What Are The Signs & Symptoms Of Hav Infection
Hepatitis A can be a mild infection, particularly in kids younger than 6, so many people might not ever know that they had an infection.
When symptoms do happen, they typically start 2 to 6 weeks after exposure to the virus and are more likely in adults and kids older than 6. HAV can cause vomiting and diarrhea, as well as fever, loss of appetite, darker than usual urine , jaundice , and abdominal pain.
HAV infections that cause serious symptoms can last for weeks or even months. Some people with HAV can feel ill for up to 6 months.
How Is Hepatitis A Diagnosed
Your healthcare provider will listen to your symptoms and will take a blood test to confirm the diagnosis of hepatitis A. If the test finds immunoglobulin M antibodies, you have an acute hepatitis A. If there are antibodies, but not IgM antibodies, you are immune to the virus either because you had a case of it and recovered, or you got the hepatitis A vaccine.
How Do I Prevent The Spread Of Infection To Others
Sometimes it is not possible to know for a few months if you have acquired an infection after an exposure to blood or body fluids. If you have, you can potentially transmit the infection to others. While you are waiting for your test results, follow these steps to help prevent spreading the infection to others:
- Do not have sex . If you have sex, use a male or female condom every time. For information on preventing STIs, see HealthLinkBC File #08o Preventing Sexually Transmitted Infections .
- Do not donate blood, plasma, organs, breast milk, tissue, or sperm.
- Do not share toothbrushes, dental floss, razors, or other items that may have blood or body fluids on them.
- Cover open cuts and scratches until they heal.
- Carefully throw away anything with blood on it, such as tampons, pads, tissues, dental floss, and bandages. Put sharp items such as used razors or needles into a container and tape shut. Throw away in the garbage do not place in a recycling box.
- Do not share drug snorting, smoking or injection equipment such as needles and syringes, straws and pipes.
Women who are breastfeeding and have been exposed to blood or body fluids should speak with their health care provider to find out if it is recommended that they continue to breastfeed.
If you become pregnant, see your health care provider or call the Oak Tree Clinic at BC Womens Hospital and Health Centre at 604-875-2212 or toll-free in B.C. at 1-888-711-3030.
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Hepatitis A In Australia
In recent years, hepatitis A notifications and hospitalisations have been low and trending down.1An increasing proportion of cases relate to travel to countries where hepatitis A is endemic.12-14
Hepatitis A in Aboriginal and Torres Strait Islander children
The hepatitis A vaccination program was initially established in north Queensland in 1999 for Aboriginal and Torres Strait Islander children aged 18 months.15 In 2005, it expanded to include all Aboriginal and Torres Strait Islander children aged 2 years in:
- the Northern Territory
- South Australia
- Western Australia
Before the vaccination program, rates of hepatitis A in Aboriginal and Torres Strait Islander communities were very high. Factors associated with high rates were poor living conditions, overcrowding and poor sanitation.16 The hepatitis A vaccination program for Aboriginal and Torres Strait Islander children in endemic areas substantially reduced hospitalisations and notifications for this population.17
Many Aboriginal and Torres Strait Islander children > 2 years of age in states and territories targeted by the hepatitis A vaccination program have received hep A vaccine. However, Aboriginal and Torres Strait Islander children remain at greater risk than non-Indigenous children of acquiring hepatitis A.17
History of hepatitis A in Australia
More recently, Hepatitis A outbreaks have been associated with a common food source.17,21,22
Efficacy Of Hepatitis A Vaccines
Randomised controlled trials show that the vaccines have protective efficacy of nearly 100%.28,29 This is supported by the apparent eradication of hepatitis A from Aboriginal and Torres Strait Islander communities in north Queensland and the Northern Territory since the vaccination program started in these regions.15,17,30
A single dose of Hepatitis A vaccine can confer protection for several years. There is evidence to suggest that a single dose of HAV hepatitis A vaccine can be 100% efficacious in preventing hepatitis A infection in seronegative young children in the study period from 6 weeks to 15 months post vaccination.31 Other studies have demonstrated effectiveness of a single dose in preventing hepatitis A infection up to 7 years after vaccination.25,32
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Vaccination Against Hepatitis A
Vaccination against hepatitis A is not routinely offered in the UK because the risk of infection is low for most people.
It’s only recommended for people at an increased risk, including:
- close contacts of someone with hepatitis A
- people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
- people with any type of long-term liver disease
- men who have sex with other men
- people who inject illegal drugs
- people who may be exposed to hepatitis A through their job this includes sewage workers, people who work for organisations where personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas
The hepatitis A vaccine is usually available for free on the NHS for anyone who needs it.
Who Is At Risk
Anyone who has not been vaccinated or previously infected can get infected with the hepatitis A virus. In areas where the virus is widespread , most hepatitis A infections occur during early childhood. Risk factors include:
- poor sanitation
- living in a household with an infected person
- being a sexual partner of someone with acute hepatitis A infection
- use of recreational drugs
- travelling to areas of high endemicity without being immunized.
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Hepatitis A And International Travel
Who should receive protection against hepatitis A virus before travel?
All susceptible people traveling to or working in countries that have high or intermediate HAV endemicity are at increased risk for HAV infection. These travelers should be vaccinated or receive immune globulin before departure . For more information on international travel and hepatitis A, see CDCs travel page or ACIP updated recommendations on Prevention of Hepatitis A after Exposure to Hepatitis A Virus and in International Travelers.
How soon before international travel should the first dose of hepatitis A vaccine be given?
All unvaccinated people 12 months of age planning travel to an area with high or intermediate HAV endemicity should receive a single dose of vaccine as soon as travel is considered they should then complete the vaccine series with the appropriate dose and schedule. People traveling within 2 weeks should receive the initial dose of hepatitis A vaccine before departure and also simultaneously may be administered IG at a separate anatomic injection site for additional short-term protection . The hepatitis A vaccine series should be completed according to the routine schedule. Information on immune globulin dosing and additional information on hepatitis A vaccine and travel is available.
What should be done to protect international travelers < 6 months of age and other travelers unable to receive hepatitis A vaccine?
Who Is At Risk For Hepatitis A
Although anyone can get hepatitis A, you are at higher risk if you
- Travel to developing countries
The symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.
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Reducing The Risk Of Hepatitis A
Protecting yourself from hepatitis A
The most important action you can take to protect yourself against hepatitis A is to get vaccinated.
Practising strict personal hygiene is also essential to reducing the risk of hepatitis A. Steps you can take include:
- Wash your hands with soap and hot running water before handling food, after going to the toilet and after handling used condoms or having contact with nappies or the anal area of another person. Use a clean towel to dry your hands.
- Use barrier protection when engaging in oral-anal sex and avoid sex with someone who is infected with the hepatitis A virus.
- Vaccination may prevent illness if given within 2 weeks of contact with an infectious person.
- Clean bathrooms and toilets often, paying attention to toilet seats, handles, taps and nappy change tables.
- Boil your drinking water if it comes from an untreated source, such as a river.
- If you are travelling overseas, particularly to countries where hepatitis A is widespread, take special care to avoid hepatitis A. Before travelling, talk to your doctor about immunisation for protection.
Protecting others from hepatitis A
If you have hepatitis:
- Wash eating utensils in soapy water, and machine wash linen and towels.
Household contacts and sexual partners of an infectious person may need to be immunised.
All people who have hepatitis A should check with their doctor before returning to work or school.
Protecting yourself from hepatitis A when overseas
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 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.
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When Will Symptoms Appear After You Have Been Exposed To Hav
It generally takes about 4 weeks for symptoms to appear, but they can start at 2 weeks or they can start up to 8 weeks after you have been exposed. You probably wont get every symptom immediately, but they tend to emerge over days.
Also, you can have no symptoms and have the virus and be contagious. Children especially may be free of symptoms despite being infected.
How Is Hepatitis A Transmitted
HAV is highly contagious. It is spread primarily when a person ingests the virus from food, drinks, or objects that have been contaminated by small amounts of stool from an infected person sex with an infected person, particularly if it involves anal-oral contact and through injection drug use. In crowded, unsanitary conditions, HAV can be spread quickly and cause outbreaks by exposure to contaminated water or food .
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I Think I Have Been Exposed To Hepatitis A What Should I Do
If you have any questions about potential exposure to hepatitis A, call your health professional or your local or state health department. If you were recently exposed to hepatitis A virus and have not been vaccinated against hepatitis A, you might benefit from an injection of either immune globulin or hepatitis A vaccine. However, the vaccine or immune globulin are only effective if given within the first 2 weeks after exposure. A health professional can decide what is best based on your age and overall health.
How Do Doctors Treat Hepatitis A
Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.
Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicinesany of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.
See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.
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How Is Hepatitis A Infection Prevented
- The hepatitis A vaccine offers excellent protection against HAV. The vaccine is safe and highly effective. Vaccination consists of 2 doses of vaccine spaced 6-12 months apart. Protection starts 1-2 weeks after the first dose of vaccine, and lasts for 20 years to life after 2 doses.
- The American Academy of Pediatrics recommends that all children should receive hepatitis A vaccine starting at 1 year of age .
- The CDC recommends hepatitis A vaccine for all persons traveling to countries where HAV is common . For infants that will be traveling internationally, an early dose of Hepatitis A vaccine can be given at age 6-11 months.
- People who have hepatitis A infection become immune to HAV for the rest of their lives once they recover. They cannot get hepatitis A twice.
- The blood test for immunity to hepatitis A is called the Hepatitis A Total Antibody test. People who have had hepatitis A and those who have received hepatitis A vaccine show positive antibodies to hepatitis A on this test for the rest of their life.
- Good personal hygiene and proper sanitation help prevent the spread of the HAV virus. Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing, serving, or eating food.
- Alcohol-based hand sanitizers do not kill the hepatitis A virus
After Exposure to HAV
Contact With Blood Or Body Fluids: Protecting Against Infection
Blood and body fluids, such as saliva, semen and vaginal fluid, can contain viruses that can be passed on to other people. If you have contact with a persons blood or body fluids you could be at risk of HIV, hepatitis B or hepatitis C, or other blood borne illnesses. Body fluids, such as sweat, tears, vomit or urine may contain and pass on these viruses when blood is present in the fluid, but the risk is low.
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What Will Happen At The Emergency Department
You will be asked to give informed consent in order for your blood to be tested for HIV, hepatitis B and C. Your treatment will be determined based on the type of exposure to blood or body fluids and your test results. The health care provider may also try to determine whether the persons blood or body fluid with which you had contact may be infectious for HIV, hepatitis B and C.
In case of possible exposure to HIV, the health care provider may start you on a course of antiviral medications without waiting for test results. These medications should be started as soon as possible, and are most effective if started within 2 hours of exposure. You will be referred to your own health care provider if you need to continue taking these medications for 1 full month.
To help protect you from hepatitis B disease, you may be given a hepatitis B vaccine and hepatitis B immune globulin. Hepatitis B immune globulin contains antibodies that provide immediate but short-term protection against hepatitis B virus. The hepatitis B vaccine provides long lasting protection by helping your body make its own antibodies against the virus.
There is no vaccine to prevent infection with hepatitis C. Blood tests will show if you were exposed to hepatitis C or have acquired the virus.
If you have a serious cut or wound you may need to get the tetanus vaccine depending upon the type of wound and your immunization history.
How Is Hepatitis A Spread
The hepatitis A virus is usually spread by putting something in your mouth that is contaminated with the virus. The virus is found in the stool of people with hepatitis A and is spread when someone’s stool accidentally contaminates food or water. This can happen when an infected person does not adequately wash their hands after using the bathroom then touches other things such as food. When other people eat that food, they can get infected with hepatitis A. Usually the transmission is between people in very close personal contact.
Foods themselves can be contaminated with hepatitis A virus, such as raw oysters harvested from sewage-contaminated water. When people eat food contaminated with hepatitis A virus, they can get infected with the virus.
Hepatitis A is usually spread through:
- household contact with an infected person
- sexual contact with an infected person
- eating or drinking contaminated food or water
- sharing eating utensils that are contaminated
- touching contaminated surfaces and then placing your hands near or in the mouth
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More About Hepatitis A
Hepatitis A virus infection can cause a mild illness lasting a few weeks to a severe illness lasting several months. People with liver disease, including chronic hepatitis B or C infection, are at greater risk of developing severe disease as a result of hepatitis A infection. People over 50 years old are also at greater risk of developing severe disease. Unlike hepatitis B and C, hepatitis A does not cause a chronic infection.
Who Should Get Vaccinated Against Hepatitis A
The Advisory Committee on Immunization Practices recommends hepatitis A vaccination for the following people:
- All children at age 1 year
- Travelers to countries where hepatitis A is common
- Family and caregivers of adoptees from countries where hepatitis A is common
- Men who have sexual encounters with other men
- Users of recreational drugs, whether injected or not
- People with chronic or long-term liver disease, including hepatitis B or hepatitis C
- People with clotting-factor disorders
- People with direct contact with others who have hepatitis A
- Any person wishing to obtain immunity
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