Hepatitis A is sometimes called hep A or HAV. It is a liver disease caused by the hepatitis A virus. You can prevent illness by having a vaccination that will protect you from being infected for up to 10 years.
Where is hepatitis A common?
Hepatitis A is common in places where water supplies and sewage disposal are of a poor standard, and where personal and food hygiene standards are poor. Southern and Eastern Europe, Africa and parts of the Middle and Far East are high-risk areas.
How is hepatitis A passed on?
Hepatitis A is passed from person to person by eating food or drinking water contaminated (infected) with the virus. The illness can spread easily within families and where people live closely together. The virus is passed out in the bowel motions of an infected person, which is why it is important to wash your hands after going to the toilet. Drinking water can be contaminated with the virus. Fruit, vegetables and uncooked food washed in contaminated water can cause infection, especially in hot countries. Shellfish can be infected if it comes from sea contaminated with sewage. Cooked food is safe, but can be contaminated if it has been handled by someone with the virus.
Infection is not very common in the UK. But the true number of people affected is unknown as people who only have mild symptoms may not go to a doctor.
What are the symptoms?
After the virus enters the body, there are no symptoms for two to six weeks (the incubation period). Some people, particularly young children, may only have a mild illness. They may not know they are infected, although they can pass on the virus to others.
A few people (especially older) develop a serious illness and need to be looked after in hospital. However, there may be general symptoms — often mistakenly diagnosed as flu – such as tiredness, aches and pains, a fever and/or loss of appetite. There may also be nausea (feeling sick), vomiting, stomach ache and/or diarrhoea. These symptoms may last for a week or more. Then jaundice may develop.
Jaundice is easily noticeable because the whites of the eyes go yellow, and in more serious cases the skin goes yellow, urine may turn dark and bowel motions become pale. Jaundice is caused by too much of a yellow substance called bilirubin building up in the body. Bilirubin is a waste product from the breakdown of red blood cells which the liver normally gets rid of by passing it out in your bowel motions. When the liver is not working properly, bilirubin builds up in the body.
It will take a while to recover from hepatitis A. Most people feel better within a few weeks, although they may feel tired and lack energy for many more months. Once you have recovered, you will never be infected with hepatitis A again. Unlike other hepatitis viruses, the illness does not cause long-term liver damage.
Protect yourself with a vaccination
If you are going to visit countries where hepatitis A is common, we recommend that you have a vaccination. You will receive one injection four to six weeks before you travel and a booster six to 12 months later. Your doctor will be able to give you advice about vaccinations.
If you have been in close contact with an infected person or are travelling at late notice, short-term protection lasting three to six months is available; this is an injection of antibodies called immunoglobulin. We recommend you get vaccinated if you:
- are visiting countries where hepatitis A is common.
- are an injecting drug user.
- are a gay man (or your sexual behaviour may put you at risk).
- at risk through your work (for example, if you come into contact with sewage).
- already have long-term liver disease (infection with hepatitis A in someone who already has liver disease can cause a more serious illness).
Not everyone needs to be vaccinated. Some people have antibodies from a previous infection that they may not have known they had. Your doctor can check this with a blood test.
Avoid infection with hepatitis A by:
- visiting your doctor or travel clinic for a vaccination four to six weeks before you travel to a high-risk area.
- avoiding having ice cubes in drinks, drinking tap water, eating ice cream or cleaning your teeth in tap water in countries where hepatitis A is common.
- not eating poorly-cooked shellfish, uncooked vegetables, salads, unpeeled fruit or unpasteurised milk in high-risk countries.
If you are worried that you may have hepatitis A, you must contact your doctor.