How You Get Hepatitis A

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

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 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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People At Risk Of Hepatitis A In The Uk

Although the chances of getting hepatitis A in the UK are much smaller than in other parts of the world, certain groups have an increased risk.

These include:

• close contacts of someone with hepatitis A
• 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 levels of personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas

People in these groups are usually advised to have the hepatitis A vaccine to minimise their risk of infection.

Page last reviewed: 11 March 2019 Next review due: 11 March 2022

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.

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Side Effects Of Immunisation Against Hepatitis A

Immunisations against hepatitis A are effective and safe. All medications can have side effects.

For most people, the chance of a serious side effect from a vaccine is much lower than the chance of serious harm if you catch the disease.

Common side effects from the hepatitis A vaccine include:

• localised pain, redness and swelling at the injection site
• low-grade temperature
• headache.

How Is Hepatitis A Infection Prevented

Vaccination

• 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.

Natural Immunity

• 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.

Healthy Habits

• 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

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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

Questions To Ask Your Doctor

• Do I need treatment?
• What treatment is best for me?
• Will I need be hospitalized?
• Are there any medicines I should avoid taking?
• Are there foods I should avoid eating?
• Can I drink alcohol?
• How can I protect my family from getting hepatitis A?
• If Ive had hepatitis A, am I at higher risk of getting other types of hepatitis?
• Will I have permanent liver damage?
• How soon before I travel should I be vaccinated?

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What Is Hepatitis A Symptoms Causes Diagnosis Treatment And Prevention

Hepatitis is an inflammation of the liver, an organ with several important functions.

Your liver converts dietary nutrients into useful substances and breaks down toxins and chemicals.

Hepatitis A is a type of hepatitis caused by the hepatitis A virus . Its generally acquired through consuming contaminated food or water but can also be spread from person to person and is highly contagious.

Numerous other types of viral and nonviral hepatitis also exist, including hepatitis B, hepatitis C, alcohol-related hepatitis, and nonalcoholic steatohepatitis, which is caused by a buildup of fat in the liver.

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, HA vaccine is in limited use.

HA vaccination should be considered for all persons from HA-endemic countries. Individuals born in HA-endemic countries are more likely to be immune to HA therefore, serologic testing for immunity before HA immunization should be considered. If persons from HA-endemic countries are not immune, they should be offered HA immunization because they are at increased risk for HA exposure through visits to their country of origin, or when receiving friends and family from their country of origin.

In addition, persons new to Canada should be tested for hepatitis C antibody and susceptible persons chronically infected with hepatitis C should be vaccinated against HA and HB. Persons new to Canada should also be tested for HB and vaccinated against HA if found to be a HB carrier. Household or close contacts of children adopted from HA-endemic countries should be immunized with HA-containing vaccine. Adults travelling to pick up adopted children from HA-endemic countries should be vaccinated before departure.

Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.

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Guidance On Reporting Adverse Events Following Immunization

Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.

Refer to Reporting Adverse Events Following Immunization in Canada and Vaccine Safety and Pharmacovigilance in Part 2 for additional information about AEFI reporting.

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

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Persons With Chronic Diseases

Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional general information about vaccination of people with chronic diseases.

Chronic renal disease and patients on dialysis

HA vaccine is recommended for people with chronic renal disease or undergoing dialysis if they are at increased risk of HA infection or severe HA . A study assessing the immune response of hemodialysis patients to standard doses of HA vaccine demonstrated a good HA antibody response and no serious adverse effects.

Chronic liver disease

HA immunization is recommended for susceptible persons with chronic liver disease, including those infected with hepatitis C and chronic HB carriers, because they are at risk of more severe disease if infection occurs. Vaccination should be completed early in the course of the disease, as the immune response to vaccine is suboptimal in advanced liver disease.

Non-malignant hematologic disorders

Concerns About Immunisation Side Effects

If a side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your childs condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.

Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and central reporting service. Adverse events in other states or territories can be reported through SAEFVAC.

It is important to seek medical advice if you are unwell, as this may be due to other illness rather than because of the vaccination.

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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

Take Care When Eating And Drinking

You should avoid eating and drinking the following when travelling to high-risk countries:

• Raw or inadequately cooked shellfish.
• Raw salads and vegetables that may have been washed in dirty water.
• Other foods that may have been grown close to the ground such as strawberries.
• Untreated drinking water, including ice cubes made from untreated water.
• Unpasteurised milk, cheese, ice cream and other dairy products.

Also be careful when buying food from street traders. Make sure that food has been recently prepared and that it is served hot and on clean serving plates. Food that has been left out at room temperature or food that may have been exposed to flies could also pose a risk.

Note: if you have had hepatitis A infection, you will be immune to further infection. This means that you can’t catch the infection again.

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What Is The Treatment For Hepatitis A

There is no specific treatment needed for hepatitis A. It is usually a self-limiting illness, which means it usually goes away on its own. Your immune system will normally clear away the infection. Most people with hepatitis A infection don’t need to be admitted to hospital. However, admission to hospital may be suggested if you are severely ill or you are being sick and are lacking in fluid in the body .

Treatment is aimed at relieving your symptoms. It is common to feel more tired than usual when you have hepatitis A so you may need to have plenty of rest. Your doctor may be able to suggest some painkillers and some antisickness medication if needed. To help ease the symptom of itch, keep cool, wear loose clothing and avoid hot baths or showers. Avoiding fatty foods may help to reduce the feeling of sickness. Also, you should not drink alcohol whilst you are ill.

During your illness, your doctor may also want to keep a check on how your liver is working by repeating blood tests from time to time to look at this.

It is important to have excellent personal hygiene to reduce the risk of passing the virus on to others. Thoroughly wash your hands after going to the toilet. You should also avoid handling food and having unprotected sex when you are infected with the virus. Ask your doctor when it is safe for you to return to work, or for your child to return to school or nursery.

Who Is At Risk Of Hepatitis A

Anyone can get hepatitis A if they have not beenvaccinated. In the U.S., you are at a higher risk if you:

• Use illegal drugs, whether injected or not
• Live with someone who has hepatitis A
• Have bleeding problems and take clotting factors
• Have oral-anal sexual contact with someone who has hepatitis A
• Travel to areas that have high rates of hepatitis A

Travel to Africa, Asia, Eastern Europe,or Central and South America,including Mexico, increases the riskof getting hepatitis A.

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For How Long Is An Infected Person Able To Spread The Virus

The contagious period begins one to two weeks before symptoms appear, and is minimal about one week after the onset of jaundice. Food workers should be excluded from work for at least two weeks after the onset of clinical symptoms of hepatitis A. If jaundiced, food workers should not return to work for at least one week after onset of jaundice.

If I Have Hepatitis How Can I Avoid Giving It To Someone Else

For hepatitis A, one of the best things you can do is wash your hands a lot. That will keep the virus out of food and drinks.

If you have hepatitis B and C, you need to find ways to keep others from making contact with your blood. Follow these tips:

• Cover your cuts or blisters.
• Carefully throw away used bandages, tissues, tampons, and sanitary napkins.
• Don’t share your razor, nail clippers, or toothbrush.
• If your blood gets on objects, clean them with household bleach and water.
• Don’t breastfeed if your nipples are cracked or bleeding.
• Don’t donate blood, organs, or sperm.
• If you inject drugs, don’t share needles or other equipment.

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Who Should Obtain The Hepatitis A Vaccine

Hepatitis A vaccine is recommended for the following persons:

• Travelers to areas with increased rates of hepatitis A
• Men who have sex with men
• Injecting and non-injecting drug users
• Persons with clotting-factor disorders
• Persons with chronic liver disease
• All children aged 12-23 months children not fully vaccinated by age two

The hepatitis A vaccine may also be used in certain outbreak situations where ongoing transmission is occurring. Although studies of certain occupational groups have not shown an increased risk, such people may consider vaccination if they wish to further reduce their risk or are in communities where ongoing outbreaks are occurring.