What Is Hepatitis A?
Hepatitis A is a contagious infection of the liver caused by the hepatitis A virus (HAV). HAV causes swelling and inflammation of the liver that impairs its normal function. Hepatitis A can cause gastrointestinal upset, fever, malaise and other symptoms, and the infection can last from weeks to months.
Hepatitis A is relatively common, and in 2016, there were an estimated 4,000 cases in the United States. Hepatitis A rates have declined by more than 95 percent since the hepatitis A vaccine first became available in 1995 .
Hepatitis A usually does not require treatment and most people who are infected recover with no permanent damage to their liver.
You do not need treatment as no specific treatment exists for Hepatitis A. You can cope with symptoms with rest, snacking for the nausea and stop drinking alcohol to give your liver a rest.
How common is Hepatitis A?
Hepatitis A Symptoms
Symptoms of hepatitis A are usually very mild and go away within a few weeks. However, in some cases, hepatitis A infection can result in a severe, long-term illness that can last many months. Symptoms of acute Hepatitis A include:
Hepatitis A Causes
Hepatitis A infection occurs when a person comes into contact with food, drinks or objects contaminated with virus-infected fecal matter (stool or poop) [2,3]. Even the smallest, undetectable amounts of stool can carry the virus, so many people become infected unknowingly. HAV can be spread in a few different ways, but cannot be spread by the air. Some people and environments have certain characteristics that place them a higher risk of HAV prevalence.
How HAV is spread
People can become infected from the virus by:
- Food: Eating food handled by someone with the virus who does not properly wash his or her hands after using the bathroom
- Drinking contaminated water
- Polluted water: Eating raw shellfish from water polluted with sewage
- Close contact: Being in close contact with a person who is infected even if that person has no signs or symptoms
- Sexual contact: Having sex with someone who has the virus
How HAV is not spread
It is important to note that Hepatitis A is not spread through sneezing or coughing (airborne transmission).
Given the ways that hepatitis A virus is spread from person-to-person, certain people are at a greater risk for contracting the disease. The following may increase the risk of contracting hepatitis A:
- Travel or work: Such as traveling or working in areas of the world where hepatitis A is common
- Child care: Such as attending child care or working in a child care center
- Household: Such as living with another person who has hepatitis A
- Sexual contact: Having any type of sexual contact with someone who has hepatitis A
- Being HIV positive
- Man-to-man sexual contact/activity
- Use of any type of illegal drugs: Both injection and non-injection drugs
- Working with primates
HAV is more common in certain environments than others due to certain characteristics and methods of sanitation.
- In developing countries: Contamination of food or water with hepatitis A is more likely to occur in countries where there are poor sanitary conditions or poor personal hygiene. Hepatitis A is very common in these areas.
- In the United States: Hepatitis A is less common in the United States because regular chlorination of the water kills any hepatitis A virus that enters the water supply . The Food and Drug Administration (FDA) routinely monitors natural bodies of water used for recreation for fecal contamination so there is no need to monitor for hepatitis A virus specifically.
Treatment Options and Prevention for Hepatitis A
There is no medication that treats hepatitis A. Because it is a short-term infection that often resolves on its own, your physician may just recommend rest, fluids, and adequate nutrition.
In rare cases, people with hepatitis A may experience more severe symptoms that require hospitalization. Though it usually does not cause long-term liver damage, the virus can occasionally cause permanent liver damage. This is more common in people older than 50 and in those with other liver diseases. For these reasons, it is best to see a physician if you think you have hepatitis A .
Fortunately, hepatitis A is a preventable disease. The best way to prevent a hepatitis A infection is by practicing good hygiene. Properly and thoroughly washing your hands can go a long way in preventing the spread and transmission of the disease, especially after using the bathroom, before preparing food, and before eating .
Prevention and travel
Furthermore, if you know you will be traveling to an area where hepatitis A is common, it is important to be cautious when eating or drinking and practicing strategies such as:
- Peel and wash all fresh fruits and vegetables yourself
- Drink bottled water and use bottled water for brushing your teeth
- Refrain from drinking beverages with ice
- Avoid all beverages of unknown purity
- Avoid raw or undercooked meat and fish
Prevention through vaccination
There is also a vaccine for hepatitis A that is safe, effective, and can be used in all age groups. It is a series of two shots that causes your body to make antibodies that protect against the virus. The hepatitis A vaccine can prevent future infections with hepatitis A in healthy individuals. The hepatitis A vaccine may also help to prevent infection and further complications when it is given within two weeks of exposure to hepatitis A [6,7]. This vaccine is often recommended for the following populations:
- Men who have sex with men
- Illegal drug users
- People with bleeding disorders who often receive blood products for treatment
- People traveling to parts of the world where hepatitis A is common
An immunoglobulin injection is similar to a vaccine, and may be given to prevent disease after a known exposure .
When to Seek Further Consultation for Hepatitis A
Make an appointment with your physician promptly if you have signs or symptoms of hepatitis A. The hepatitis A vaccine or an immunoglobulin (antibody) injection within two weeks of exposure to hepatitis A may protect you from infection. Furthermore, ask your physician or your local health department about receiving the hepatitis A vaccine if any of the following apply.
- You've traveled out of the country recently: Particularly to Mexico or South or Central America, or to areas with poor sanitation
- Dining out: Such as a restaurant where you recently ate reports a hepatitis A outbreak
- Household HIV: Someone close to you, such as a roommate or caregiver, is diagnosed with hepatitis A
- Sexual contact: You recently had sexual contact with someone who has hepatitis A
Questions Your Doctor May Ask to Determine Hepatitis A
To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.
- Have you lost your appetite recently?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Any fever today or during the last week?
- Have you experienced any nausea?
- Are you sick enough to consider going to the emergency room right now?
The above questions are also covered by our A.I. Health Assistant.
- Surveillance for Viral Hepatitis - United States 2016. Centers for Disease Control and Prevention. Published October 1, 2018. CDC Link.
- Matheny SC, Kingery JE. Hepatitis A. American Family Physician. 2012;86(11):1027-1034. AAFP Link.
- Lai M, Chopra S. Hepatitis A Virus Infection in Adults: Epidemiology, Clinical Manifestations, and Diagnosis. UpToDate. Published July 13, 2018. UpToDate Link.
- Manka P, Verheyen J, Gerken G, Canbay A. Liver Failure Due to Acute Viral Heptatis (A-E). Visceral Medicine. 2016;32(2):80-85. Published April 7, 2016. NCBI Link.
- Hepatitis A. World Health Organization. Published September 19, 2018. WHO Link.
- Victor JC, Monto AS, Surdina TY, et al. Hepatitis A Vaccine Versus Immune Globulin for Postexposure Prophylaxis. The New England Journal of Medicine. 2007;357:1685-1694. NEJM Link.
- Gellis SS, Hsia DY. Viral Hepatitis. The New England Journal of Medicine. 1953;249:400-409. NEJM Link.