THIS INFORMATION IS NOT MEDICAL ADVICE. THIS IS INFORMATION SOURCED FROM THE CDC, AND THE SF DEPARTMENT OF PUBLIC HEALTH.
Hepatitis A is a contagious liver infection caused by the hepatitis A virus (HAV). In the USA, hepatitis A infections have declined by 90% since 1995. Hepatitis A is still common in Latin America, Africa, the Middle East, and Asia.
If you're traveling to higher risk places where hepatitis A outbreaks frequently occur, then take the necessary precautions. More specifically, peel and thoroughly wash all fresh fruits and veggies yourself before eating them. Avoid eating any raw or undercooked meat, poultry and fish. Drink only bottled water and also use it when brushing your teeth. Don't drink any beverages with ice added.
Hepatitis A virus is found in the stool (feces) of people with HAV infection. It enters the body through the mouth after someone handles something contaminated with HAV, or eats or drinks something contaminated with HAV.
People usually get hepatitis A by having close contact with a person who is infected, from food or drinks prepared by someone who is infected, or by eating shellfish harvested from sewage-contaminated water. After the virus enters the body, there is an incubation period lasting 2 to 7 weeks until illness begins.
Anyone who is not immune to hepatitis A can get hepatitis A infection. Food-borne outbreaks occur sporadically throughout the USA. Certain groups of people do have a higher risk of developing HAV infection:
The incubation period averages 28 days (range, 15–50 days). Infection can be asymptomatic or range in severity from a mild illness lasting 1–2 weeks to a severely disabling disease lasting several months. Clinical manifestations include the abrupt onset of fever, malaise, anorexia, nausea, and abdominal discomfort, followed within a few days by jaundice. The likelihood of having symptoms with HAV infection is related to the age of the infected person. In children aged <6 years, most (70%) infections are asymptomatic; jaundice is uncommon in symptomatic young children. Among older children and adults, the illness usually lasts <2 months, although approximately 10%–15% of infected people have prolonged or relapsing symptoms over a 6- to 9-month period. Severe hepatic and extrahepatic complications, including fulminant hepatitis and liver failure, are rare but more common in older adults and people with underlying liver disease. Chronic infection does not occur. The overall case-fatality ratio is 0.3%; however, the ratio is 1.8% among adults aged >50 years.
HAV cannot be differentiated from other types of viral hepatitis on the basis of clinical or epidemiologic features. Diagnosis requires a positive test for antibody to HAV (anti-HAV) IgM in serum, detectable from 2 weeks before the onset of symptoms to approximately 6 months afterward.
Serologic tests for total anti-HAV (IgG and IgM) are available commercially. A positive total anti-HAV result and a negative IgM anti-HAV result indicate past infection or vaccination and immunity. The presence of serum IgM anti-HAV usually indicates current or recent infection and does not distinguish between immunity from infection and vaccination. Acute hepatitis A is a nationally notifiable disease.
Supportive care. There are many natural treatments to deal with the symptoms of Hepatitis A.
Hepatitis A–containing vaccines should not be administered to individuals with a history of hypersensitivity to any vaccine component, including neomycin. Twinrix should not be administered to people with a history of hypersensitivity to yeast. The tip caps of prefilled syringes of Havrix and Twinrix and the vial stopper, syringe plunger stopper, and tip caps of Vaqta may contain dry natural rubber, which may cause allergic reactions in latex-sensitive people. Because hepatitis A vaccine consists of inactivated virus and hepatitis B vaccine consists of a recombinant protein, no special precautions are needed for vaccination of immunocompromised travelers. Providers should check precautions and contraindications before administering IG.
The safety of hepatitis A vaccine for pregnant women has not been determined.