Several members of a family develop malaise, nausea, low-grade fever and dark urine two weeks after attending a wedding feast. Liver enzymes show ALT of 1200 U/L. Anti-HAV IgM is positive in all cases. Which feature of hepatitis A virus infection best explains why the food handler who prepared the meal was not advised long-term follow-up?

• A HAV never infects adults, only children
• B HAV replicates in the intestine without entering blood
• C Anti-HAV IgM persists lifelong and prevents relapse
• D HAV does not cause chronic infection or carrier state ✓

Explanation

Hepatitis A is an acute self-limiting illness; viremia clears with the onset of immunity and there is no chronic carrier state, so no long-term follow-up is needed. The key that kills distractor B is that HAV does cause a transient viremia during the incubation period, which is how it contaminated the food in the first place. Diagnosis here rests on anti-HAV IgM, which indicates current or recent infection.

Reference: Ananthanarayan and Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.