Hepatitis A
- Hepatitis A [HEP-uh-TI-tus AY] is a contagious
liver infection caused by the hepatitis A
virus.
- Hepatitis A virus is passed in the stool
of infected persons.
- Hepatitis A is usually spread from person
to person by hand-to-mouth contact with stool
from an infected person.
- Prevention against hepatitis A includes:
1) hepatitis A vaccine for long-term protection,
2) good personal hygiene and sanitation, and
3) immune globulin for short-term prevention.
What is hepatitis A?
Hepatitis A is a contagious liver disease.
What is the infectious agent that causes
hepatitis A?
Hepatitis A infection is caused by the hepatitis
A virus. Hepatitis A virus is passed in the
stool of infected persons. Unlike many other
viruses, it can survive for a long time at room
temperature in food and on surfaces and objects.
The virus is not affected by cold or by freezing,
but it is inactivated by heating foods to >185o
F (85o C) for one minute. Adequate
chlorination of water also kills the hepatitis
A virus.
Where is hepatitis A found?
Hepatitis A infection occurs worldwide. The
disease is common in Africa, Asia (except Japan),
parts of the Caribbean, Central and South America,
Eastern Europe, the Mediterranean Basin, and
the Middle East. In the United States, hepatitis
A occurs in isolated cases, in outbreaks, and
in widespread epidemics.
How do people get hepatitis A infection?
Hepatitis A virus is usually spread from person
to person. People get hepatitis A infection
by putting something in the mouth that has been
contaminated with the stool of an infected person.
For this reason, the virus is more easily spread
in places with poor sanitary conditions or in
places where people are not careful about washing
their hands.
Persons with hepatitis A can also spread the
virus to household members and to sex partners.
In rare cases, people have been infected after
getting a transfusion of infected blood. Outbreaks
of hepatitis A have also occurred among illegal
drug users. The virus is not spread by casual
contact, as in the usual work or school setting.
Because the virus can live in the environment
for a long time, people can also get hepatitis
A by:
- Swallowing contaminated water or ice
- Eating raw or undercooked shellfish harvested
from sewage-contaminated water
- Eating raw fruits, vegetables, or other
foods that were contaminated during growing,
harvesting, processing, or handling
- Eating cooked foods that were contaminated
after cooking
What are the signs and symptoms of hepatitis
A?
Children infected with hepatitis A virus often
have no symptoms. Most adults have symptoms
that develop over several days. Symptoms include:
- Fever
- Tiredness
- Loss of appetite
- Nausea, vomiting, or stomach ache
- Dark urine
- Jaundice (yellowing of the skin and whites
of the eyes)
If symptoms do occur, they usually last less
than 2 months, although 10% to 15% of persons
have prolonged or relapsing disease that can
last up to 6 months.
How soon after exposure do symptoms appear?
The average time between exposure to the virus
and the development of symptoms is about 28
days. Signs of illness usually begin abruptly.
Infected persons with no symptoms can still
spread the virus. This often happens with young
children who unknowingly spread hepatitis A
virus to older children and adults.
How is hepatitis A diagnosed?
Hepatitis A can be diagnosed by a blood test
called IgM anti-HAV.
Who is at risk for hepatitis A?
Anyone who has not already been infected with
hepatitis A virus can become infected, but some
people are at increased risk:
- Persons who share a household or have sexual
contact with someone who is infected with
hepatitis A virus
- Children and staff in child-care centers
(especially centers where children are in
diapers) where someone has hepatitis A virus
infection
- Travelers to countries where hepatitis A
is common and where proper sewage disposal
and clean water, food, and sanitation are
not available
- Residents and staff of institutions for
developmentally disabled persons where someone
has hepatitis A
- Men who have sex with men
- Persons who use street drugs
- Workers who handle animals infected with
hepatitis A virus or who work with hepatitis
A virus in a research laboratory
- Persons with clotting factor disorders who
receive injections of factor concentrates
What complications can result from hepatitis
A?
Unlike other types of hepatitis, such as hepatitis
B and hepatitis C, hepatitis A causes no long-lasting
liver damage. Deaths from hepatitis A infection
are rare.
What is the treatment for hepatitis A?
There is no treatment for hepatitis A infection.
People usually recover on their own after 2
or 3 weeks of bed rest. Having had the disease
produces lifelong protection against future
hepatitis A virus infection.
How common is hepatitis A?
In the United States, about 180,000 persons
become infected with hepatitis A virus yearly,
most from person-to-person contact. Outbreaks
occur periodically in many American Indian,
Alaska native, Pacific Islander, and some religious
communities. These outbreaks occur mainly among
young children.
Is hepatitis A an emerging infectious disease?
Yes. Hepatitis A is the seventh most commonly
reported infectious disease in the United States.
It ranks sixth among the top ten causes of foodborne
disease. Drug users have become an important
source of community-wide outbreaks, and there
has recently been an increase in hepatitis A
in men who have sex with men.
How can hepatitis A be prevented?
1. Hepatitis A vaccine provides long-term protection.
The vaccine is licensed for use in persons 2
years of age and older. It must be given before
exposure to the hepatitis A virus. Two shots
are needed for long-term protection.
Hepatitis A vaccine is recommended for:
- Persons who travel to or work in areas where
hepatitis A is common. The first dose should
be given at least 4 weeks before travel.
- Children living in communities with high
rates of hepatitis A, such as Alaska native
villages, American Indian reservations, and
Pacific Islander and some religious communities
- Men who have sex with men
- Persons who use street drugs
- Persons with chronic liver disease
- Persons with clotting factor disorders,
such as hemophilia
- Persons who work with animals infected with
hepatitis A virus or who work with hepatitis
A virus in a research setting
The vaccine is not recommended for children
under age 2. Immune globulin is recommended
in this age group for short-term protection.
2. To prevent person-to-person spread, good
personal hygiene and proper sanitation are important.
Always wash hands with soap and warm water after
using the toilet and changing a diaper and before
eating or preparing food.
3. Immune globulin is recommended for short-term
prevention against hepatitis A in all age groups.
Immune globulin is a sterile preparation of
antibodies. Immune globulin shots can lower
the risk of disease in close contacts, household
members, and sex partners of infected persons.
However, immune globulin must be given within
2 weeks of exposure to hepatitis A virus, and
protection lasts only 3 to 5 months, depending
on the dosage. Immune globulin is currently
in short supply.
Where can I find more information about
hepatitis A?
American Liver Foundation
1-800-GoLiver or 1-888-4HEPABC
http://www.liverfoundation.org/
Centers for Disease Control and Prevention
(CDC)
Hepatitis Hotline: 1-888-4HEPCDC
http://www.cdc.gov/ncidod/diseases/hepatitis/hepatitis.htm
Hepatitis Foundation International
1-800-891-0707
http://www.hepfi.org/
Immunization Action Coalition
612-647-9009
http://www.immunize.org/
National Digestive Diseases Information Clearinghouse
(NDDIC)
301-654-3810
nddic@aerie.com
This fact sheet is for information only and
is not meant to be used for self-diagnosis or
as a substitute for consultation with a health-care
provider. If you have any questions about the
disease described above, consult a health-care
provider
