How Does It Spread
Hepatitis A is spread when a person ingests faecal matter from an infected person. This can occur through person-to-person contact , or consumption of contaminated food and water.
Hepatitis A is quite an infectious virus. Only microscopic amounts of poo are needed to infect people and cause symptoms. People living in the same house with a person with hepatitis A have an increased risk of acquiring hepatitis A unless receiving preventive interventions.
The virus can survive on hands and other surfaces such as cooking utensils and plates for hours. So its important to ensure that infected people properly wash their hands after using the toilet, and completely avoid handling food.
Hepatitis A infections occur infrequently in Australia, with the number of cases detected dropping profoundly in the last 20 years. Most infections are in people who have travelled in countries where hepatitis A transmission is common due to poor sanitation and lack of access to safe water.
When outbreaks occur, they are due to contaminated foods, as we saw with the frozen pomegranate seeds, or person-to-person transmission. This is the case for the current outbreak in Victoria, which has predominantly been spread between sexual partners, although other routes of transmission have also occurred.
How Do I Avoid Getting Sick
These tips will help protect you and your family from Hepatitis A:
- Wash your hands after using the washroom and changing diapers, and before preparing or eating food.
- When travelling, especially to developing countries:
- drink water from a safe supply
- avoid ice cubes in drinks
- eat only freshly cooked food
- avoid non-peelable raw fruit or vegetables
Also, these safe food practices will reduce your risk of contracting Hepatitis A and other foodborne illnesses.
Who Is At Risk For Infection
Anyone who is not immune to hepatitis A can get hepatitis A infection. Food-borne outbreaks occur sporadically throughout the USA. Certain groups of people do have a higher risk of developing HAV infection and should be vaccinated:
- Persons experiencing homelessness
- People who eat raw or under-cooked shellfish
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How Hepatitis A Spreads
HAV infection is a fecal-oral disease. This means the virus is transmitted via somethingoften food or water that has been contaminated with fecal matter from an infected person.
Chefs, cooks, line prep workers, and other restaurant workers with HAV infection who do not thoroughly wash their hands and put on fresh disposable gloves after using the bathroom can easily pass the virus onto food, dishes, utensils, and other surfaces touched and ingested by patrons.
The hepatitis A virus is especially infectious because it can live for up to four hours on fingers and hands and for several days in water.
Can You Get Hepatitis From Raw Beef
There were 269 cases of hepatitis A we registered. The consumption of raw beef is recommended. The percentage difference between the two is 0% 95% CI 2. 1-120. The most likely way to get sick was by drinking alcohol . One month before the outbreak began, a food handler at an epidemiologically linked meat distribution plant contracted hepatitis A.
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How Does Hepatitis A Spread
Hepatitis A is a communicable disease that is acquired primarily by the fecal oral route either from person to person or through contaminated food or water.
Food-related outbreaks are most commonly associated with contamination of food during preparation by an HAV-infected food handler. The food handler may not recognize they are contagious or ill because the peak time of infectivitythat is, when the most virus is present in the stool of an infected individualoccurs during the two weeks before symptoms begin.
Figure 1. Hepatitis A outbreaks associated with shellfish, worldwide, from 1956 to 2016.
Fresh produce contaminated during cultivation, harvesting, processing, and distribution has also been a source of hepatitis A infections. In 1997, frozen strawberries were the source of a hepatitis A outbreak in five states and, in 2016, were the source of a hepatitis A outbreak in nine states. In 2003, fresh green onions were identified as the source of a hepatitis A outbreak traced to consumption of food at a Pennsylvania restaurant. Other produce, such as blueberries, lettuce, blackberries, and pomegranate seeds, has been associated with hepatitis A outbreaks in the U.S. as well as in other developed countries.
Figure 2. Hepatitis A outbreaks associated with fresh, frozen, and minimally processed produce, worldwide, from 1983 to 2016.
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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.
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Pregnancy And Hepatitis A Immunisation
Hepatitis A immunisation is not usually recommended for women who are pregnant although vaccination might be recommended in some situations.
Speak with your doctor if you are not immune to hepatitis A and you are at increased risk of infection or if you have a pre-existing medical condition such as liver disease.
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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Why It Is Done
Hepatitis virus testing is done to:
- Identify the type of hepatitis virus causing the infection.
- Screen people who have a higher chance of getting or spreading hepatitis A. This includes doctors, dentists, and nurses.
- Screen blood donors and donor organs. This is done to help prevent the spread of hepatitis A.
- Find out if a person has antibodies after getting a hepatitis A vaccination. Having antibodies means the vaccine worked.
- Find out if hepatitis A is the cause of abnormal liver function tests.
What Are The Treatments For Hepatitis A
If you have not had the vaccine, and your infection has been confirmed by a blood sample, your healthcare provider might give you the hepatitis A vaccine or immune globulin . This only works if the medicine is given within two weeks of you being exposed to HAV.
If you were exposed and are unable to get the vaccine or the immune globulin, you are likely to recover without treatment. However, your healthcare provider will probably recommend that you follow the following self-care recommendations:
- Get plenty of rest.
- Eat a healthy diet.
- Avoid alcohol.
- Review any type of medicineprescription and over-the-counterthat you take with your healthcare provider. Even things like supplements or vitamins could cause damage to your liver.
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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
Who Should Get The Hepatitis A Vaccine
The Advisory Committee on Immunization Practices recommends that all children in the U.S. get vaccinated against hepatitis A at age 12 months. However, if an infant aged 6-11 months will be traveling to a country with a significant number of people with hepatitis A, the child should get one dose before leaving the U.S. The child should then get 2 doses separated by 6 to 18 months when the child is between 12 months and 23 months.
You should also get the hepatitis A vaccine if you fall into one of the following groups:
- Men who have sexual contact with other men.
- Users of any type of illegal drugs.
- People with blood clot disorders, such as hemophilia.
- People who have chronic liver disease.
- Homeless people.
- People who will be closely involved with a person being adopted from a country with high rates of hepatitis A infections.
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Hepatitis A Immunisation Is Recommended For High
In Victoria, the vaccine is recommended for:
- people travelling to places where hepatitis A is common
- people whose work puts them at increased risk of infection including:
- plumbers and sewage workers
- people who work with children
- people who work with people with developmental disabilities
Remember that immunisation against hepatitis A does not protect you against hepatitis B or hepatitis C.
How Is Hepatitis A Treated
Unlike other types of viral hepatitis, hepatitis A rarely causes long-term liver damage and doesn’t become a long-term illness. There isnt a specific treatment for hepatitis A, and most people will recover fully within one to two months. Usually, symptoms are managed at home with plenty of rest and painkillers and/or medication to help with itchiness, nausea or vomiting may be prescribed.
Occasionally hepatitis A can last longer and, in rare cases, it can be life-threatening if it causes the liver to stop working properly .
Whether youve got symptoms or not, dont prepare food for others or have sex until a healthcare professional tells you that youre no longer infectious.
Once youve recovered from hepatitis A youre immune this means you cant get it again. But you can get other types of hepatitis.
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Immunizing Agents Available For Use In Canada
Hepatitis A-containing vaccines
- AVAXIM® and AVAXIM®-Pediatric , Sanofi Pasteur SA , Sanofi Pasteur Ltd.
- HAVRIX®1440 and HAVRIX®720 Junior , GlaxoSmithKline Inc.
- TWINRIX® and TWINRIX®Junior , GlaxoSmithKline Inc. Refer to Hepatitis B Vaccine in Part 4 for additional information about HAHB vaccine.
- VAQTA® , Merck Canada Inc.
- ViVAXIM® , Sanofi Pasteur Ltd.
Human immunoglobulin
- GamaSTAN® , Grifols Therapeutics LLC.
Standard human immunoglobulin is a sterile, concentrated solution for intramuscular injection containing 15% to 18% immunoglobulin. It is obtained from pooled human plasma from screened donors and contains mainly IgG with small amounts of IgA and IgM. For complete prescribing information, consult the product leaflet or information contained within the product monograph available through Health Canada’s Drug product database.
Refer to Contents in Immunizing Agents Available for Use in Canada in Part 1 for lists of vaccines and passive immunizing agents available for use in Canada and their contents.
What To Do If You Get Food Poisoning From A Restaurant
First, it may not have been what you ate last night. Many of the most common foodborne illnesses have incubation periods that can be hours, days or even several weeks.
Incubation Periods for Common Foodborne Pathogen
Pathogen – Incubation Period
Staphlococcus aureus – 1 to 8 hours, typically 2 to 4 hours
Campylobacter – 2 to 7 days, typically 3 to 5 days
E. coli O157:H7 – 1 to 10 days, typically 3 to 4 days
Salmonella – 6 to 72 hours, typically 18 to 36 hours
Shigella – 12 hours to 7 days, typically 1 to 3 days
Hepatitis A – 15 to 50 days, typically 25 to 30 days
Listeria – 3 to 70 days, typically 21 days
Norovirus – 24 to 72 hours, typically 36 hours
- If you have common symptoms of a foodborne illness stomach cramps, vomiting, diarrhea rehydrate SLOWLY , as drinking fluids rapidly can increase vomiting.
- Do NOT self-treat with anti-diarrheal medications or anti-nausea medications unless advised to do so by a medical provider — especially if you have bloody diarrhea. Some can slow stool transit or suppress vomiting that can make some kinds of food poisoning worse.
- Do NOT take antibiotics unless prescribed by a medical provider, as this can also make some kinds of food poisoning worse.
- If youre going to go to emergency room, ask about stool testing to identify the bug that is making you ill. If you have a pathogen identified proactively contact local public health department, relating known food exposures for incubation period of known pathogen.
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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
- Persons traveling to countries where hepatitis A is common
- Men who have sex with men
- Injecting and non-injecting drug users
- Sexual contacts of infected persons
- Household contacts of infected persons
How Does A Person Get Hepatitis
A person can get hepatitis A through the following sources:
- Food or water contaminated with the fecal matter of an infected person
- Sexual contact
A person can get hepatitis B in many ways, which include:
- Having sexual contact with an infected person
- Sharing needles
- Being in direct contact with an infected persons blood
- Transferred from mother to the fetus
- Getting an infected needle prick
- Being in contact with an infected persons body fluid
A person can get hepatitis C through:
- Sharing infected needles
- Being in direct contact with an infected persons blood
- Getting an infected needle prick
- Having sexual contact with an infected person
Hepatitis D can be spread through:
- Transferred from mother to the fetus
- Being in contact with the infected fluid or blood
- A person can get hepatitis D only if they are infected previously with hepatitis B.
Hepatitis E mainly infects people who eat or drink food or water contaminated with the virus. Under-cooked foods can also spread hepatitis E. It is more dangerous in pregnant women.
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Treatment And Prevention Of Hepatitis A
Because hepatitis A virus infections can have serious health consequences, the Centers for Disease Control and Prevention recommends providing post-exposure prophylaxis for unvaccinated people who have consumed any contaminated food or water within two weeks of exposure.
PEP consists of:
- Hepatitis A vaccine for people between the ages of 1 and 40 years
- Hepatitis A virus-specific immunoglobulin for people outside of this age range, but the hepatitis A vaccine can be substituted if IG is not available.
- Those with evidence of previous vaccination or who can confirm previous hepatitis A illness do not require PEP.
If you are unsure if you have been vaccinated against hepatitis A, contact your health professional to check your immunization records. If you have been vaccinated, no further action is needed. If you have never received the hepatitis A vaccine, getting a single dose within two weeks of exposure can protect against illness. If you are unable to determine whether you have already been vaccinated, receiving an additional dose of vaccine is not harmful if you have already been vaccinated.
Can Bleach Or Cleaner Kill Hepatitis A
Disinfectant that contains bleach can kill the hepatitis A virus on hard non-porous surfaces like toilet seats. However, freezing does not kill HAV.
If you cook food that is contaminated for one minute at cooking temperatures higher than 185ºF , it will kill HAV. However, food can be contaminated after cooking, so it is very important to wash your hands well with soap and water.
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