Hepatitis A

What is hepatitis A?

Hepatitis A is a viral disease that is common in developing countries and is generally associated with poor sanitation and poor hygiene. It is one of the most common vaccine-preventable illnesses in travellers.

What is my risk?    

Your risk depends on several factors: destination, length of trip, and your living conditions.

The risk of hepatitis A is highest among travellers:

• visiting or living in rural areas
• eating and drinking in locations with poor sanitation or unsafe food handling practices

The risk of hepatitis A exists even for travellers going for short periods of time to urban areas, staying in luxury hotels and who follow good hygiene and water and food precautions.

How is it transmitted?         

• The hepatitis A virus is found in the stool (feces) of an infected person.
• It can be spread through contaminated food and water or through close contact with an infected person.
• Certain uncooked foods such as shellfish, fruits or salads can be contaminated, as well as foods that are prepared in unsanitary conditions or by an infected person with unsafe food handling practices.
• It can also be transmitted through close personal contact when poor hygiene is practised:
  • in day cares, households, schools, etc.
  • less commonly, through sexual contact.
• Infection with the virus gives lifelong immunity (protection) against the virus.

What are the symptoms?

• Symptoms can take from 15 to 50 days to appear (average 28 days).
• Some people who are infected have no symptoms, others may have only mild symptoms that last from 1 to 2 weeks and some may experience more severe symptoms that can last several months.
• In children, symptoms are mild to non-existent. Severity of the illness increases with age.
• Symptoms can include fever, fatigue, loss of appetite, nausea and vomiting, abdominal discomfort, dark urine and grey-colored stool, jaundice (yellowing of skin and whites of eyes).
• In severe and rare occasions, symptoms can include liver damage, liver failure, or death. Individuals with pre-existing chronic liver disease and older people are most at risk for this.
• Recovery generally takes a few weeks, but can take months. Most people recover without side effects and have lifelong immunity against hepatitis A.

Can hepatitis A be treated?

There is no treatment for hepatitis A, only supportive care to help relieve symptoms.

Where is hepatitis A a concern?

• Hepatitis A occurs worldwide but is more common in regions with poor sanitation and lack of safe food and water.
• Regions where there is a high risk of hepatitis A transmission include Africa, Asia and Central and South America.
• A map of countries and areas of risk for hepatitis A is available on the World Health Organization (WHO) website. 

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

1. Practise safe food and water precautions

2. Wash your hands frequently

• Wash your hands with soap under warm running water for at least 20 seconds, as often as possible, including before eating or preparing food and after using the bathroom or changing diapers.
• Use alcohol-based hand sanitizer if soap and water are not available. It’s a good idea to always keep some with you when you travel.

3. Get vaccinated if you are at risk but are not immunized (either through previous vaccination or previous hepatitis A infection)

• Discuss the benefits of getting vaccinated with a health care provider before travelling if you are:
  
  • travelling to countries where hepatitis A occurs.
  • visiting areas where drinking water may be unsafe and poor sanitation and hygiene conditions exist.

4. Monitor your health 

• If you develop symptoms similar to hepatitis A when you are travelling or after you return, see a health care provider and tell them where you have been travelling or living.