Hepatitis A

About This Disease

Current News (as of May 4, 2017): The Hawaii State Department of Health (DOH) has been notified of imported frozen raw tuna or ahi cubes distributed on Oahu that tested positive for hepatitis A. The product, imported from Indonesia, was used to prepare poke sold between April 27–May 1 by food establishments on Oahu. Customers who purchased and consumed the product and are not vaccinated for hepatitis A are advised to consult with their doctor.  More information


Hepatitis A is a contagious liver infection caused by the hepatitis A virus (HAV).  The disease can range from a mild illness lasting 1 to 2 weeks to a severe illness lasting for several months.  HAV is found in the stool of people with hepatitis A infection and is usually spread through close personal/sexual contact or by consuming contaminated food or water.

Signs and Symptoms

Some people with hepatitis A have no symptoms of the disease.  Adults are more likely to have symptoms than children.  If symptoms develop, they may include:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored stools
  • Joint pain
  • Jaundice (a yellowing of the skin or eyes)

If symptoms occur, they usually appear anywhere from 2 to 6 weeks after exposure.  Symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.

Transmission

Hepatitis A is spread from person to person through the fecal-oral route [i.e. ingestion of something that has been contaminated by the feces (or stool) of an infected person].  Most infections result from close personal contact with an infected household member or sex partner.

Hepatitis A can also be spread by consuming food or water contaminated with the stool of an infected person.

A person with Hepatitis A is most infectious during the 1 to 2 weeks before the onset of symptoms until at least 1 week after the onset of jaundice.

Diagnosis

Hepatitis A is diagnosed by a combination of symptoms, physical signs, and laboratory tests.  People with symptoms of Hepatitis A or who have been exposed to someone with Hepatitis A should contact a healthcare provider immediately.

Treatment

There is no special treatment for Hepatitis A.  Most people with Hepatitis A will feel sick for a few months before they begin to feel better.  A few people will need to be hospitalized.  People with Hepatitis A should check with a health care professional before taking any prescription pills, supplements, or over-the-counter medications, which can potentially damage the liver.  Alcohol should be avoided.

Immunity

In general, persons with at least one of the following may be considered protected from hepatitis A:

  • Persons who have had a blood test showing they are immune to hepatitis A or have had the disease
  • Persons who have written documentation of adequate hepatitis A vaccination (see “Prevention” below)

Once a person recovers from Hepatitis A disease, they develop antibodies that protect them from the virus for life.

Risk in Hawaii

Prevention

The best way to prevent Hepatitis A is through vaccination.  The Hepatitis A vaccine is given as 2 shots, 6 months apart and is highly effective in preventing Hepatitis A infection.  Protection begins approximately 2 to 4 weeks after the first injection.  The second injection results in long-term protection.

Hepatitis A vaccination is recommended for:

  • All children at age 1 year
  • Travelers to countries that have high rates of Hepatitis A
  • Family members or caregivers of a recent adoptee from countries where Hepatitis A is common
  • Men who have sexual contact with other men
  • Users of injection and non-injection illegal drugs
  • People with chronic liver diseases, such as Hepatitis B or Hepatitis C
  • Persons with clotting factor disorders
  • People who work with Hepatitis A infected animals or in a Hepatitis A research laboratory
  • Anyone wishing to obtain protection from Hepatitis A

If you are not protected against Hepatitis A and are exposed to someone with the disease, contact your healthcare provider immediately.  Administration of the Hepatitis A vaccine or Immune globulin (IG) [a substance made from human blood plasma that contains antibodies that protect against infection and provides short-term protection] may help to prevent infection with Hepatitis A disease if given within the first two weeks after exposure.

Good hygiene, including handwashing after using the bathroom, changing, diapers, and before preparing or eating food, plays an important role in preventing Hepatitis A disease.

 

Additional Resources

Information for Clinicians