Hepatitis A is a viral infection of the liver. The virus is spread by the faecal-oral route, including contaminated food or water or direct contact with an infected person. Vaccination and good hygiene prevents infection.
Last updated: 29 May 2019
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What is hepatitis A?

'Hepatitis' means inflammation or swelling of the liver. It can be caused by chemicals or drugs, or by different kinds of viral infections. One common cause of infectious hepatitis is hepatitis A virus. Infection with one type of hepatitis virus does NOT give protection against infection with other hepatitis viruses.

What are the symptoms?

Symptoms include feeling unwell, tiredness, fever, nausea, lack of appetite, abdominal discomfort, and occasionally joint pains, followed by dark urine, pale stools and jaundice (yellowing of the eyeballs and skin). Jaundice, dark urine and pale stools do not occur in all cases.

Illness is usually mild and lasts one to three weeks. It is almost always followed by complete recovery. Occasionally it is more severe and symptoms can last longer, particularly in people with chronic liver disease. Small children who become infected usually have no symptoms.

Hepatitis A does not cause long-term liver disease and deaths caused by hepatitis A do occur but are very rare. Occasionally people are hospitalised for the disease and can have relapsing symptoms after the disease has seemed to have cleared.

The period between exposure to the virus and the development of symptoms is usually about four weeks, but can range from two to seven weeks.

How is it spread?

Infected people may pass on the virus to others typically from two weeks before the development of symptoms until one week after the appearance of jaundice, or until two weeks after the onset of symptoms if there is no jaundice (about four weeks in total). Caution is advised even beyond this period as the virus can be shed in stools for longer periods.

Large amounts of the virus are found in the faeces (stools) of an infected person during this infectious period. The virus can survive in the environment for several weeks in the right conditions.

Hepatitis A is usually transmitted when virus from an infected person is swallowed by another person through:

  • Eating contaminated raw, frozen or undercooked food
  • Drinking contaminated water
  • Transferring the virus onto hands and eventually mouth after handling soiled nappies, linen or towels of an infectious person
  • Sharing personal items such as toothbrushes
  • Direct contact (including sexual) with an infectious person

Outbreaks of hepatitis A have been traced to:

  • Person-to-person spread
  • Sexual contact especially among men who have sex with men
  • Consumption of imported frozen fruits
  • Drinking water contaminated with sewage
  • Eating food that has been contaminated at its source such as vegetables, berries and shellfish
  • Eating food contaminated by an infectious food handler
  • Child-care centres, nursing homes and prisons.

Infection with hepatitis A continues to be a problem for people travelling overseas, especially people visiting developing countries where hepatitis A is common.

Who is at risk?

Those who have not had hepatitis A and who have not been vaccinated against it are at risk of catching the disease.

How is​ it prevented?

Vaccination

A safe and effective vaccine is available against hepatitis A, but may take two weeks or more to provide protection. It can protect someone exposed to the virus if given within two weeks of contact. A two-dose course six months apart is recommended for long-lasting protection. Vaccination is recommended for the following higher-risk groups:

  • travellers to countries where hepatitis A is common (most developing countries)
  • frequent visitors to rural and remote indigenous communities
  • some health care workers who work in or with indigenous communities
  • sewerage workers
  • plumbers
  • men who have sex with men
  • child care and pre-school workers
  • the intellectually disabled and their carers​
  • people who use / inject illicit drugs
  • patients with chronic liver disease
  • people with haemophilia needing regular blood products.

What else can be done to avoid hepatitis A?

Everyone should always wash their hands thoroughly with soap and running water for at least 10 seconds and dry them with a clean towel:

  • after going to the toilet
  • before eating
  • before preparing food or drink
  • after handling objects that may have been contaminated with body fluids, such as nappies and condoms.
Imported frozen fruit products have been the source of numerous outbreaks of hepatitis A. Cooking these products prior to consuming eliminates the risk of hepatitis A and other potential foodborne infections.
 

What can be done to avoid infecting others?

If you have hepatitis A, as well as washing your hands thoroughly, you should avoid the following activities while infectious (your doctor will advise, but typically you are infectious until at least one week after onset of jaundice or two weeks after the onset of symptoms if there is no jaundice):

  • do not prepare food or drink for other people
  • do not share eating or drinking utensils with other people
  • do not share linen and towels with other people
  • do not have sex
  • wash eating utensils in soapy water, and machine wash linen and towels.
All people who have hepatitis A should check with their doctor before returning to work or school.
The following people have increased risk of passing hepatitis A on to others and must check with their doctor before returning to work or school:
  • People who handle food or drink
  • People whose work involves close personal contact, such as child carers and health workers
  • Children who attend child-care facilities.

How is it diagnosed?

Diagnosis is based on the patient's symptoms and confirmed by by hepatitis A antibody testing on the patient’s blood. Occasionally, hepatitis A DNA testing (PCR) may also be used for diagnosis on blood or faeces samples.

How is it treated?

There is no specific treatment for hepatitis A. Rest, good nutrition and fluids are recommended. Avoiding alcohol will reduce the stress on the liver. Household contacts and sexual partners of an infectious person may need to be immunised. Vaccination may prevent illness if given within two weeks of contact with the infectious person.

What is the public health response?

  • ​Doctors, hospitals and laboratories must confidentially notify cases of hepatitis A infection to the local Public Health Unit.
  • Public Health Unit staff will work with the doctor, the patient or the patient's family to identify close contacts at risk of infection and arrange for those at risk to receive information about the disease. Public Health Unit staff follow special guidelines for managing cases of hepatitis A in people who attend or work at a child care centre, and in people who handle food for sale.
  • Public Health Unit staff also investigate outbreaks of hepatitis A to identify the cause of the outbreak, control its spread and prevent further infections.

For further information please call your local Public Health Unit on 1300 066 055​​

Contact page owner: Communicable Diseases