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Indiana State Department of Health

ISDH Home > About the Agency > Schools Communicable Disease Guide > Hepatitis A Infection Hepatitis A Infection


Clinical Description
Hepatitis A is a disease of the liver that results from infection with the Hepatitis A virus. Symptoms can include diarrhea, nausea, vomiting, fatigue, stomach cramps, fever, dark urine, pale, clay-colored stool, loss of appetite, and jaundice. 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. Some people, especially children, may have no symptoms but can still spread the virus to others.

Incubation Period
Symptoms usually occur suddenly. Symptoms usually begin 28-30 days (range of 15-50 days) after exposure and usually last less than 2 months.    

Mode of Transmission
Hepatitis A is transmitted by the fecal-oral route.

Period of Communicability
A person can spread Hepatitis A 14 days before and 7 days after the onset of jaundice, or if jaundice does not occur, 7 days before and 14 days after the onset of symptoms.  

Exclusion/Attendance
Persons diagnosed with Hepatitis A or symptomatic persons linked by person, place, or time to a confirmed case are excluded from attending school during the infectious period until:

•14 days before or 7 days after onset of jaundice
•7 days before and 14 days after symptom onset (if no jaundice)
•Case prevention education provided by local health department

For more information, please see the Communicable Disease Reporting Rule 410 IAC 1-2.3 Sec. 72 http://www.in.gov/isdh/files/comm_dis_rule.pdf.

Prevention/Care
Persons recommended for prophylaxis are household and sexual and contacts exposed to food prepared by the case. Passive immunization with immunoglobulin (IG) can be given within 2 weeks of exposure for household, daycare, sexual, and food handler contacts. In place IG, persons can also get the first dose of the Hepatitis A vaccine. If IG is not available, persons can also receive the first dose of the Hepatitis A vaccine.

•Encourage frequent hand washing, particularly after using the restroom, assisting someone with diarrhea and/or vomiting, after swimming, and before and after food preparation (please refer to the ISDH Quick Facts about Hand Washing)
•A vaccine is available to prevent Hepatitis A infection in individuals >1 year of age.  The vaccine is 100% effective after two doses. 

Other Resources
Indiana State Department of Health Quick Fact Link:
http://www.in.gov/isdh/21931.htm 

Centers for Disease Control and Prevention (CDC) Link:
http://www.cdc.gov/Hepatitis/ChooseA.htm