Hepatitis A

What is hepatitis A?

Hepatitis means inflammation of the liver. When the inflammation is caused by infection with the hepatitis A virus (HAV), the disease is called hepatitis A. Hepatitis A ranges in severity from a mild disease lasting several weeks to a severe disease lasting several months. About 3,000 cases of hepatitis A are estimated to occur in the United States each year; a smaller number of cases are actually reported to public health each year because many infected people have no symptoms or mild symptoms and do not go to see a doctor.

Who gets hepatitis A?

Anyone who has not been infected with HAV previously or has not been vaccinated against hepatitis A can become infected and ill from HAV. People at greater risk of getting hepatitis A include those who travel to or live in countries where hepatitis A is common, those who have sexual contact with someone who has hepatitis A, men who have sex with other men, people who use recreational drugs, people who have clotting disorders, and household members or caregivers of a person infected with hepatitis A.

How is hepatitis A spread?

HAV can be found in the feces (stool) of infected people and their feces can contaminate surfaces, objects, food, or water. People get sick by swallowing the contaminated food or water or by putting their hands in their mouths after touching contaminated surfaces or objects. The virus can also spread from person to person through sexual activities and sharing contaminated needles.

What are the symptoms of hepatitis A?

Not everyone who is infected will have symptoms. If symptoms develop, they can include tiredness, poor appetite, fever, or nausea. Some people might also have vomiting or abdominal pain, clay-colored stool, or dark urine. Jaundice (a yellowing of the skin and the whites of the eyes) might appear. The disease is rarely fatal and most people recover in a couple of months. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults.

How soon after exposure do symptoms appear?

Symptoms usually appear within 4 weeks after exposure, with a range of 15–50 days.

How is hepatitis A diagnosed?

Signs and symptoms are the same for all types of acute viral hepatitis, including hepatitis A. As a result, acute hepatitis A must be diagnosed by a specific laboratory test on a sample of blood.

What is the treatment for hepatitis A?

Unvaccinated people who have been recently exposed to HAV can be given the hepatitis A vaccine or a shot of immune globulin within two weeks of the exposure to prevent severe illness. Otherwise, there are no special medicines that can be used to treat a person once the symptoms appear. Generally, doctors recommend rest, good nutrition, fluids, and treatment of symptoms to help a person recover from hepatitis A. A small number of people might need to be hospitalized. It might take a few months before people with hepatitis A begin to feel better.

How can hepatitis A be prevented?

The best way to prevent hepatitis A is by getting vaccinated. The hepatitis A vaccine is recommended for the following groups: all children at age 1 year, travelers to countries where hepatitis A is common, family and caregivers of adoptees from countries where hepatitis A is common, men who have sex with men, users of recreational drugs (whether injected or not), people working with non-human primates, people with chronic or long-term liver disease (including hepatitis B or hepatitis C), people with clotting-factor disorders, and people with direct contact with others who have hepatitis A.

Hand hygiene is important to prevent the spread of HAV. Always wash hands carefully after using the toilet, changing diapers, engaging in sexual activity that involves anal contact, and before eating or preparing food. Avoid eating raw shellfish taken from potentially contaminated waters. People with hepatitis A should not handle foods during the contagious period.

To clean contaminated surfaces, use approximately ¼ cup of 5.25% bleach in one gallon of water or use cleaning solutions containing quaternary ammonium and/or hydrogen chloride (found in many toilet cleaners).

What should I do if I have been exposed to hepatitis A?

Close contacts of an infected person and other people who have been exposed to HAV (e.g., by a food handler or contaminated food) should call their doctor or local health department to see if they should get a shot of vaccine or immune globulin to reduce their chance of becoming ill.

How long can an infected person carry the hepatitis A virus?

The contagious period begins about two weeks before symptoms appear. Most people are probably no longer contagious after the first week of jaundice. People, especially children younger than 6 years of age, can spread the virus without having any symptoms.

Should an infected person be excluded from work or school?

Yes. People with symptoms should be excluded, especially children who attend day care and people who work in locations where there is an increased risk of spreading the virus, including restaurant, day care, and healthcare workers.

How can I get more information about hepatitis A?

September 2018