What is the best way to prevent the spread of hepatitis A?

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause liver inflammation and affect your liver's ability to function.

You're most likely to get hepatitis A from contaminated food or water or from close contact with a person or object that's infected. Mild cases of hepatitis A don't require treatment. Most people who are infected recover completely with no permanent liver damage.

Practicing good hygiene, including washing hands frequently, can prevent the spread of the virus. The hepatitis A vaccine can protect against hepatitis A.

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Hepatitis A symptoms typically appear a few weeks after you've had the virus. But not everyone with hepatitis A develops symptoms. If you do, symptoms can include:

  • Unusual tiredness and weakness
  • Sudden nausea and vomiting and diarrhea
  • Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs, which is over your liver
  • Clay- or gray-colored stool
  • Loss of appetite
  • Low-grade fever
  • Dark urine
  • Joint pain
  • Yellowing of the skin and the whites of your eyes (jaundice)
  • Intense itching

These symptoms may be relatively mild and go away in a few weeks. Sometimes, however, hepatitis A results in a severe illness that lasts several months.

When to see a doctor

Make an appointment with your health care provider if you have symptoms of hepatitis A.

Getting the hepatitis A vaccine or an injection of an antibody called immunoglobulin within two weeks of exposure to the hepatitis A virus may protect you from infection.

Ask your health care provider or your local health department about receiving the hepatitis A vaccine if:

  • You traveled recently to areas where the virus is common, particularly Mexico, Central America and South America or to areas with poor sanitation
  • You ate at a restaurant with a hepatitis A outbreak
  • You live with someone who has hepatitis A
  • You recently had sexual contact with someone who has hepatitis A

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Hepatitis A is a highly contagious disease that attacks the liver. It is the most common type of hepatitis reported in the United States.

Who gets hepatitis A?

Anyone can get hepatitis A, but certain persons are at increased risk of infection, including:

  • Children and adults living in areas with increased rates of hepatitis (i.e., certain Western states in the U.S.)
  • Persons traveling to countries where hepatitis A is common (i.e., Central and South America, Africa, the Middle East, Asia and the Western Pacific)
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Sexual contacts of infected persons
  • Household contacts of infected persons

How is the virus spread?

Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called the "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.

Most infections in the United States result from contact with a household member or sex partner who has hepatitis A.Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person. Waterborne outbreaks are infrequent and are usually associated with sewage-contaminated or inadequately treated water. Casual contact, as in the office, factory or school setting, does not spread the virus.

What are the symptoms of hepatitis A?

The symptoms of hepatitis A may include an abrupt onset of fever, malaise, loss of appetite, nausea, stomach pain, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). The disease is rarely fatal and most people recover in a few weeks without any complications. Adults have signs and symptoms of illness more often than children. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

How soon do symptoms appear?

The symptoms commonly appear within 28 days of exposure, with a range of 15-50 days.

For how long is an infected person able to spread the virus?

The contagious period begins one to two weeks before symptoms appear, and is minimal about one week after the onset of jaundice. Food workers should be excluded from work for at least two weeks after the onset of clinical symptoms of hepatitis A. If jaundiced, food workers should not return to work for at least one week after onset of jaundice.

Does past infection with hepatitis A make a person immune?

Once an individual recovers from hepatitis A, he or she cannot be re-infected. He or she is immune for life and does not continue to carry the virus.

What is the treatment for hepatitis A?

There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear.

How can hepatitis A be prevented?

To prevent person-to-person spread, careful hand washing after using the bathroom, changing diapers and before preparing or eating food, is the single most important means of prevention.

Foodborne hepatitis A outbreaks are relatively uncommon in the United States; however, when they occur, intensive public health efforts are required for their control. To prevent the spread of hepatitis A from an infected food worker to co-workers and/or restaurant patrons, food workers should never touch ready-to-eat foods with bare hands, and should carefully wash their hands after using the bathroom, even if the food worker does not feel sick. Food workers should never work while they are sick with stomach (gastrointestinal) illnesses.

Immune globulin shots are effective in preventing the spread of hepatitis A if given within 14 days of exposure. Immune globulin may be recommended for co-workers of infected food workers. Under certain circumstances, particularly when recommended food safety procedures are not followed by food workers, public health officials may recommend that restaurant patrons receive immune globulin.

For long-term protection, hepatitis A vaccine is the best method of prevention.

Who should obtain the hepatitis A vaccine?

Hepatitis A vaccine is recommended for the following persons:

  • Travelers to areas with increased rates of hepatitis A
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Persons with clotting-factor disorders (e.g., hemophilia)
  • Persons with chronic liver disease (including persons with chronic hepatitis B or chronic hepatitis C virus infection)
  • All children aged 12-23 months; children not fully vaccinated by age two

The hepatitis A vaccine may also be used in certain outbreak situations where ongoing transmission is occurring. Although studies of certain occupational groups (for example, food service workers, health care workers, child care workers, sewerage workers) have not shown an increased risk, such people may consider vaccination if they wish to further reduce their risk or are in communities where ongoing outbreaks are occurring.

Why isn't hepatitis A vaccine required for food service workers?

While food service employers can offer hepatitis A vaccine to their employees if they wish, most public health authorities prefer not to make it mandatory for the following reasons:

  • There is no evidence that food service workers are at any greater risk of acquiring hepatitis A than are people in other occupations.
  • Only 2-3 percent of all hepatitis A cases are acquired through restaurant food.
  • Employee turnover in some segments of the food service industry is high, making it impractical to vaccinate staff.
  • Emphasis on careful hand washing, use of disposable gloves and not working when ill are measures that can greatly minimize the risk of spreading hepatitis A and a number of other infections.
  • Hepatitis A vaccine would be strongly recommended for food service workers in a county or region where a community-wide outbreak has been recognized.

What about the vaccine?

Currently, there are two hepatitis A vaccines on the market. Both vaccines are safe and highly effective. Two doses given at least six months apart, are recommended. Approximately 99-100 percent of persons vaccinated with hepatitis A vaccine will develop long-lasting immunity.

Where can I obtain more information?

People interested in receiving the vaccine should contact their health care provider or employer. For general information, please call your local health department.

How can you prevent hepatitis A naturally?

To avoid catching the hepatitis A virus, stay away from undercooked or raw shellfish, especially in areas where the sanitation is “fishy.” And if you are traveling to an area that has a history of hepatitis A outbreaks, avoid drinking the tap water and use bottled water instead.

How is hepatitis A most commonly spread?

Hepatitis A is very contagious. It is spread when someone unknowingly ingests the virus — even in microscopic amounts — through close personal contact with an infected person or through eating contaminated food or drink.