What is Hepatitis A?
Hepatitis A is an infection affecting the liver caused by hepatitis A virus (HAV). The incubation period is usually 14 to 28 days. Typical signs and symptoms of hepatitis A include fever, malaise, abdominal discomfort, loss of appetite, nausea, diarrhoea and jaundice (yellow discoloration of skin and sclera of the eyes, dark urine and pale stool).
Some people with hepatitis A infection may not have any signs and symptoms of the disease. Adults are more likely to have signs and symptoms than children. Recovery from symptoms following infection may be slow and may take several weeks or months. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure), which is associated with high mortality.
How does it spread?
HAV is transmitted primarily by the faecal-oral route, that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water. The virus can also be transmitted through close physical contact with an infectious person, although casual contact among people does not spread the virus.
In view of recent hepatitis A outbreaks affecting men who have sex with men (MSM) in various countries, it is suggested that male person-to-person sexual transmission may be accountable.
How can you prevent it?
Travellers can protect themselves by observing good personal hygiene and food hygiene. They should always wash their hands before eating or handling food, and after going to the 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 illnesses like cholera and travellers' diarrhoea.
Safer sex and strict personal hygiene are key to preventing hepatitis A via sexual transmission.
Hepatitis A vaccine is available and is highly effective in preventing hepatitis A infection. The vaccine should be considered for those at risk of infection, i.e. international travellers visiting high risk areas, MSM and chronic liver disease patients. It is used in persons one year of age or older. The first doses of Hepatitis A vaccine shall be administrated at least 2 weeks before departure. After completed the second dose within 6 -12 months, the protection is lifelong.
How is it treated?
There is no specific treatment for hepatitis A. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.