Question

Alarmingly high number of people describing similar acute symptoms. An investigation team composed of medical professionals and scientists was assigned to determine the root of the problem. 30 patients from different parts of the town exhibited similar symptoms at various hospitals in town.

Symptoms include vomiting, liver damage, abdominal pain and edema.
Aside from the symptoms reported, patients appear intact, that is no cuts or skin bruises.

Thorough analysis of blood, urine and stool for microbial pathogens did not identify any known pathogens. All patients do not recall specific trauma leading to these symptoms, nor visiting an exotic place in the months before the outbreak. Patient’s ages range from 10-55 with a clear trend of increased severity of the symptoms amongst young patients (under 16).

Patient’s ethnicity is diverse.

Below is an initial list of questions to guide you in solving the case. Note, it is an initial list and you are expected to come up with further ideas at the workshop.
4. How does this agent cause the disease?

Edit: Considering the symptoms, agent is most likely Acute Hepatitus virus.

Seeming there has been a rapid onset of the disease in a single town, mostly likely Hepatitus A transimtted from a infected fast food worker who did not sufficently wash their hands. (Food/Drink contaminated with infected feces)

Pathogen attacked liver causing inflamation (Edema) to the liver resulting in the vomiting and pain mentioned along with bodily edema.

Not really necessary to answer this question at this point as I have more or less answered it myself at this point.

Answer 1

Hepatitis A is a liver disease caused by hepatitis A virus(HAV). hepatitis B and C cuases chronic liver diseases while hepatitis A causes acute liver failure.

The HAV's life cycle in human host begins with ingestion of virus from mouth( by contaminated food or water with infected feces). Absorption in the stomach or small intestine allows entry into the circulation and is uptaken by the liver. Replication of the virus occurs in the hepatocytes and GI epithelial cells.It attacks the cytotoxic T cells and causes damage to hepatocytes.New virus particles are released into the blood and is secreted into the bile by the liver. The virus is then reabsorbed to continue the cucle or excreted through stools.

Hope this helps you. Thank you! :-)