Hepatitis A is a viral infection that causes inflammation of the liver.
It is usually spread through contact with an infected person's faeces (poo). Most commonly the symptoms are mild and the infection goes away over 1 to 2 weeks (unlike the more serious types of viral hepatitis caused by hepatitis B or hepatitis C).
How is hepatitis A spread?
The hepatitis A virus is carried in the poo of an infected person. You can come into contact with this when you:
- drink contaminated water
- eat food prepared by someone with hepatitis A virus who did not wash their hands after going to the toilet
- have sexual contact with someone with the virus
- do not wash your hands after toileting.
Only a small amount of virus is necessary to spread the infection. The virus can potentially survive on objects and in water for months.
Who is at risk of hepatitis A infection?
Hepatitis A is rare in New Zealand but can affect anyone who is not immune. Those at higher risk of contracting the infection are:
- people who travel overseas
- children and staff in day care centres
- people in other jobs that exposes them to poo, such as sex industry workers, healthcare workers and people who work with sewerage
- inmates of correctional facilities
- men who have sex with men
- people who inject illegal drugs
- people who are in close personal contact with an infected person.
Hepatitis A infection is more common in developing countries so if you are travelling overseas, talk with your doctor to see if you need hepatitis A vaccination before you leave. Also, when travelling to other countries, find out if it is safe to drink the tap water and take extra care about all you eat and drink.
Good rules of thumb when travelling in developing countries include:
- Avoid foods you cannot peel or cook.
- Don’t drink unpackaged drinks or ice.
- Don’t eat shellfish.
What are the symptoms of hepatitis A?
Hepatitis A can cause temporary swelling of the liver, but it rarely causes lasting damage. Some people get no symptoms at all. It usually gets better on its own after several weeks. Symptoms can include:
- abdominal (tummy) pain
- nausea (feeling sick) and vomiting (being sick)
- diarrhoea (runny poos)
- loss of appetite
- flu-like symptoms (without cough or runny nose)
- jaundice (yellowing of the skin and eyes)
- feeling very tired
- dark (reddish brown) urine.
Symptoms can appear anywhere from 2 to 6 weeks after exposure and usually only last 1 to 2 weeks. Sometimes, in more severe cases, it can last weeks to months. In very rare cases, it can be life-threatening.
The older you are, the more severe the symptoms of hepatitis A infection tend to be. Many children under 5 years of age do not experience any symptoms.
How long is the infectious period?
If someone has hepatitis A, they are infectious (can pass infection on to someone else) for the 2 weeks before they show any symptoms and until 1 week after they develop jaundice (yellowing of skin and eyes).
To reduce the risk of other people becoming infected, anyone with hepatitis infection should stay home and not prepare food for other people for 7 days from the onset of jaundice.After a person has recovered from hepatitis A, they are immune and cannot get it again.
After a person has recovered from hepatitis A, they are immune and cannot get it again.
How is hepatitis A diagnosed?
To diagnose hepatitis A infection, your doctor:
- will ask you about your symptoms, travel history and will check your immunisation status
- will look for noticeable physical signs such as jaundice (yellowing of the skin and eyes)
- may also request blood tests, such as liver function tests.
How is hepatitis A treated?
Usually, no specific treatment is needed. In most cases, your immune system will fight the virus and your liver will heal completely. To aid your recovery, you may be advised to:
- rest – hepatitis A infection can make you tired and less energetic, so rest when you feel you need to
- protect your liver – the liver processes certain medications and alcohol. Avoid alcohol and ask review your medication with your doctor.
Very rarely, people are very sick and need to be cared for in hospital.
How can hepatitis A be prevented?
Practising good hygiene
Good hygiene is the best way to prevent hepatitis A. Avoid the spread of germs by:
- washing hands before and after preparing food
- washing hands before eating
- washing hands after going to the toilet or changing a baby’s nappy.
Read more about hand hygiene
Take care with what you eat and drink
- Hepatitis A virus is resistant to heating and freezing, you cannot kill it by cooking it or by putting it in the freezer.
- Boil your drinking water if it comes from an untreated source, such as a river.
Protect your body from infection
- Avoid contact with other people’s blood.
- Don’t share personal items like razors or injecting gear.
- Practice safe sex by using condoms.
Get vaccinated if you are high risk
There is a vaccine that protects against hepatitis A infection. It is recommended for people who are at high-risk of getting the virus, such as those travelling overseas. It is not part of the childhood immunisation schedule.
The vaccine begins to protect 4 weeks after the first dose is received. A booster or 2nd vaccine at 6- to 12-months is needed to give long-term protection.
Hepatitis A vaccine information sheet in multiple languages Medline Plus (US)
High five for clean hands Ministry of Health