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What is hepatitis A?

Hepatitis A is an infection of the liver caused by the hepatitis A (HAV) virus. After the hepatitis virus enters your body it can take anywhere from 15-50 days before you feel sick. The symptoms can be so mild that many people are not aware that they have the disease. Often children do not show any symptoms of hepatitis A; however, adults with hepatitis A may be quite ill for up to 2 months and full recovery can take up to 6 months.

What are the symptoms?

Symptoms may include loss of appetite, fever, dark urine, a tired feeling (like you have the flu), vomiting (throwing up), clay-coloured bowel movements, a sore feeling in the upper-right stomach area, and the yellowing of the skin and eyeballs. The symptoms may last from 1-2 weeks to several months. Most people recover completely and then are immune to re-infection. A blood test is necessary to diagnose hepatitis A.

How is it spread?

The hepatitis A virus is found in the bowel movements of infected persons even if they do not know they are ill. People who go to the bathroom and then don’t wash their hands properly can pass the disease to others through food preparation or other hand to mouth contact. Once infected, a person can pass the virus on to others for two weeks or more before they even know they are sick themselves. They are still infectious for up to one week after they become ill. Hepatitis A can be caused by drinking water or by eating shellfish that have been exposed to sewage, such as crabs, clams, oysters, or mussels. This disease can also be spread when feces may enter the mouth through oral-anal sexual contact.

How can I prevent it?

Protect yourself against hepatitis A and other gastrointestinal germs by always washing your hands with soap and water after using the bathroom, before preparing meals and before eating. Do not share food, drinks or cigarettes. If you have had close contact with someone who is infected with hepatitis A, getting the hepatitis A vaccine within the first week or two after exposure is considered to be effective in preventing infection. Immune globulin (IG) by injection is the recommended preventative measure for infants under one year, persons who are immuno-compromised and those for whom the vaccine is contraindicated.

Hepatitis A protection for travel:

• Get vaccinated for hepatitis A if traveling to an area where this virus is common
• Proper hygiene and taking precautions with food and drink are important
• Avoid peeled fruit and raw vegetables, salads and dairy products made with unpasteurized milk
• Swim only in chlorinated pools

Hepatitis A vaccine:

This vaccine protects people against Hepatitis A. After the first dose, a booster is recommended 6-12 months later to ensure long-term protection. Protection begins about two to four weeks after the first needle and lasts for at least 20 years.

Who should be vaccinated?

The vaccine is recommended for people who are likely to come in contact with the hepatitis A virus. This includes persons who will be living, working or travelling in areas where there is a higher prevalence of hepatitis A, such as Africa, Asia, Central America, and South America. The vaccine is also recommended for:

• Contacts of infected persons
• Anyone who is travelling to a country where hepatitis A commonly occurs
• Individuals with chronic liver disease, including those with hepatitis C
• Individuals who engage in anal-oral sex practices
• Injection drug users

The vaccine is not recommended to anyone with a fever, severe acute illness, a known sensitivity to any part of the vaccine, or to anyone with a previous allergic reaction to the vaccine. It is not recommended for pregnant women because its safety in pregnancy is unknown.

Is the hepatitis A vaccine safe?

Yes. Reactions to the vaccine tend to be very mild and short-lasting. Reactions may include soreness, redness and swelling at the injection site. A person may have a headache, fever, nausea, and lack of appetite. All severe side effects should be reported to your family doctor or Public Health.

What if I am already sick with hepatitis A?

If you already have hepatitis A you will need to get lots of rest. Drinking lots of fluids and eating good meals will also help you become healthy again. If you feel sick to your stomach or have a poor appetite, it might help to eat smaller meals and eat more often. No alcohol should be taken when you are ill because it may further inflame your liver. Avoid any kind of hard work or exercise. Your family doctor can give you specific directions or medical treatment that you need.

If food handling is part of your job, you may need to take some time off work.

If you would like information regarding hepatitis A please contact Public Health at 519-376-9420 or link to the Canadian Liver Foundation website at www.liver.ca.