How Common Is Hepatitis A
In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked.1 However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness.1 Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.2
Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.
Signs And Symptoms Of Hepatitis
If you contract hepatitis, it may present in a way that is similar to a nasty bout of a flu, says Dr. Gulati. Common symptoms of hepatitis include:
- Joint pains
Other warning signs to look out for include dark urine, light, clay-colored stools, abdominal discomfort, and jaundice, the yellowing of the whites of the eyes or the skin due to an accumulation of bilirubin.
If you have hepatitis, a simple blood test will show elevated liver enzymes. Additional blood tests can help identify which virus, if any, is to blame.
How Do You Get Hep C
You can acquire Hep C if you receive blood from a person infected with HCV. Before 1992, when blood screening for HCV infection was not available, Hep C spread through blood transfusion and organ donation. This is not the case now due to widespread screening of blood donors in the United States. However, one can still get Hep C in the following situations:
- Sharing needles and syringes
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Concurrent Administration Of Vaccines
HA vaccine may be administered concomitantly with other vaccines or with Ig. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
If concurrently providing HA-containing vaccine and Ig, separate anatomic injection sites should be used for each injection.
Passive immunization with human Ig preparations can interfere with the immune response to measles-mumps-rubella , measles-mumps-rubella-varicella and univalent varicella vaccines . These vaccines should be given at least 14 days prior to administration of a human Ig preparation, or delayed until the antibodies in the Ig preparation have degraded. Refer to Blood Products, Human Immunoglobulin and Timing of Immunization in Part 1 for additional information.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
How Do People Get Sick
Hepatitis viruses are spread from person to person through contact with infected feces , either directly or indirectly . People can carry the virus without showing symptoms, then spread it to other people, foods or surfaces.
People can get Hepatitis A after eating contaminated food and beverages. Food and drinks can become contaminated through:
- a contaminated food handler
- hands that were not washed properly after using the washroom
- contamination during harvest, manufacturing and processing
Common food sources of Hepatitis A include:
- contaminated water
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How Do I Get Hepatitis A
Hepatitis A is spread through close contact with an infected person, or by eating hepatitis A contaminated food or drinking water. Because the virus is found in the stool of infected people, eating food prepared by an infected person, who does not wash his/her hands properly after using the washroom, is one way of getting the virus.
Eating raw or undercooked seafood and shellfish from water polluted with sewage, or eating salad greens that are rinsed in contaminated water are other ways of becoming infected. Sharing drug-use equipment, or having sexual contact with an infected person can also give you hepatitis A.
While often considered to be a travellers disease, hepatitis A can be contracted in Canada. Hepatitis A outbreaks or scares in Canada are most often associated with infected food handlers in restaurants and grocery stores or with contaminated produce.
Cirrhosis Of The Liver
Extensive fibrosis is called cirrhosis. Hepatitis B, hepatitis C, and alcoholic hepatitis can cause cirrhosis as well as fatty liver disease and other liver-related conditions. Cirrhosis-related scarring is often irreversible. In severe cases and without treatment, the best course of action may be a liver transplant.
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Is Hepatitis A Contagious
Hepatitis A Transmission
Hepatitis A is a type of liver infection caused by a virus termed hepatitis A . Symptoms, if they occur, start about 2 to 6 weeks after exposure to HAV. About 80% of adults have symptoms while children seldom show symptoms. Symptoms of hepatitis A may include the following:
- Nausea and/or vomiting
- Joint pain
Who Is At Risk For Hepatitis A
Although anyone can get hepatitis A, in the United States, certain groups of people are at higher risk, such as:
- People with direct contact with someone who has hepatitis A
- Travelers to countries where hepatitis A is common
- Men who have sexual contact with men
- People who use drugs, both injection and non-injection drugs
- Household members or caregivers of a recent adoptee from countries where hepatitis A is common
- People with clotting factor disorders, such as hemophilia
- People working with nonhuman primates
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Can Hepatitis A Be Treated
There is no drug treatment for hepatitis A. The disease will eventually run its course and an infected person will recover completely although recovery time varies for each person. Recovery from this virus infection means that you are protected for life from getting it again.
The following are some ways of dealing with the symptoms:
- You will feel tired and may have very little energy. You may need to take time off from daily activities, work or school to recover.
- Nausea and vomiting may cause you to lose your appetite. Try to eat small snacks and soft foods such as soup or toast.
- You may look yellow. Once you become yellow, you are no longer infectious. There is no need to isolate yourself. Let people around you know it is OK to be near you.
- Try not to drink alcohol. Your liver may not be able to process alcohol and alcohol may make your symptoms worse.
- Talk to your doctor before taking over-the-counter medications or complementary medicine. None of the alternative therapies have proved helpful in treating hepatitis A.
Who Is More Likely To Get Hepatitis A
People more likely to get hepatitis A are those who
- travel to developing countries
- have sex with an infected person
- are men who have sex with men
- use illegal drugs, including drugs that are not injected
- experience unstable housing or homelessness
- live with or care for someone who has hepatitis A
- live with or care for a child recently adopted from a country where hepatitis A is common
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Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and started on an immunization schedule appropriate for their age and risk factors. HA vaccine may be given, if indicated, regardless of possible previous receipt of the vaccine or pre-existing immunity, because adverse events associated with repeated immunization have not been demonstrated.
Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.
Hepatitis A B And C: Whats The Difference
Hepatitis is often caused by a virus that comes in different strains. The most common strains of hepatitis are hepatitis A, B, and C. They all are contagious, but they differ primarily by the way they are spread.
Table: Differences among hepatitis A, B, and C
Table: Differences among hepatitis A, B, and C
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What Causes Hepatitis A
The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected persons stool. Contact can occur by
- eating food made by an infected person who did not wash his or her hands after using the bathroom
- drinking untreated water or eating food washed in untreated water
- placing a finger or an object in your mouth that came into contact with an infected persons stool
- having close personal contact with an infected person, such as through sex or caring for someone who is ill
You cannot get hepatitis A from
- being coughed on or sneezed on by an infected person
- sitting next to an infected person
- hugging an infected person
A baby cannot get hepatitis A from breast milk.4
How Do You Get Hepatitis A
The main way you get hepatitis A is when you eat or drink something that has the hep A virus in it. A lot of times this happens in a restaurant. If an infected worker there doesn’t wash their hands well after using the bathroom, and then touches food, they could pass the disease to you.
Food or drinks you buy at the supermarket can sometimes cause the disease, too. The ones most likely to get contaminated are:
- Ice and water
Another way you can get hep A is when you have sex with someone who has it.
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What To Do About Hepatitis
If you have hepatitis A or B, in most cases youll get better with a doctors care and supportive treatment without specific anti-viral treatments.
Hepatitis C and other chronic forms will probably affect your life more profoundly, but you can do a lot to manage the condition and keep it under control.
If someone in your home has hepatitis, it is also important to take appropriate precautions to avoid spreading the disease.
For hepatitis A, handwashing is extremely important. For hepatitis B and C, care should be taken to avoid contact with the blood of the infected individual, even the microscopic amounts that hide in toothbrushes and on razors, so never share these items.
Treatment can suppress or even eradicate hepatitis C. Older treatments for hepatitis C are combination antiviral therapy with pegylated interferon and ribavirin.
The treatment came with difficult side effects, and was effective for only about 40 to 80 percent of patients, depending on the type of hepatitis C they carried.
Newer drugs approved by the FDA in 2013 and 2014 are more effective, curing the viral infection for 90 percent of patients or more. New antiviral medications to treat hepatitis C include simeprevir and sofosbuvir , and combination therapies include Harvoni and Viekira Pak.
Can Hepatitis A Be Prevented Or Avoided
The best way to protect yourself against hepatitis A is to get the vaccine. The hepatitis A vaccination is recommended for all children older than age 1. It begins to protect you only 4 weeks after you are vaccinated. A 6- to 12-month booster is required for long-term protection. Ask your doctor if the vaccination is right for you.
You should also wash your hands with soap and warm water before and after cooking, after using the bathroom, and after changing diapers.
Wash fruits and vegetables thoroughly before eating and avoid raw or undercooked meat and fish.
You are at higher risk for hepatitis A if you:
- Live with or have sex with someone who has hepatitis A
- Travel to countries where hepatitis A is common
- Are a man who has sex with other men
- Use illegal drugs
- Have a clotting-factor disorder
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What Is The Outlook For Hepatitis
Hepatitis A and E usually only cause short-term infections that your body can overcome. The others can also cause acute infections, but might also cause chronic infections. The chronic forms are more dangerous. Hepatitis non-E is usually acute, but can become chronic.
Most people recover fully from hepatitis even though it might take several months for the liver to heal. To help improve your health and to help speed up your recovery:
- Avoid alcohol.
- Practice good nutrition.
- If you feel sick, rest.
- Talk to your healthcare provider about your medicines, even over-the-counter drugs or vitamins and supplements, to know which ones you should take and which to avoid until you are recovered.
With hepatitis, your healthcare provider will also be looking for long-term damage to the liver in the forms of cirrhosis or liver failure. You may be asked to take other types of tests, such as liver function tests, imaging tests or possibly a liver biopsy.
If you have questions, new symptoms, or worsening of any existing symptoms, you should call the office of your healthcare provider.
In the U.S., A, B and C are the most common viral forms of hepatitis. It doesnt matter how you were infectedwhat matters is taking care of yourself once you have been diagnosed and taking care not to spread the infection to anyone else.
Last reviewed by a Cleveland Clinic medical professional on 01/06/2020.
How Can I Prevent Spreading Hepatits A To Others
If you have hepatitis A, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before fixing or eating food. While you are sick, avoid close contact with others, and donât prepare food or serve food to others. Also, tell your doctor, dentist, and other health care professionals that you have hepatitis A.
Talk with a blood donation center before you donate blood. If you had hepatitis A when you were younger than 11, you may be able to donate blood. If you had hepatitis A when you were age 11 or older, you should not donate blood.
You are most contagiousâable to spread the virus to othersâduring the 2 weeks before you have symptoms. You may be contagious for up to 3 weeks after you develop symptoms. Children are often contagious longer than adults.
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How Dangerous Is Hep C
Hep C, specifically chronic Hep C, can be a serious disease. It can lead to long-term health issues, including liver damage, liver failure, liver cancer, or even death. Hep C is a major cause of cirrhosis and liver cancer.
This makes it the most common reason for liver transplant in the United States. In 2016, CDC reported over 1,800 deaths related to the HCV. Nevertheless, the actual deaths due to Hep C are believed to be far more in number because not all people are tested for the virus.
How Is Hepatitis Diagnosed
To diagnose hepatitis, your health care provider:
- Will ask about your symptoms and medical history
- Will do a physical exam
- Will likely do blood tests, including tests for viral hepatitis
- Might do imaging tests, such as an ultrasound, CT scan, or MRI
- May need to do a liver biopsy to get a clear diagnosis and check for liver damage
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How Is It Tested For And Diagnosed
After you discuss your symptoms with your doctor, they may order a blood test to check for the presence of a viral or bacterial infection. A blood test will reveal the presence of the hepatitis A virus.
Some people have only a few symptoms and no signs of jaundice. Without visible signs of jaundice, its hard to diagnose any form of hepatitis through a physical examination. When symptoms are minimal, hepatitis A can remain undiagnosed. Complications due to a lack of diagnosis are rare.
What Is Hepatitis C
The HCV virus infects the liver and leads to its inflammation. Hep C can manifest in a variety of ways, ranging from a mild illness lasting a few weeks to a serious, lifelong illness. Thus, Hep C is divided into two broad categories: acute, meaning a new infection and chronic, meaning a potentially lifelong infection.
- Acute Hep C occurs within the first six months of HCV infection. Around 50% of acute cases progress to a long-term chronic stage.
- Chronic Hep C refers to the long-term persistence of Hep C disease and can be a lifelong infection if left untreated. Without proper treatment chronic Hep C can cause serious health problems, including:
- Liver damage
- Easy bruising and bleeding
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How Does It Affect The Body
The incubation period for hepatitis B can range from . However, not everyone who has acute hepatitis B will experience symptoms.
About 95 percent of adults completely recover from hepatitis B. However, hepatitis B can also become chronic.
The risk of chronic hepatitis B is greatest in those who were exposed to HBV as young children. Many people with chronic hepatitis B dont have symptoms until significant liver damage has occurred.
In some people whove had hepatitis B, the virus can reactivate later on. When this happens, symptoms and liver damage may occur. People with a weakened immune system and those being treated for hepatitis C are at a higher risk for HBV reactivation.
Whats The Best Way To Stop The Spread Of Hepatitis A
Hepatitis A vaccination is the best way to prevent hepatitis A. The hepatitis A vaccine is given in 2 doses, usually about 6 months apart.
Other ways to stop the spread of HAV are:
- Always washing your hands with soap and warm water immediately after using the bathroom or changing a diaper
- Always washing your hands with soap and warm water before preparing or eating food
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