Hepatitis A
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About... Hepatitis A
What is Hepatitis A?
Hepatitis (hep-ah-TY-tiss) A is a vaccine-preventable inflammation of the liver caused by the hepatitis A virus, which is found in the stool of an infected person. Hepatitis A virus is not found in animals. There are several other very different “hepatitis” viruses that cause the same symptoms but are completely unrelated diseases. Hepatitis A rarely causes long-term liver damage or death. On average, 70 cases of hepatitis A are reported in Indiana each year.
How is it spread?
Hepatitis A virus is passed in the stool, and people become infected by having contact with the stool of an infected person (fecal-oral route). For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.
Persons are at risk for hepatitis A infection if they have:
- Exposure to contaminated food or water:
- Consuming untreated water.
- Consuming food prepared by an infected person.
- Consuming raw produce or raw shellfish (e.g., oysters).
- Traveling to countries where hepatitis A is common and where there is little clean water or proper sewage disposal.
- Exposure to the stool or blood of an infected person, who is a(n):
- Household member or sexual partner (men who have sex with men are at higher risk).
- Child or staff member of a daycare center (including centers for the disabled).
- Resident or staff member of a health care center.
- Injection drug user.
Casual contact, as in the usual workplace or school setting, does not spread the virus. However, most cases of hepatitis A have an unknown exposure, because the time from exposure to the time symptoms begin can be long (range of 15-50 days). Outbreaks have occurred in all of the higher risk settings listed above.
What are the symptoms of hepatitis A?
- Diarrhea
- Nausea
- Vomiting
- Tiredness
- Stomach pain
- Fever
- Dark urine
- Pale, clay-colored stool
- Loss of appetite
- Yellowing of skin and eyeballs (jaundice)
Symptoms usually occur suddenly. People are most contagious from about 2 weeks before symptoms begin until 2 weeks after. Some people, especially children, may have no symptoms but can still spread the virus to others.
Symptoms usually begin 28-30 days (range of 15-50 days) after exposure and usually last less than 2 months. Sometimes a person can recover and become ill again (relapse) for as long as 12 months. However, people will eventually recover, and there is no long-term carrier state with hepatitis A infection. Death from hepatitis A is rare, 0.1-0.3 percent, but is more common in adults over 50.
How do I know if I have hepatitis A?
A person having diarrhea lasting more than 24 hours or having jaundice should consult a health care provider immediately. The health care provider may collect a blood sample to test for hepatitis A.
How is hepatitis A treated?
There is no specific treatment for hepatitis A other than treating symptoms. People who have had hepatitis A develop lifelong immunity and cannot get hepatitis A again.
Hepatitis A can be effectively prevented. Within 2 weeks of exposure to hepatitis A, persons can get hepatitis A immune globulin (Ig). Ig is 80-90 percent effective during the 2-week time frame from exposure and provides protection for about 3 months. Ig is not effective if given more than 2 weeks following exposure. In place of Ig, persons can also get the first dose of hepatitis A vaccine. This 2-dose vaccination series will provide 100 percent lifelong protection once completed.
Is hepatitis A a reportable disease?
Yes. Health care providers and laboratories must immediately report the disease to the local health department (LHD) or the Indiana State Department of Health (ISDH). The LHD will contact all cases diagnosed with hepatitis A, so a possible exposure can be determined to help prevent others from becoming ill.
How can hepatitis A be prevented?
In general, hepatitis A can be prevented by strictly adhering to the following guidelines:
- Vaccination:
- Hepatitis A vaccine is given as 2 doses separated by 6 months. The vaccine should be given according to the Recommended Childhood and Adolescent and Adult Immunization schedules published by the ACIP (Advisory Committee on Immunization Practices).
- Hepatitis A vaccine should be given to persons traveling to a country where the risk of exposure is high.
- Practice good hygiene:
- Thoroughly wash hands with soap and water after using the restroom; after assisting someone with diarrhea and/or vomiting; after swimming; and before, during, and after food preparation (please refer to Quick Facts about Hand Washing).
- Clean food preparation work surfaces, equipment, and utensils with soap and water before, during, and after food preparation.
- Eat safe foods and drink safe water (Remember: Contaminated foods may look and smell normal):
- Wash all produce before eating raw or cooking.
- Use treated water for washing, cooking, and drinking
- Avoid swallowing untreated water.
- Protect others:
- Persons with diarrhea and/or vomiting should not prepare food or provide health care for others and should limit direct contact with others as much as possible.
- Persons with diarrhea and/or vomiting should not attend a daycare facility or school.
- Persons with diarrhea, vomiting, and/or jaundice shall be excluded from employment involving food handling (Indiana Retail Food Establishment Sanitation Requirements, 410 IAC 7-24-122).
- Do not change diapers near recreational water.
- Do not go swimming or use hot tubs if you have diarrhea and for at least two weeks after diarrhea stops.
- Safe travel outside of the United States:
- Drink bottled beverages and water, even when brushing teeth.
- Do not eat uncooked fruits or vegetables unless you peel them yourself.
- Do not eat foods or beverages from street vendors.
- Do not consume local water or ice
Where can I learn more about hepatitis A?
To search Indiana data and statistics:
www.in.gov/isdh/dataandstats/disease/diseases_index.htm
To search the Indiana Food Protection Program:
http://www.in.gov/isdh/regsvcs/foodprot/index.htm
To search disease information:
http://www.cdc.gov/ncidod/diseases/hepatitis/a/index.htm
http://www.cfsan.fda.gov/~mow/chap31.html
To search vaccination and travel:
http://www.cdc.gov/vaccines/vpd-vac/hepa/default.htm
http://wwwn.cdc.gov/travel/
To search for national data, statistics, and outbreaks:
www.cdc.gov/mmwr/
Updated on January 9, 2009
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