Medical Guides - Hepatitis A

What Is Hepatitis A?
Hepatitis A is a highly contagious and rarely fatal liver disease. Historically, it was called infectious hepatitis, now it's more commonly known as hepatitis A, named after the virus that causes it. The incidence of hepatitis A varies throughout the world. Areas where hepatitis A is common or "endemic" are shown in the map below. In unprotected people traveling to highly endemic areas, hepatitis A occurs 10 to 100 times more frequently than typhoid fever and 1,000 times more often than cholera.

It is sometimes called a travel disease because it is the most frequently occurring, vaccine-preventable infection in travelers. The incidence of hepatitis A disease in travelers increases with the length of travel and is highest for those who stay in or visit rural areas, frequently eat or drink in areas poor hygiene or sanitary controls. Note however, hepatitis A can also occur among travelers who stay only in city areas and even those living in luxury hotels.

What Are The Symptoms of Hepatitis A?
In those who develop symptomatic hepatitis A:

  • flu-like symptoms - fever, chills, and a general feeling of weakness, may occur.
  • anorexia
  • nausea
  • jaundice (yellowing of the eyes and skin), this is the result of the virus affecting the liver's ability to metabolise the bile salts - bilirubin and biliverdin.
  • dark urine and light-colored stools (again this is due to liver dysfunction).
  • abdominal pain.
  • fatigue.

Although hepatitis A does not result in chronic infection, complete recovery from hepatitis A can be slow. Generally:

  • In children, especially in those younger than 6 years of age, there are often no symptoms.
  • Adult patients with hepatitis A may be quite ill for at least a month, and full recovery can take up to 6 months.

Up to 20% may have a relapse of the disease and may be impaired for as long as 15 months. In addition, it is estimated that 15% of patients require hospitalization for hepatitis A.

How is Hepatitis A Transmitted?
Hepatitis A is usually spread through person-to-person contact or through contaminated food or water - the virus is water-borne. It is also found in the stool of persons with hepatitis A. It can therefore spread from food handlers infected by Hepatitis A who fail to wash their hands after going to the bathroom, or it may be contracted from changing diapers of an infected child.

If the fecal contaminant somehow gets on food - for example, if a contaminated cook handles food in a restaurant - the disease can spread quickly. A person can also get hepatitis A by drinking water that is contaminated with the virus or by eating food washed in contaminated water, such as raw or undercooked shellfish, salads, or unpeeled fruits.

The table below shows the common routes of transmission for hepatitis A,B and C.

At Risk Individuals
People at risk of hepatitis A, either from spreading or contracting the disease, include:

  • Persons traveling to areas of higher endemicity for hepatitis A. These areas include Africa, Asia (except Japan), the Mediterranean basin, Eastern Europe, the Middle East, Central and South America, Mexico, and parts of the Caribbean .
  • Persons living in or relocating to any community with one or more recorded hepatitis A outbreaks within the past 5 years .
  • Military personnel .
  • Persons who engage in high-risk sexual activity .
  • Users of illicit injectable drugs .
  • Hemophiliacs and other recipients of therapeutic blood products .
  • Employees of day-care centers .
  • Institutional care workers .
  • Laboratory workers who handle live hepatitis A virus .
  • Handlers of primate animals that may be harboring hepatitis A virus .


Minimizing The Risk Of Infection
Avoiding risk factors and taking care when you travel can dramatically reduce the risk of contracting and/

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