Hepatitis A What is Hepatitis A? Hepatitis A is an infection affecting the liver caused by hepatitis A virus. The incubation period is fifteen to fifty days (average is 28 - 30 days ). Onset of disease is usually abrupt with fever, malaise, upper abdominal discomfort, loss of appetite and nausea, followed within a few days by yellow discoloration of skin and eyes. Some people with hepatitis A infection may not have any signs and symptoms of the disease. Older persons are more likely to have symptoms than children. Complete recovery without sequelae and recurrences is the rule. After recovery the person has immunity which is probably lifelong. How does it spread? Hepatitis A virus is transmitted from person to person and through food or drink that has been contaminated with the stool of someone with hepatitis A infection. Therefore the disease occurs more frequently in places where sanitation is unsatisfactory, contaminated water is used and infected food handlers are employed. How can you prevent it? Travellers can protect themselves by observing good personal hygiene and food hygiene. They should always wash their hands before preparing food, before meals and after going to toilet. They should avoid drinking contaminated water or beverage with ice of doubtful origin, eating uncooked or undercooked food, particularly shellfish, and eating cut or peeled fruits. These measures can also effectively prevent other infectious food-borne illness like cholera and travellers' diarrhea. Hepatitis A vaccine is available and is highly effective in preventing hepatitis A infection. The vaccine should be considered for those at increased risk of infection, i.e. international travellers visiting high risk areas. It is used in persons two years of age or older. The vaccine is administered in two doses six months apart. Protection against hepatitis A begins four weeks after the first dose. It is safe and does not cause serious side effects. Current evidence suggests that the protection of hepatitis A vaccination lasts for at least 10 years. How is it treated? The diagnosis of hepatitis A infection is confirmed by blood test. Treatment is mainly supportive. Bed rest should be at the patient's option during the acute initial phase of the disease. Return to normal activity in the convalescent period should be gradual.