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Hepatitis A - including symptoms, treatment and prevention

Hepatitis A is an infection of the liver caused by the hepatitis A virus.

Hepatitis A is a notifiable condition1

How hepatitis A is spread

The infection is spread when traces of faeces (containing hepatitis A virus) contaminate hands, objects, water or food and the virus is then taken in by mouth. Hepatitis A virus is extremely durable in the environment.

In Australia, most cases of hepatitis A are associated with the below. It is occasionally transmitted during sexual activity where faecal-oral contact occurs and rarely is transmitted by blood transfusion.

  • childcare centres enrolling children not yet toilet trained
  • sexual and household contacts of people infected with hepatitis A
  • overseas travel to high risk countries
  • injecting and non-injecting drug use.

Signs and symptoms

yellowing of the eyes, indicating jaundiceSymptoms include:

  • abdominal pain
  • loss of appetite
  • weight loss
  • nausea (and sometimes vomiting)
  • fever and chills
  • mild headache
  • tiredness
  • yellow skin and eyes (jaundice) (see image)
  • dark urine and pale faeces.

Adults and older children are more likely to have symptoms lasting 1 to 2 weeks, or in severe cases, up to several months. Children under age 3 rarely have symptoms.

Most people recover fully and subsequently will have life-long immunity. Death from hepatitis A is rare.

Image Courtesy Public Health Image Library (PHIL), Department of Health and Human Services, Centers for Disease Control and Prevention (CDC-USA) CDC,Dr. Thomas F. Sellers / Emory University

Diagnosis

The diagnosis is made by a blood test.

Incubation period

(time between becoming infected and developing symptoms)

Generally 15 to 50 days, usually 28 to 30 days.

Infectious period

(time during which an infected person can infect others)

A person is considered infectious from 2 weeks prior to the onset of illness, to 2 weeks after the onset of illness (or 1 week after the onset of jaundice, if it occurs).

Treatment

There is no specific antiviral treatment for hepatitis A. Rest, good fluid intake and alteration in diet may decrease symptoms. Severely ill people require admission to hospital.

Prevention

  • Exclude people with hepatitis A from childcare, preschool, school and work for 7 days after the onset of jaundice (if present) or 2 weeks from the onset of illness.
  • Follow good personal hygiene practices, especially thorough hand washing.
  • Good food handling procedures should always be followed.
  • Immunisation against hepatitis A. The hepatitis A vaccine provides protection within 4 weeks of having the vaccine and lasts for more than 10 years, if a booster dose is administered at least 6 months after the first dose. See Hepatitis A vaccine for detailed information on who the vaccine is recommended for.

Immunisation and immunoglobulin

Hepatitis A vaccine is offered to non-immune household and/or sexual contacts of all people with hepatitis A who have had contact during the 2 weeks before, until 1 week after the onset of jaundice. A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person.

If contacts are under 1 year of age, are immune suppressed, have chronic liver disease or for whom vaccine is contraindicated, normal human immunoglobulin can be offered. Immunoglobulin is a solution containing human antibodies that is made from blood products.

If given within 2 weeks after exposure, vaccine or immunoglobulin will prevent or decrease the severity of symptoms of hepatitis A. Contacts (including those given vaccine or immunoglobulin) may remain infectious to others even if they do not develop symptoms themselves and should therefore continue to follow good personal hygiene practices.

If a person with hepatitis A is a food handler by occupation, vaccine (or immunoglobulin if in one of the groups for whom vaccine is not recommended) should be administered to the other food handlers working in the same establishment.

Under certain circumstances vaccine (or immunoglobulin) may be offered to staff and children at childcare facilities.

Useful links


1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.

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