Hepatitis A (infectious hepatitis)

Last Reviewed: October 2010

What is hepatitis A?

Hepatitis A is caused by the hepatitis A virus. It is a highly contagious disease that attacks the liver. It is the most common type of viral hepatitis and one of the most frequently reported vaccine preventable diseases in the United States.

Who gets hepatitis A?

Anyone can get hepatitis A, but you are at greater risk if you:

  • live in an area with increased rates of hepatitis A (i.e., certain Western states in the United States)
  • travel to regions where hepatitis A is common (i.e., Central and South America, Africa, the Middle East, Asia, and the Western Pacific)
  • are a man and have sex with men
  • are an injection or non-injection drug user
  • have sex with someone infected with hepatitis A
  • live in the same house with someone who has hepatitis A

How is the virus spread?

Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called the "fecal-oral" route. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

Most infections in the United States result from contact with a household member or sex partner who has hepatitis A. Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person. Waterborne outbreaks are infrequent and are usually associated with sewage-contaminated or inadequately treated water. Casual contact, as in the usual office, factory, or school setting, does not spread the virus.

What are the symptoms of hepatitis A?

The symptoms of hepatitis A may range from mild to severe and can include an abrupt onset of fever, fatigue, poor appetite, nausea, stomach pain, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). The disease is rarely fatal and most people recover in a few weeks without any complications. Adults are more likely than children to develop symptoms. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

How soon do symptoms appear?

The symptoms commonly appear within 28 days of exposure, with a range of 15-50 days.

For how long is an infected person able to spread the virus?

The contagious period begins about two weeks before symptoms appear and lasts about one week after symptoms appear.

Does past infection with hepatitis A make a person immune?

Once an individual recovers from hepatitis A, he or she cannot be re-infected. He or she is immune for life and does not continue to carry the virus.

What is the treatment for hepatitis A?

There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear. Generally, bed rest is all that is needed.

How can hepatitis A be prevented?

In the event of exposure to hepatitis A, consult a doctor or the local health department.

To prevent person-to-person spread, careful hand washing after using the bathroom, changing diapers and before preparing or eating food, is the single most important means of prevention.

Close contacts who do not have immunity to hepatitis A virus should be administered immune globulin (IG) or hepatitis A vaccine within 2 weeks of exposure to a person who is contagious with hepatitis A infection. Close contacts include:

  • Household contacts
  • Sexual contacts
  • Playmates
  • Attendees at childcare centers
  • Persons sharing illegal drugs
  • Persons sharing food or beverages
  • Persons in common-source exposure situations (i.e., coworkers and/or restaurant patrons where an infected food worker has been identified)

Current Advisory Committee on Immunization Practices (ACIP) recommendations for post-exposure prophylaxis:

  • For healthy persons ages 12 months through 40 years, hepatitis A vaccine at the age appropriate dose is preferred.
  • For children <12 months, immunocompromised persons, persons with chronic liver disease and persons for whom vaccine is contraindicated, IG should be administered.
  • For persons > 40 years, IG is preferred; vaccine can be used if IG cannot be obtained.

Who should obtain the hepatitis A vaccine?

For long-term protection, hepatitis A vaccine is best. A safe and effective vaccine to prevent hepatitis A is available. The hepatitis A vaccine is recommended for all children aged 12-23 months. Hepatitis A vaccine is also recommended for the following persons who have not already been vaccinated or infected:

  • Travelers to areas with increased rates of hepatitis A
  • Men who have sex with men
  • Injection and non-injection drug users
  • Persons with blood clotting disorders (i.e., hemophilia)
  • Persons with chronic liver disease (including persons with chronic hepatitis B or chronic hepatitis C virus infection)