73] There is no firm evidence that Echinacea
products provide any meaningful benefit in treating or preventing colds. [74] It is unknown if garlic is
effective.[75] A single trial of vitamin D did not find benefit.[76]

Prognosis
The common cold is generally mild and self-limiting with most symptoms generally improving in a
week.[4] Half of cases go away in 10 days and 90% in 15 days.[77] Severe complications, if they occur,
are usually in the very old, the very young 1911 , or those who are immunosuppressed.[78] Secondary
bacterial infections may occur resulting insinusitis, pharyngitis, or an ear infection.[79] It is estimated
that sinusitis occurs in 8% and an ear infection in 30% of cases.[80]

Epidemiology
The common cold is the most common human disease,[78] and affects people all over the globe.
[25]
Adults typically have two to five infections annually[4][5] and children may have six to ten colds a
year (and up to twelve colds a year for school children). [50] Rates of symptomatic infections increase
in the elderly due to a worsening immune system.[33]
Native Americans and Inuit are more likely to be infected with colds and develop complications such
as otitis media more often than Caucasians.[20] This may be explained by issues such as poverty and
overcrowding rather than by ethnicity.[20]

History

A British poster from World War IIdescribing the cost of the common cold[81]
While the cause of the common cold has only been identified since the 1950s the disease has been
with humanity since antiquity.[2] Its symptoms and treatment are described in the Egyptian Ebers
papyrus, the oldest existing medical text, written before the 16th century BCE. [82] The name "cold"
came into use in the 16th century, due to the similarity between its symptoms and those of exposure
to cold weather.[83]
In the United Kingdom, the Common Cold Unit was set up by the Medical Research Council in 1946
and it was here that the rhinovirus was discovered in 1956. [84] In the 1970s, the CCU demonstrated
that treatment with interferon during the incubation phase of rhinovirus infection protects somewhat
against the disease,[85] but no practical treatment could be developed. The unit was closed in 1989,
two years after it completed research of zinc gluconate lozenges in the prophylaxis and treatment of
rhinovirus colds, the only successful treatment in the history of the unit. [86]

Society and culture

The economic impact of the common cold is not well understood in much of the world. [80] In the
United States, the common cold leads to 75100 million physician visits annually at a conservative
cost estimate of $7.7 billion per year. Americans spend $2.9 billion on over-the-counter drugs and
another $400 million on prescri 134b ption medicines for symptomatic relief. [87] More than one-third of
people who saw a doctor received an antibiotic prescription, which has implications for antibiotic
resistance.[87] An estimated 22189 million school days are missed annually due to a cold. As a
result, parents missed 126 million workdays to stay home to care for their children. When added to
the 150 million workdays missed by employees suffering from a cold, the total economic impact of
cold-related work loss exceeds $20 billion per year.[21][87] This accounts for 40% of time lost from work
in the United States.[88]

Research directions
A number of antivirals have been tested for effectiveness in the common cold; however as of 2009
none have been both found effective and licensed for use.[68] There are ongoing trials of the anti-viral

drug pleconaril which shows promise against picornaviruses as well as trials of BTA-798.[89] The oral
form of pleconaril had safety issues and an aerosol form is being studied. [89]
DRACO, a broad-spectrum antiviral therapy being developed at the Massachusetts Institute of
Technology, has shown preliminary effectiveness in treating rhinovirus, as well as a number of other
infectious viruses.[90][91]
Researchers from the University of Maryland School of Medicine in Baltimore and the University of
WisconsinMadison have sequenced the genome for all known human rhinovirus strains.[92]

What Is a Common Cold?

Sneezing, scratchy throat, runny nose -- everyone knows the first miserable
signs of a common cold. But what is a common cold really? What causes you
to catch colds frequently while your best friend stays well? And more
importantly, how can you prevent getting a cold this season? Here are some
common cold basics to help you protect yourself and your family from getting
sick.
The common cold is a group of symptoms in the upper respiratory tract
caused by a large number of different viruses. Although more than 200 viruses
can cause the common cold, the perpetrator is usually the rhinovirus, which is
to blame for causing 10% to 40% of colds. Also, the coronaviruses cause
about 20% of colds and the respiratory syncytial virus (RSV) causes 10% of
colds.
Although the common cold is usually mild, it is a leading cause of doctor visits
and missed days from school and work. According to the CDC, 22 million
school days are lost annually in the U.S. because of the common cold. Some
estimates state that Americans suffer 1 billion colds annually.
For more detail, see WebMD's article on Common Cold Causes.

How a Common Cold Starts

You can catch a common cold from another person who is infected with the
virus. This usually happens by touching a surface contaminated with cold
germs -- a computer keyboard, doorknob, or eating utensil, for example -- and
then touching your nose or mouth. You can also catch a cold by encountering
secretions someone with a cold has sneezed into the air.
A cold begins when a cold virus attaches to the lining of your nose or throat.
Your immune system sends white blood cells out to attack this germ. Unless
you've encountered that exact strain of the virus before, the initial attack fails
and your body sends in reinforcements. Your nose and throat get inflamed
and produce a lot of mucus. With so much of your body's energy directed at f
18ef ighting the cold virus, you're left feeling tired and miserable.
While getting chilled or wet is not a cause of common colds, there are factors
that make you more susceptible to catching a cold virus. For example, you are
more likely to catch a common cold if you are excessively fatigued, have
emotional distress, or have allergies with nose and throat symptoms.

Common Cold Symptoms

With the common cold, you may have cold symptoms such as an itching or
sore throat with sneezing, nasal congestion, watery eyes, and mucus
drainage. More severe symptoms, such as high fever or muscle aches, may
indicate you have a flu rather than a cold.
For more detail, see WebMD's article on Common Cold Symptoms: What You
Might Feel.

What is the common cold, and what causes it?

The common cold is a self-limited contagious illness that can be caused by a number of
different types of viruses. The common cold is medically referred to as a viral upper

respiratory tract infection. Symptoms of the common cold may include cough, sore
throat, nasal congestion, runny nose, and sneezing. More than 200 different types of
viruses are 1426 known to cause the common cold, with rhinovirus causing
approximately 30%-35% of all adult colds. Other commonly implicated viruses include
coronavirus, adenovirus, respiratory syncytial virus, and parainfluenza virus. Because
so many different viruses can cause the common cold and because new cold viruses
constantly develop, the body never builds up resistance against all of them. For this
reason, colds are a frequent and recurring problem. In fact, children in preschool and
elementary school can have six to 12 colds per year while adolescents and adults
typically have two to four colds per year. The common cold occurs most frequently
during the fall and winter months.
The common cold is the most frequently occurring illness in the world, and it is a leading
cause of doctor visits and missed days from school and work. It is estimated that
individuals in the United States suffer 1 billion colds per year, with approximately 22
million days of school absences recorded annually. In the United States, the common
cold is thought to account for approximately 75-100 million physician visits annually,
with an economic impact of greater than $20 billion per year due to cold-related work
loss.

Common Cold
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Sneezing, sore throat, a stuffy nose, coughing - everyone knows the symptoms of th 27ec e
common cold. It is probably the most common illness. In the course of a year, people in the
United States suffer 1 billion colds.
You can get a cold by touching your eyes or nose after you touch surfaces with cold germs on
them. You can also inhale the germs. Symptoms usually begin 2 or 3 days after infection and
last 2 to 14 days. Washing your hands and staying away from people with colds will help you
avoid colds.
There is no cure for the common cold. For relief, try
Getting plenty of rest
Drinking fluids

 Gargling with warm salt water

Using cough drops or throat sprays
Taking over-the-counter pain or cold medicines

A cold is a mild viral infection of the nose, throat, sinuses and

upper airways. It can cause a blocked nose followed by a runny
nose, sneezing, a sore throat and a cough.
In adults and older children, the cold will usually last for about a
week as the body fights off the infection. Colds in younger
children can last up to two weeks.
There is no cure for a cold, although you can usually relieve
the symptoms of a cold at home by taking over-the-counter
medication, such as paracetamol, and drinking plenty of fluids.
Read more information about treating colds.

When to see a GP
You only really need to see your GP if:

your symptoms persist for more than three weeks

you have a high temperature (fever) of 39C (102.2F) or above

you cough up blood-stained phlegm (thick mucus)

you feel chest pain

you have breathing difficulties

you experience severe swelling of your lymph nodes (glands) in your neck and/or
armpits

See your GP if you're concerned about your baby, an elderly

person, or if you have a long-term illness, such as a chest condition.
You can also phone NHS 111 for an assessment.
Tests may be needed to rule out a more serious infection such
as pneumonia (a bacterial infection of the lungs) orglandular
fever (a viral infection caused by the Epstein-Barr virus).

What causes a cold?

Colds are caused by viruses which attack the lining of the nose and
throat, inflaming these areas. As they become inflamed, they begin
to produce more mucus, resulting in a runny nose and sneezing.
More than 200 types of virus can cause a cold. Those most
responsible for colds belong to one of two groups, rhinoviruses and
coronaviruses.
Because a number of viruses can cause a cold, it's possible to have
several colds, one after the other, as each one is caused by a
different virus.

How does a cold spread?

A cold can be spread through:

direct contact if you sneeze or cough, tiny droplets of fluid containing the cold

virus are launched into the air and can be breathed in by others
indirect contact if you sneeze onto a door handle and someone else touches
the handle a few minutes later, they may catch the cold virus if they then touch
their mouth or nose

In general, a person first becomes contagious two to three days

before their symptoms begin, and they remain contagious until all
their symptoms have gone. So most people will be contagious for
around two weeks.

How can I prevent a cold spreading?

You can take steps to help prevent the spread of a cold. For
example:

wash your hands regularly and properly, particularly after touching your nose

or mouth and before handling food

always sneeze and cough into tissues as this will help to prevent the viruscontaining droplets from your nose and mouth entering the air where they can

infect others; throw away used tissues immediately and wash your hands
clean surfaces regularly to keep them free of germs

use your own cup, plates, cutlery and kitchen utensils

use disposable paper towels to dry your hands and face, rather than shared
towels. As with tissues, always dispose of the paper towels after you have
finished using them

The 'common' cold

On average, adults have about two to four colds a year. Children have
three to eight as their immune system is more vulnerable to infection.
Women tend to get more colds than men, possibly because they're more
likely to come into close contact with children.
Colds are also more frequent during the winter months. This may be
because people are more likely to stay indoors and be in close contact
with each other.

With kids getting as many as eight colds per year or more, this contagious viral
infection of the upper respiratory tract is the most common infectious disease in the
United States and the No. 1 reason kids visit the doctor and stay home from school.

Causes
Most colds are caused by rhinoviruses that are in invisible droplets in the air we breathe
or on things we touch. More than 100 different rhinoviruses can infiltrate the protective
lining of the nose and throat, triggering an immune system reaction that can cause a
throat sore and headache, and make it hard to breathe through the nose.
Air that's dry indoors or out can lower resistance to infection by the viruses that
cause colds. And so can being a smoker or being around someone who's smoking.
People who smoke are more likely to catch a cold than people who don't and their
symptoms probably will be worse, last longer, and are more likely to lead to bronchitis
or even pneumonia.
But despite some old wives' tales, not wearing a jacket or sweater when it's chilly,
sitting or sleeping in a draft, and going outside while your hair's wet do not cause
colds.

Signs and Symptoms

The first symptoms of a cold are often a tickle in the throat, a runny or stuffy nose, and
sneezing. Kids with colds may also have a sore throat, cough, headache, mild fever,

fatigue, muscle aches, and loss of appetite. Nasal discharge may change from watery to
thick yellow or green.

Overview of Common Cold

A cold usually includes a runny nose, sore throat, sneezing, and coughing. These
symptoms can last for up to two weeks.

Causes
Common Cold

Over 200 viruses can cause the common cold

The rhinovirus is the most common type of virus that causes colds

Runny Nose during a Cold

When germs that cause colds first infect the nose and sinuses, the nose makes clear
mucus. This helps wash the germs from the nose and sinuses. After two or three
days, the body's immune cells fight back, changing the mucus to a white or yellow
color. As the bacteria that live in the nose grow back, they may also be found in the
mucus, which changes the mucus to a greenish color. This is normal and does not
mean you or your child needs antibiotics.

Signs and Symptoms of the Common Cold

Sneezing

Stuffy or runny nose

Sore throat

Coughing

Watery eyes

Mild headache

Mild body aches

See a Healthcare Provider if You or Your Child has:

Temperature higher than 100.4 F

Symptoms that last more than 10 days

Symptoms that are not relieved by over-the-counter medicines

Your healthcare provider can determine if you or your child has a cold and can
recommend symptomatic therapy. If your child is younger than three months of age
and has a fever, its important to always call your healthcare provider right away.

Antibiotics are Needed When

Antibiotics are needed only if your healthcare provider tells you that you or your
child has a bacterial infection. Your healthcare provider may prescribe other
medicine or give tips to help with a cold's symptoms, but antibiotics are not needed
to treat a cold or runny 68b4 nose.

Antibiotics Will Not Help if

Since the common cold is caused by a virus, antibiotics will not help it get better. A
runny nose or cold almost always gets better on its own, so it is better to wait and
take antibiotics only when they are needed. Taking antibiotics when they are not
needed can be harmful, and may lead to unwanted side effects like diarrhea, rashes,
nausea, and stomach pain. More severe side effects may rarely occur, including lifethreatening allergic reactions, kidney toxicity, and severe skin reactions.
Each time you or your child takes an antibiotic, the bacteria that normally live in
your body (on the skin, in the intestine, in the mouth and nose, etc.) are more likely
to become resistant to antibiotics. Common antibiotics cannot kill infections caused
by these resistant germs. Learn more about antibiotic resistance.

How to Feel Better

Rest, over-the-counter medicines and other self-care methods may help you or your
child feel better. For more information about symptomatic relief, visit the Symptom
Relief section of this website or talk to your healthcare provider or pharmacist.
Remember, always use over-the-counter products as directed. Many over-thecounter products are not recommended for children younger than certain ages.

Preventing the Common Cold

Practice good hand hygiene

Avoid close contact with people who have colds or other upper respiratory
infections