Hepatitis A

What is hepatitis A?

Hepatitis A is a highly contagious, short-term liver infection caused by the hepatitis A virus.

How serious is hepatitis A?

People who get hepatitis A may feel sick for a few weeks to several months but usually recover completely and do not have lasting liver damage. In rare cases, hepatitis A can cause liver failure and even death; this is more common in older people and in people with other serious health issues, such as chronic liver disease.

How common is hepatitis A in the United States?

In 2018, a total of 12,474 hepatitis A cases were reported in the United States. Because some people don’t ever get diagnosed, the actual number of cases reported in that year is probably closer to 24,900. Since 2016, person-to-person outbreaks of hepatitis A have been occurring across the United States mainly among people who use injection drugs or are experiencing homelessness, resulting in more than 32,000 cases.

Are cases of hepatitis A increasing in the United States?

Since the hepatitis A vaccine was first recommended in 1996, cases of hepatitis A in the United States declined dramatically. Unfortunately, in recent years the number of people infected has been increasing because there have been multiple outbreaks of hepatitis A in the United States resulting from person-to-person contact, especially among people who use drugs, people experiencing homelessness, and men who have sex with men.

How can I protect myself against hepatitis A?

The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. To get the full benefit of the hepatitis A vaccine, more than one shot is needed. The number and timing of these shots depends on the type of vaccine you are given. Practicing good hand hygiene — including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food — plays an important role in preventing the spread of hepatitis A.

Who should get vaccinated against hepatitis A?

The following people should be vaccinated against hepatitis A:

• Children
• All children aged 12–23 months
• All children and adolescents 2–18 years of age who have not previously received hepatitis A vaccine (known as “catch up” vaccination)
• People at increased risk for hepatitis A
• People at increased risk for severe disease from hepatitis A infection
• Other people recommended for vaccination
• Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
• Any person who requests vaccination

How is hepatitis A spread?

The hepatitis A virus is found in the stool and blood of people who are infected. The hepatitis A virus is spread when someone ingests the virus (even in amounts too small to see) through:

►Person-to-person contact: Hepatitis A can be spread from close, personal contact with an infected person, such as through certain types of sexual contact (like oral-anal sex), caring for someone who is ill, or using drugs with others. Hepatitis A is very contagious, and people can even spread the virus before they feel sick.

►Eating contaminated food or drink: Contamination of food with the hepatitis A virus can happen at any point: growing, harvesting, processing, handling, and even after cooking. Contamination of food and water happens more often in countries where hepatitis A is common. Although uncommon, foodborne outbreaks have occurred in the United States from people eating contaminated fresh and frozen imported food products.

Who is at risk for hepatitis A?

Although anyone can get hepatitis A, in the United States, certain groups of people are at higher risk for getting infected and for having severe disease if they do get hepatitis A.

People at increased risk for hepatitis A

• International travelers
• Men who have sex with men
• People who use or inject drugs (all those who use illegal drugs)
• People with occupational risk for exposure
• People who anticipate close personal contact with an international adoptee
• People experiencing homelessness
• People at increased risk for severe disease from hepatitis A infection
• People with chronic liver disease, including hepatitis B and hepatitis C
• People with HIV

What should I do if I think I have been exposed to hepatitis A virus?

If you think you have been exposed to the hepatitis A virus, call your health professional or your local or state health department as soon as possible, ideally within 2 weeks. A health professional can decide next steps based on your age and overall health.

Can I prevent infection after an exposure to the hepatitis A virus?

A single shot of the hepatitis A vaccine can help prevent hepatitis A if given within 2 weeks of exposure. Depending upon your age and health, your doctor may recommend immune globulin in addition to the hepatitis A vaccine.

If I have had hepatitis A in the past, can I get it again?

No. Once you recover from hepatitis A, you develop antibodies, protecting you for life.

How long does hepatitis A virus survive outside the body?

The hepatitis A virus can survive outside the body for months. Heating food and liquids to temperatures of 185°F (85°C) for at least 1 minute can kill the virus. Exposure to freezing temperatures does not kill the virus.

What are the symptoms of hepatitis A?

Not everyone with hepatitis A has symptoms. Adults are more likely to have symptoms than children. If symptoms develop, they usually appear 2 to 7 weeks after infection. Symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.

If symptoms develop, they can include:

• Yellow skin or eyes
• Not wanting to eat
• Upset stomach
• Throwing up
• Stomach pain
• Fever
• Dark urine or light- colored stools
• Diarrhea
• Joint pain
• Feeling tired

Can a person spread hepatitis A virus without having symptoms?

Yes. Many people, especially children, have no symptoms but can still spread the infection. In addition, a person can transmit the hepatitis A virus to others up to 2 weeks before symptoms appear.