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More and more tourists are bringing home more than souvenirs. They're picking up the hepatitis A virus during their travels. About 10 million people in the world pick up the infection every year, according to estimates. "And the numbers are climbing, because ever more people are traveling," says Anton Gillessen, chief doctor for the internal medicine clinic at the Heart of Jesus hospital in Muenster, in Germany. Anyone traveling to southern or eastern Europe, the Mediterranean region (including Greece, Egypt or Tunisia) or any tropical region should consider an immunization before travel, recommends the Robert Koch Institute in Berlin. That's because 40 to 50 percent of all infected people catch the infection while on vacation. An immunization usually costs about $135. He recommends a combination treatment for hepatitis A and C. "Everyone should think about it," he says. The virus spreads via contaminated water, body contact and unclean food. Every second mussel in the Mediterranean Sea allegedly contains the hepatitis A virus. Gillessen advises this rule of thumb for every traveler when it comes to eating: "Cook it, boil it, peel it or forget it!" And make sure water bottles have their original seal.
Anyone who gets infected usually doesn't notice any symptoms until long after their return home. "As a rule, about a month passes between infection and outbreak. In the best-case scenario, the vacation is over then," says Gillessen. Children usually recover without any major problems. Adults usually have less specific symptoms. The disease will start with general complaints in the intestinal tract or with an elevated temperature. "Later, the urine turns dark, the stool turns pale and the skin yellow," explains Gillessen. Exhaustion and sluggishness are also common. It's best to visit a doctor as soon as the symptoms become obvious. "Hepatitis A is highly infectious," warns Thomas Loescher of the Professional Association of German Internists. Anyone infected has to protect those around him. "There should be no physical contact. There should be separate silverware, toothbrushes in separate containers and regular disinfections of the toilet," advises Christoph Jochum, a gastro-intestinologist at the University Clinic in Essen. As a rule, the disease lasts about three months in adults and goes away without complications, although these do arise in about 2 percent of all cases. Senior citizens, diabetes patients, alcoholics and people who already have HIV or hepatitis B are hit especially hard. "People with prior liver damage can suffer liver failure with hepatitis A," warns Jochum. Stefan Zeuzern of the Johann-Wolfgang-Goethe University Clinic in Frankfurt advises people in high-risk groups to have their livers checked regularly. "That's the only way hepatitis can be diagnosed in its early stages and be treated." 2009-06-22
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