Hepatitis A (infectious hepatitis)

Last Reviewed: November 2006

What is hepatitis A?

Hepatitis A is caused by the hepatitis A virus. It is a highly contagious disease that attacks the liver. It is the most common type of hepatitis and one of the most frequently reported vaccine-preventable diseases in the U.S.

Who gets hepatitis A?

Anyone can get hepatitis A, but certain persons are at increased risk of infection, including:

  • Children and adults living in areas with increased rates of hepatitis (i.e., certain Western states in the U.S.)
  • Persons traveling to countries where hepatitis A is common (i.e., Central and South America, Africa, the Middle East, Asia, and the Western Pacific)
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Sexual contacts of infected persons
  • Household contacts of infected persons

How is the virus spread?

Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called the "fecal-oral" route. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

Most infections in the United States result from contact with a household member or sex partner who has hepatitis A. Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person. Waterborne outbreaks are infrequent and are usually associated with sewage-contaminated or inadequately treated water. Casual contact, as in the usual office, factory, or school setting, does not spread the virus.

What are the symptoms of hepatitis A?

The symptoms of hepatitis A may range from mild to severe and can include an abrupt onset of fever, malaise, loss of appetite, nausea, stomach pain, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). The disease is rarely fatal and most people recover in a few weeks without any complications. Adults have signs and symptoms of illness more often than children. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

How soon do symptoms appear?

The symptoms commonly appear within 28 days of exposure, with a range of 15-50 days.

For how long is an infected person able to spread the virus?

The contagious period begins about two weeks before symptoms appear and lasts about one week after symptoms appear.

Does past infection with hepatitis A make a person immune?

Once an individual recovers from hepatitis A, he or she cannot be re-infected. He or she is immune for life and does not continue to carry the virus.

What is the treatment for hepatitis A?

There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear. Generally, bed rest is all that is needed.

How can hepatitis A be prevented?

For long-term protection, hepatitis A vaccine is best. The vaccine is now approved for children as young as 12 months of age. To prevent person-to-person spread, careful hand washing, after using the bathroom, changing diapers and before preparing or eating food, is the single most important means of prevention. For close contacts of a person with hepatitis A virus infection, immune globulin (IG) shots are recommended to minimize the risk of disease. Immune globulin for hepatitis A virus protection is only effective if given within two weeks of the last contact with a person that is contagious. If given within two weeks of exposure, IG prevents clinical illness in more than 85 percent of recipients.

Who should obtain the hepatitis A vaccine?

Hepatitis A vaccine is recommended for the following persons 12 months of age and older:

  • Travelers to areas with increased rates of hepatitis A
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Persons with clotting-factor disorders (i.e., hemophilia)
  • Persons with chronic liver disease (including persons with chronic hepatitis B or chronic hepatitis C virus infection)
  • All children 12 months of age and older