Hepatitis A

What is Hepatitis A?

Hepatitis A is an infection affecting the liver caused by hepatitis A virus (HAV). The incubation period ranges from 15–50 days and is usually 14 to 28 days. Typical signs and symptoms of hepatitis A include fever, malaise, abdominal discomfort, loss of appetite, nausea, diarrhoea and jaundice (yellow discoloration of skin and sclera of the eyes).

Some people with hepatitis A infection may not have any signs and symptoms of the disease. Adults are more likely to have signs and symptoms than children. Recovery from symptoms following infection may take several weeks or months. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause fulminant hepatitis (acute liver failure), which is associated with high fatality rates.

How does it spread?

HAV is transmitted primarily by the faecal-oral route, that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. The virus can also be transmitted through close physical and sexual contact with an infectious person, and is not limited to anal-oral contact. Hepatitis A outbreaks among men who have sex with men have been reported. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water.

How can you prevent it?

Travellers can protect themselves by observing good personal hygiene and food hygiene. They should always wash their hands before eating or handling food, and after going to the toilet. They should avoid drinking contaminated water or beverage with ice of doubtful origin, eating uncooked or undercooked food, particularly shellfish, and eating cut or peeled fruits.

Safer sexual practice and strict personal hygiene to avoid direct and indirect faecal-oral contact are keys to preventing hepatitis A via sexual transmission.

Hepatitis A vaccine is available and is highly effective in preventing hepatitis A infection. Persons who are at increased risk for acquiring hepatitis A and persons with increased risk for severe adverse consequences should discuss with their doctors about hepatitis A vaccination for personal protection. According to the Scientific Committee on Vaccine Preventable Diseases, Centre for Health Protection, the following groups are recommended to have hepatitis A vaccination:

• Travellers to endemic areas of hepatitis A
• Persons with clotting factors disorders receiving plasma-derived replacement clotting factors
• Persons with chronic liver diseases
• Men who have sex with men

It is used in persons one year of age or older. The first dose of Hepatitis A vaccine shall be administrated at least 2 weeks before departure.

How is it treated?

There is no specific treatment for hepatitis A. Therapy is aimed at relieving discomfort and maintaining adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.