The highly contagious hepatitis A has been designated as a legal infectious disease, and its spread is alarming. In particular, there has been a rapid increase in infections among people in their 30s and 40s, especially in the metropolitan area. In addition to hepatitis A, as previously reported, there are also cases of other infectious diseases such as measles and dengue fever being imported from abroad. 

Let’s delve deeper with a professor of infectious diseases. Yes, regarding hepatitis A patients, it has been noted that the number of cases identified this year has already reached three times that of the same period last year. The speed of its spread is indeed very fast, which is a serious concern. Last year, about 1,500 cases were reported within a year, but by April of this year, approximately 3,600 cases have already been recorded, which is nearly double compared to the same period last year. Furthermore, the total number of cases reported last year has already increased by more than 1.5 times. Health authorities are concerned about how quickly hepatitis A is spreading.

It is not easy to understand why this is the case. The incubation period for hepatitis A is about 28 days, and if we consider the time until symptoms appear, it can be up to 50 days. Therefore, when conducting an epidemiological investigation, we first find that the virus can be detected in patients. However, when we visit places like restaurants or side dish shops, we often see that food from a month ago is still there, indicating that proper storage is not being followed. This makes it quite difficult to trace common ingredients or food items. While we can estimate potential infections, it is challenging to confirm where the actual contamination occurred and how it spread, making epidemiological investigations one of the more difficult tasks in infectious disease control. So, does this mean that infections often occur when consuming contaminated food or water? Yes, that is correct.

During the incubation period, the virus can be excreted through feces. Once it is excreted, the virus can contaminate drinking water or food ingredients, or it can lead to contamination during food preparation at home. If someone consumes contaminated food or drinks, they can develop an infection. In the metropolitan area, particularly among people in their 30s and 40s, there seems to be a significant number of cases. Why is that? Currently, the metropolitan area is experiencing a surge in cases, especially in regions like Daejeon and Chungcheong. The reason why those in their 30s and 40s are particularly vulnerable is that older adults in their 50s and 60s often have access to tap water, while many younger individuals may have consumed well water or contaminated water, leading to natural infections. As a result, they tend to have more antibodies. In 2009, there was a significant outbreak, and at that time, there were also many cases among teenagers.

In the case of people under the age of 10, there has been a neglect of vaccinations. Since 2015, vaccinations have been provided for free starting from the first year of life. As a result, people in their 20s to 40s are not getting vaccinated, and this has led to a generation that is not naturally immune. Consequently, there is a significant occurrence of diseases in that age group. Therefore, it seems very important to get vaccinated. Hepatitis A vaccinations are currently recommended for children between 6 and 18 months. Additionally, it is essential to receive the second dose to ensure the most effective results. It is crucial to get both doses. You mentioned that contaminated water and food can be causes of hepatitis A. In that case, there are instances of food poisoning, and hepatitis A and food poisoning are related.

How much of a situation can we have? There is no correlation, but it could be a situation where the cooking environment or ingredients can be contaminated due to certain factors. In such cases, it can be more helpful to predict when these situations might arise. Therefore, making the cooking process transparent and maintaining the integrity of the distribution process of ingredients are important methods to prevent hepatitis A during food preparation. It has been reported that the number of cases has decreased somewhat compared to last year, but this year's situation is quite unusual. In 2016 and 2017, there were about a thousand cases, and last year it decreased to about two thousand five hundred, which made the health authorities feel somewhat relieved. However, the sudden increase in cases has raised concerns, and it is frustrating that we cannot identify specific causes or areas of contamination.

In the early stages, symptoms such as a cold or indigestion can be quite common, and it can be confusing because they are often considered mild. Recently, we had a patient who presented with a fever, and due to the initial symptoms, we were uncertain whether it was a different illness. After a few days, the liver enzyme levels began to rise, leading us to suspect hepatitis. Therefore, it is difficult to confirm whether it is hepatitis based solely on initial symptoms. Diagnosis typically begins when liver enzyme levels start to rise or when jaundice appears. If there are any unusual or suspicious symptoms, it would be necessary to conduct a blood test to check liver enzyme levels. This is especially important if there is a high fever and gastrointestinal symptoms arise.

For those who are unable to get vaccinated, it would be a good idea to measure the waist size. This is important because there are people who need to be cautious about receiving the vaccine. The hepatitis B vaccine is relatively safe, and there aren't many people who absolutely cannot receive it. However, there are individuals in their 30s who may already have underlying liver issues. Hepatitis B can be quite serious for those with liver cirrhosis or similar conditions, so these individuals need to be particularly careful and should not delay in seeking treatment. You mentioned that it can be fatal, but the real concern is that there is no treatment for hepatitis A, right? So what should we do? In most cases of hepatitis A, most people recover within about two weeks with proper rest and care. This means that recovery can happen naturally.

If possible, please choose the English version. Most people have recovered significantly, but there are a very small number of cases where individuals with acute hepatitis have become severely ill and entered a state of liver failure, requiring a liver transplant. Although this is not common, it does occur. Therefore, when symptoms of hepatitis A appear, it is important to monitor the situation closely and to be aware of the treatment methods provided by hospitals. Can chronic hepatitis develop after a year of having the virus, or does the situation worsen quickly enough to necessitate a liver transplant? Hepatitis A often causes acute hepatitis, and it does not typically lead to chronic conditions. A liver transplant may only be necessary in cases where acute hepatitis becomes severe and the liver condition deteriorates significantly. The number of patients with hepatitis is also increasing globally. What should we do about this? Currently, it is primarily in Europe and then...

In Africa and then in Southeast Asia, there has been a significant increase in measles cases. Interestingly, individuals in their 20s and 30s have become a vulnerable group. Therefore, for those planning to travel abroad, it is highly recommended to get vaccinated if you are unsure about your immunity. This is currently the safest option. 

Regarding dengue fever, I understand that there has been a report indicating that the number of cases has doubled. This is concerning because we need to be cautious of the mosquitoes that transmit dengue. To avoid dengue, it is advisable to get vaccinated in advance and to take precautions, especially in areas where mosquitoes are prevalent. While there are reports about dengue in certain regions, the vaccine is known to be effective primarily for residents rather than travelers. Therefore, it is essential to make efforts to avoid mosquito bites and to use mosquito repellent while traveling.

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