Hepatitis A is a viral infection that causes inflammation of the liver. Most people who contract hepatitis A recover fully after 1 to 2 weeks or in severe cases, several months. Asymptomatic infection is common, particularly in young children. Symptoms include:
nausea and vomiting
Natural hepatitis A infection confers lifelong immunity.
Transmission of hepatitis A occurs via the faecal-oral route through exposure to food, drink or objects contaminated with the faeces of another person infected with hepatitis A. In Australia, most cases of hepatitis A are associated with:
overseas travel to high-risk countries
day care centres enrolling children not yet toilet trained
sexual and household contacts of people infected with hepatitis A
illicit drug use.
Outbreaks have also been reported as a result of drinking or bathing in water contaminated by sewage, or by consumption of contaminated foods such as shellfish.
In 2017-19 an outbreak of hepatitis A occurred in South Australia among gay men and men who have sex with men (MSM). The public health response to this outbreak included a SA Health funded vaccination program for gay men and other MSM.
The incubation period is generally 15 to 50 days, usually 28 to 30 days.
Cases are considered infectious from 2 weeks prior to the onset of prodromal symptoms, to 2 weeks after symptom onset (or 1 week after the onset of jaundice, if it occurs).
On clinical suspicion of hepatitis A, request serology for hepatitis A IgM and IgG, and liver function tests (LFTs).
There is no test to detect hepatitis A during the incubation period and therefore testing of asymptomatic patients is not recommended.
There is no specific antiviral treatment for hepatitis A. Rest, good fluid intake and alteration in diet may decrease symptoms. Severely ill people may require admission to hospital for supportive treatment.
In South Australia, the Communicable Disease Control Branch coordinates the public health response to hepatitis A cases.
Exclude the case from child care, preschool, school, or work that could put others at risk for at least 7 days after jaundice onset (or if no jaundice, 14 days after the onset of illness).
Encourage good personal hygiene practices, especially thorough hand washing and safe food handling procedures.
The hepatitis A vaccine provides 6 to 12 months of protection against hepatitis A infection within two weeks of administration, and lifelong protection if a booster dose is administered at least 6 months after the first dose.
The hepatitis A vaccine is provided free to Aboriginal and Torres Strait Islander children only, as part of the National Immunisation Program at 18 months and 4 years of age.
Post-exposure prophylaxis using hepatitis A vaccine or normal human immunoglobulin (NHIG) can prevent secondary cases in close contacts of hepatitis A cases. Further information on the public health management of hepatitis A is available in the Hepatitis A National Guidelines for Public Health Units. In South Australia, the Communicable Disease Control Branch coordinates the public health response to hepatitis A cases.
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