What Is Hepatitis A
Hepatitis A is a contagious liver infection caused by the hepatitis A virus . In the USA, hepatitis A infections have declined by 90% since the hepatitis A vaccine first became available in 1995. Still, there are cases of hepatitis A reported to the San Francisco Department of Public Health every year among San Francisco residents. Hepatitis A is still common in Latin America, Africa, the Middle East, Asia, and eastern Europe.
How Is Hep A Different From Other Types Of Hepatitis
Hep A, B and C are caused by three different viruses. They cause similar symptoms but have different modes of transmission and can affect the liver differently. Hep A is usually a short-term infection and does not become chronic. Hep B and C can remain in the body in some people and result in long-term liver problems. There are vaccines against hep A and B but no vaccine against hep C.
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Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.
All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.
Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.
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How Do People Get Hepatitis A
Hepatitis A virus is found in the stool of people with HAV infection. It enters the body through the mouth after someone handles something contaminated with HAV, or eats or drinks something contaminated with HAV.
People usually get hepatitis A by having close contact with a person who is infected, from food or drinks prepared by someone who is infected, or by eating shellfish harvested from sewage-contaminated water. After the virus enters the body, there is an incubation period lasting 2 to 7 weeks until illness begins.
Are There Any Possible Complications
Serious illness is rare with hepatitis A infection. The illness can be unpleasant and make you feel quite ill however, most people make a full recovery. In a small number of cases, the infection can cause severe liver inflammation leading to liver failure. This is more common in older people who develop this infection. An extremely small number of people die from severe hepatitis A infection. A liver transplant can be life-saving if liver failure develops.
Somewhere between 1 to 2 in 10 people who get hepatitis A infection will seem to recover but will then have a return of their symptoms between about one and three months after their original illness. This is because the infection hadn’t cleared completely. This relapse will have similar symptoms to the initial illness. Some people can have a relapse of their symptoms more than once.
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Who Should Not Receive Hepatitis A Vaccine
There are a very few situations where the hepatitis A vaccine is not recommended. They include:
- If you have an illness causing a high temperature. In this situation, it is best to postpone vaccination until after you have fully recovered from the illness.
- If you have had an allergic reaction to the vaccine or to any of its components in the past.
- One type of vaccine should not be given to anyone who is known to be allergic to eggs.
- Children under the age of 1 year. However, the risk of hepatitis A in children under the age of 1 year is very low. The hepatitis A vaccine is not licensed for this age group.
The vaccine may be given if you are pregnant or breastfeeding and vaccination against hepatitis A is thought to be necessary.
Can You Get Hepatitis C More Than Once
Hepatitis C is a chronic condition which is lifelong. There are very few cases where a person’s immune system is able to fight off the virus by itself. However, there are treatments available which may slow or kill the disease, although they are not generally tolerated very well.Since you asked if you can get it more than once, you may be thinking of Hepatitis A. Hep A is an acute liver disease, unlike B and C. Most people develop immunity to Hep A once they fight off the virus, so they never get it again.
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Are There Complications From Hepatitis A
In extremely rare cases, hepatitis A can lead to acute liver failure. This complication is most common in older adults and people who already have chronic liver disease. If this occurs, you will be hospitalized. Even in cases of liver failure, a full recovery is likely. Very rarely is a liver transplant required.
What Are The Symptoms Of Hepatitis A And B
Not all infected adults will experience symptoms. That means you could contract hepatitis A or B, and spread the viruses to others, without realizing it.
Symptoms of hepatitis A may include*:
Fever
Jaundice
Loss of appetite
Dark urine
Fatigue
* TWINRIX is not indicated to treat the symptoms of, or reduce serious consequences associated with hepatitis A and B.
Possible consequences of hepatitis A.*Hepatitis A infection can have mild to severe consequences on infected individuals that can last from a few weeks to several months.
Chronic hepatitis and carrier states are not linked with hepatitis A infection.
However, relapsing hepatitis, a condition where a person gets worse again after a period of improvement, can last up to a year in 15% of cases.
While most infected people recover, the older you are, the more severe hepatitis A can be.
Approximately 25% of infected adults are hospitalized.
The overall case fatality rate, which is the proportion of deaths among the number of hepatitis A cases, is approximately 0.5%, but can reach 2.6% in adults over 60 years of age.
* TWINRIX is not indicated to treat the symptoms of, or reduce serious consequences associated with hepatitis A and B.
Symptoms of hepatitis B may include*:
Fatigue
Jaundice
Loss of appetite
Dark urine
Clay-coloured stool
* TWINRIX is not indicated to treat the symptoms of, or reduce serious consequences associated with hepatitis A and B.
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How Is Hepatitis A Treated
There is no formal treatment for hepatitis A. Because its a short-term viral infection that goes away on its own, treatment is typically focused on reducing your symptoms.
After a few weeks of rest, the symptoms of hepatitis A usually begin to improve. To ease your symptoms, you should:
- avoid alcohol
How Do You Get Hepatitis C
Just like hepatitis B, you can get this type by sharing needles or having contact with infected blood. You can also catch it by having sex with somebody who’s infected, but that’s less common.
If you had a blood transfusion before new screening rules were put in place in 1992, you are at risk for hepatitis C. If not, the blood used in transfusions today is safe. It gets checked beforehand to make sure it’s free of the virus that causes hepatitis B and C.
It’s rare, but if you’re pregnant and have the disease, it’s possible to pass it to your newborn.
There are some myths out there about how you get hepatitis C, so let’s set the record straight. It’s not spread by food and water . And you canât spread it by doing any of these things:
- Joint pain
See your doctor as soon as possible if you have any of these symptoms.
Sometimes, people have no symptoms. To be sure you have hepatitis, youâll need to get tested.
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Risk Factors For Reinfection
Even if youre cured, or have entered SVR from previous hepatitis C treatment, this doesnt mean youre immune to new infections in the future. Antivirals help get rid of existing HCV infections only. Unlike some other types of viruses, having hepatitis C in the past doesnt mean youre then immune to HCV for the rest of your life.
You may be at an increased risk of contracting HCV if you:
- were born between 1945 and 1965
- received a blood transfusion or an organ transplant before 1992
- were born to a mother with hepatitis C
- have HIV
- work in a healthcare setting where you may be exposed to others blood
- have a history of imprisonment
- have used, or are currently using, illicit drugs
Currently, theres no vaccine available for hepatitis C. The only way you can avoid contracting HCV is through preventive measures.
You can help prevent new hepatitis C infections by avoiding the following:
- having sex without a condom or other barrier method
- sharing needles and syringes
- getting homemade tattoos or piercings
- sharing razors and toothbrushes
- needlestick injuries at doctors offices and hospitals
HCV can cause some symptoms. But most cases of hepatitis C arent detectable until the infection reaches an advanced stage and starts affecting the liver.
It can take 4 to 10 weeks for an HCV antibody test to become positive after your initial exposure. This means you could unknowingly transmit HCV to others before youre aware of your own infection.
Who Should Not Get The Vaccine After Being Exposed To Hepatitis A In A Setting Such As A Restaurant
- Individuals who have had hepatitis A infection before or received 2 shots of the hepatitis A vaccine
- Individuals who have had a severe reaction to the hepatitis A vaccine or another vaccine in the past
- Individuals who are allergic to neomycin
- Infants less than 12 months of age
- Pregnant women
Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. People with a mild illness can usually get the vaccine.
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Who Should Be Immunised Against Hepatitis A
Travellers to countries outside Western Europe, North America and Australasia should consider being immunised. The highest-risk areas include the Indian subcontinent , Africa, parts of the Far East , South and Central America and the Middle East. Vaccination is generally recommended for anyone over the age of 1 year. Your doctor or practice nurse can advise if you should be immunised against hepatitis A for your travel destination.
You can find out if immunisation against hepatitis A is recommended for any countries you are planning to visit from the NHS website Fitfortravel.
Close contacts of someone with hepatitis A. Occasional outbreaks of hepatitis A occur in the UK within families or in institutions. Close contacts of someone found to have hepatitis A infection may be offered vaccination. This only happens rarely. The most important measure for anybody with hepatitis A is good personal hygiene. In particular, washing hands after going to the toilet or before eating.
People with chronic liver disease. If you have a persistent liver disease it is suggested that you have the hepatitis A vaccine. Hepatitis A infection is not more common in those with chronic liver disease but, if infection does occur, it can cause a more serious illness.
People exposed to hepatitis A at work. For example, laboratory workers who are exposed to hepatitis A during their work and sewage workers are advised to be immunised against hepatitis A.
How Do You Get Hepatitis A And How Common Is It
Hepatitis A can affect anyone. The virus is passed out in the stools of infected people. In areas of poor sanitation, or where disposal of sewage is poor, hepatitis A can become common due to dirty water and food. This means you may become infected with hepatitis A by eating uncooked food prepared or washed in contaminated water, or by drinking contaminated water. Shellfish caught in contaminated water can also carry the hepatitis A virus. Someone who has hepatitis A infection may pass on the infection to others. This can occur through preparing food, or through close contact with another person, if they have not washed their hands properly after going to the toilet.
The highest-risk areas of the world for hepatitis A infection include: the Indian subcontinent , Africa, parts of the Far East , South and Central America and the Middle East.
Hepatitis A has become uncommon in parts of the world where sanitation is generally good, such as the UK and Western Europe. Most cases of hepatitis A infection in the UK are diagnosed in people returning home after travelling to a country where sanitation is poor and risk of hepatitis A infection is higher. Outbreaks in schools and families can sometimes occur in the UK, as the virus is quite easily passed on from person to person if personal hygiene is not good. For example, the virus may be passed on if infected people do not wash their hands after going to the toilet.
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How Contagious Is Hepatitis A
Casual contacts fellow classmates or work associates, for example are generally not at risk. Because close personal contact in classroomsor offices is unlikely and because older children and adults typically practicegood hygiene, the likelihood that hepatitis A will be transmitted in thesesettings is reduced. However, hepatitis A can be transmitted in child day-caresettings, especially if good hygiene is not practiced after changing diapers.It also is due to the close personal contact among children, who are stilllearning to practice proper hygiene.
The contagious period begins about two weeks before symptoms appear andcontinues up to one week after the onset of jaundice . Because of the delay in symptoms, a person cantransmit the virus without realizing it.
In Illinois, the incidence of hepatitis A has declined since 1990, when1,726 cases were recorded, to 112 cases in 2008.
Looking After Yourself When You Have Hepatitis A
AlcoholSome people with acute hepatitis develop an aversion to alcohol in the acute phase. Previously people with this condition were told to avoid alcohol for six months following the illness. This advice is no longer thought necessary.
SmokingSmoking is dangerous to everyones health. Smoking can increase the severity of liver damage. People with liver disease are more vulnerable to infection and to poor health overall, so smoking or exposure to passive smoking is not advisable.
DietIf you have a short-term hepatitis infection, for example hepatitis A, you should try to eat a normal diet. However, some people may need extra nutrition to prevent unplanned weight loss, and may benefit from a high-energy and high-protein diet. A dietitian can advise on this.
If you develop nausea and vomiting, our coping with eating difficulties may help. Read more here.
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Can You Get Hepatitis More Than Once
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Vaccine For Hepatitis B
Hepatitis B Vaccine
It takes only a few shots to protect yourself and your loved ones against hepatitis B for a lifetime.
The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. The hepatitis B vaccine is also recommended for adults living with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease.
The hepatitis B vaccine is also known as the first anti-cancer vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.
You cannot get hepatitis B from the vaccine. All hepatitis B vaccines that have been used since 1986 are made synthetically meaning the hepatitis B vaccines do not contain any blood products. Learn more.
If you have a current HBV infection or have recovered from a past HBV infection, the hepatitis B vaccine series will not benefit you or clear the virus. However, the vaccine can provide a lifetime of protection for loved ones who do not have hepatitis B and get the vaccine as soon as possible. Testing is the only way to know if you or your loved ones have a current infection or have recovered from a past infection.
Hepatitis B Vaccine Recommendations
Three-Dose Hepatitis B Vaccine Schedule
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Hepatitis A: Caused By The Hepatitis A Virus
How is it spread?
HAV is found in the stool of HAV-infected persons. HAV 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 can happen when people dont wash their hands after using the toilet and then touch other peoples food.
Who is at risk?
- Household contacts of infected persons
- Sex partners of infected persons
- Persons, especially children, living in regions of the U.S. with consistently elevated rates of hepatitis A
- Persons traveling to countries where hepatitis A is common
- Men who have sex with men
- Infecting and non-injecting drug users
What if you are infected?
Viral hepatitis symptoms are similar no matter which type of hepatitis a person has. If symptoms occur, the individual may experience any or all of the following: jaundice, fever, loss of appetite, fatigue, dark urine, joint pain, abdominal pain, diarrhea, nausea, and vomiting. Very rarely, a new case of viral hepatitis can cause liver failure and death. Sometimes in these instances a liver transplant can save a life. Note: Symptoms are less common in children than adults, and people who have HCV infection are less likely to experience symptoms.
Incubation period: 15 to 50 days. There is no chronic infection. Once you have had hepatitis A, you cannot get it again. About 15% of people infected with HAV will have prolonged illness or relapsing symptoms over a 6-9 month period.
What treatment helps?