A mode of transmission of hepatitis A is?

Appeared in: MNS 2024

Explanation

Hepatitis A virus (HAV) is primarily transmitted via the fecal-oral route.
This occurs when a person ingests food or water that has been contaminated with microscopic amounts of fecal matter from an infected individual.
Raw foods, such as salads, are a common vehicle for transmission if they are handled by an infected person with inadequate hand hygiene or washed with contaminated water.

Option B: This is not the primary mode of transmission for Hepatitis A. While it can be transmitted through certain sexual practices (oral-anal contact), it is not the main route.
Option C: There is very little evidence to support the transmission of HAV through saliva. The virus is primarily shed in feces.
Option D: Hepatitis A is very rarely transmitted through contact with blood (parenteral route). Viraemia (virus in the blood) is brief and occurs before symptoms appear.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Transmission route of Hepatitis A virus (HAV) as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating patients and the community about the importance of thorough handwashing with soap and water, especially after using the toilet and before preparing or eating food, to prevent the spread of HAV.
Patient counseling should include advising travelers to areas with high rates of Hepatitis A to drink boiled or bottled water and to avoid raw or undercooked foods, including salads and unpeeled fruits.
Hepatitis A is a vaccine-preventable disease. Nurses should identify at-risk individuals (e.g., travelers, food handlers, men who have sex with men) and recommend vaccination.

How to Approach the Question

First, identify the core subject of the question, which is the 'mode of transmission' for 'Hepatitis A'.
Recall the different types of viral hepatitis and their primary transmission routes. A useful mnemonic is that vowels (A and E) come from the bowels (fecal-oral route).
Evaluate each option based on this knowledge.
Option A, 'Ingesting raw salads from outside,' directly represents the fecal-oral route through contaminated food.
Options B (sexual contact) and D (blood) are primary routes for Hepatitis B and C.
Option C (saliva) is not a significant route for any hepatitis virus.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 62-64

E6 Medicine Harrison 22e Part 2 p. 556-558

Practise the full MNS 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.