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    "en": "Hepatitis A is an acute vaccine-preventable viral liver disease caused by the hepatitis A virus. The infection can cause mild to severe illness and is epidemic prone (WHO, 2020). <br /> <p>WHO, 2020. <a href=\"https://www.who.int/news-room/fact-sheets/detail/hepatitis-a\">Hepatitis A. World Health Organization (WHO)</a>. Accessed 8 November 2020.</p>"
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      "The hepatitis A virus (HAV) is primarily spread when an uninfected and unvaccinated person ingests food or water that is contaminated with the faeces of an infected person. It is one of the most frequent causes of foodborne infection. There are also outbreaks among men who have sex with men and persons who inject drugs (ECDC, 2017). The symptoms of hepatitis A can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, darkcoloured urine and jaundice (a yellowing of the skin and whites of the eyes). Not everyone who is infected will have all of the symptoms. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms. In very rare instances it can cause acute liver failure, which is often fatal (WHO, 2020a). Specific diagnosis is made by the detection of HAV-specific immunoglobulin M (IgM) antibodies in the blood. Additional tests include reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA and may require specialised laboratory facilities (WHO, 2020b). Epidemics related to contaminated food or water can erupt explosively, such as the epidemic in Shanghai in 1988 that affected about 300,000 people. Epidemics can also be prolonged, affecting communities for months through person-to-person transmission. Hepatitis A viruses persist in the environment and can withstand food-production processes routinely used to inactivate and/or control bacterial pathogens (WHO, 2020b). Hepatitis A can lead to significant economic and social consequences in communities. It can take weeks or months for people recovering from the illness to return to work, school, or daily life. The impact on food establishments identified with the virus, and local productivity in general, can be substantial (WHO, 2020b). The World Health Organization (WHO) has published guidance on case classification and surveillance standards (WHO, 2018)."
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