TY - JOUR T1 - Hepatitis A in primary care: working in partnership for diagnosis, management, and prevention of outbreaks JF - British Journal of General Practice JO - Br J Gen Pract SP - 521 LP - 522 DO - 10.3399/bjgp19X705965 VL - 69 IS - 687 AU - Antiopi Ntouva AU - Bharat Sibal AU - Koye Balogun AU - Sema Mandal AU - Nick Harding Y1 - 2019/10/01 UR - http://bjgp.org/content/69/687/521.abstract N2 - GPs have a unique role in caring for patients with hepatitis A and a statutory duty for reporting suspected notifiable diseases including hepatitis A.1,2 Early identification in primary care and notification to Public Health England (PHE) is vital for effective management of cases and the prevention and control of the spread of infection. The aim of this article is to highlight the vital role of GPs in working collaboratively with PHE for the diagnosis, management, and prevention of cases and outbreaks of hepatitis A, as outlined in the recently updated PHE guidelines.3Around 300 cases of hepatitis A are reported annually,4 with 3–4 local clusters reported to PHE each year.3 In 2017, there was a surge in the number of hepatitis A virus cases (942 cases) as a result of a large outbreak predominantly in men who have sex with men (MSM), and further transmission into the wider community.4Hepatitis A is spread via the faecal–oral route mainly through person-to-person contact in developed countries, and through food and water contaminated by faeces in countries with poor sanitation standards.3 Transmission in people who inject drugs is thought to be direct person-to-person5 contact through the faecal–oral route because of poorer hygiene and unstable living conditions.6 Transmission between MSM individuals is thought to occur during sex through the faecal–oral route.6 The average incubation period is 28 days (range: 15–50 days). Patients are infectious from 2 weeks before the onset of symptoms (when infectivity is maximal), and until 1 week after.7 In children <5 years, 80–95% of the infections … ER -