Hepatitis A

Symptoms

Symptoms usually begin 2 to 6 weeks after exposure to the virus. The duration of illness varies, and most people recover within 3 weeks. Hepatitis A infection is more severe with age, and in rare circumstances, can cause severe complications and liver failure.
In adults, early symptoms include upset stomach, loss of appetite, vomiting, fatigue, fever, and stomach or side pain.
Dark yellow or brown urine, pale or white-colored stools (bowel movements), and jaundice (yellow eyes or skin) may also be present but do not occur in all cases.
Persons can have all or only a few symptoms.
Young children infected with hepatitis A may have only a mild flu-like illness without jaundice, or may have no symptoms.

How is Hepatitis A spread?

The virus passes in the stool, and enters another person when hands, food, or objects contaminated with stool are put in the mouth. The amount of contamination needed to spread infection is very small and is not visible to the eye.
Spread occurs when an infected person does not wash hands thoroughly after going to the bathroom.
Hepatitis A can be spread by drinking water or eating shellfish contaminated with the virus.
Hepatitis A can also be spread through sexual activity if hands or mouth come in contact with stool or parts of the body contaminated with stool.
A person is most contagious during the 2 weeks before illness symptoms begin.
Hepatitis A is not spread by kissing, sneezing, or by saliva.

Diagnosis and treatment

Hepatitis A is diagnosed with a blood test called the hepatitis A IgM test.
Rest, a low fat diet, and plenty of fluids are recommended. Avoid drugs and alcohol.

Prevention

Wash hands thoroughly with soap and running, warm water after using the toilet, changing diapers, and before preparing or eating food.
Keep bathrooms clean and supplied with soap and clean towels.
Change diapers on surfaces that can be cleaned and sanitized after every use.
Never change diapers on eating or food preparation surfaces.
Cook shellfish thoroughly before eating.
Drink water from approved sources only. Adequate chlorination of water as recommended in the United States will inactivate HAV. Boiling or cooking food and beverage items for at least 1 minute to 185° F (85° C) also inactivates HAV.
Hepatitis A vaccine provides protection against hepatitis A for many years. The vaccination series consists of 2 doses that are given at least 6 months apart.

Who should get Hepatitis A vaccine?

All children 1 to 18 years of age.
Gay and bisexual men.
Drug users (injection and non-injection).
International travelers where hepatitis A is common (includes all areas of the world except Canada, Western Europe & Scandinavia, Japan, New Zealand, and Australia).
Persons with chronic liver disease, including chronic hepatitis B and hepatitis C.
Persons with clotting factor disorders, such as hemophiliacs.
Anyone else who wants protection against hepatitis A.

What should I do if I was exposed to Hepatitis A?

If you were exposed to an infected individual at any point during the two weeks before that person's symptoms started through one week after, and if you have not been vaccinated against hepatitis A and have never had a hepatitis A infection, you may be at risk of infection with hepatitis A.
Preventive treatment (also called postexposure prophylaxis, or PEP) can often prevent hepatitis A if given within 14 days of exposure to an infected individual. PEP may be recommended if you:
- Have eaten food or put objects in your mouth handled by a person infected with hepatitis A.
- Have had sexual or other intimate contact with a person who has hepatitis A.
- Are a child attending, or an employee of a child care program in which another child or employee has hepatitis A.
For healthy persons 12 months through 40 years of age, PEP consists of a single dose of hepatitis A vaccine.
For persons under 12 months or over 40 years of age, and those with certain chronic medical conditions, PEP consists of a medicine called Immune Globulin (IG). For long-term protection, if a person receiving IG is also eligible for hepatitis A vaccine, the first vaccine dose should be given at the same time as IG.

Child care and food establishments

Please notify Public Health immediately at 206-296-4774 whenever a food handler, childcare worker, or child attending a childcare develops hepatitis A infection.