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Hepatitis A

Hepatitis A is caused by a virus that infects and can damage the liver. The virus is very contagious. It can be spread through direct and indirect contact, such as by eating food that was handled by a person with hepatitis A. Hepatitis A may also be transmitted if someone is exposed to feces (poop) during sexual activity.

The virus is most likely to spread in the two weeks before symptoms appear and in the first week with symptoms.

Prevention

You can avoid infection and transmission by:

  • Getting vaccinated.
  • Washing your hands with soap regularly, especially before touching food, after using the bathroom or changing diapers, and when taking care of someone with hepatitis A infection.
  • Waiting two weeks after diarrhea to engage in sexual practices that result in hand or mouth contact with stool (anal sex, fingering, rimming). Wash your buttocks, penis, and any sex toys with soap and water before and after these activities. A dental dam during rimming also provides protection (condoms prevent other sexually transmitted infections, including HIV, but may not prevent hepatitis A).
  • Using bottled water or boiling tap water for one minute if you are in a country where hepatitis A is common, including countries in the Caribbean, Central and South America, Africa, Eastern Europe and parts of Asia. You should also avoid eating shellfish that may have come from a contaminated water source in these countries.

Vaccination

For lasting protection against hepatitis A, you should get two doses of a single-antigen hepatitis A vaccine (Havrix® or Vaqta®) at least six months apart.

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Routine Vaccination

Routine hepatitis A vaccination is recommended for all children between ages 1 and 2 years. In NYC, all children and adolescents not previously vaccinated should receive the two-dose hepatitis A vaccine series by their 19th birthday for lifetime protection. In addition, you should get vaccinated if:

  • You are traveling to a country with a high rate of hepatitis A. This includes countries in the Caribbean, Central and South America, Africa, Eastern Europe and parts of Asia. You are best protected if you take the first dose at least a month before travel, but the vaccine will still provide protection if you get the first dose two weeks before travel.
  • You work with the hepatitis A virus in a laboratory.
  • You are a man who has sex with men.
  • You have chronic liver disease.
  • You use injection or non-injection drugs.
  • You are living on the street, in a shelter, or otherwise do not have a permanent address.
  • You have HIV.

Additional Vaccination Considerations

You should also consider getting vaccinated if there is an outbreak of the infection in your community.

People who have hepatitis A and work in the food service, healthcare, and child care industries can transmit hepatitis A to the people they serve. If you work in these industries, consider vaccination to reduce this risk, especially if you are in a community experiencing an ongoing outbreak.

If you are a household contact, sexual contact, or caretaker of someone with hepatitis A, or if you shared food with someone with hepatitis A, getting the hepatitis A vaccine within 2 weeks of exposure can prevent infection.

If exposed to hepatitis A:

  • People aged 12 months and older should receive 1 dose of single-antigen hepatitis A vaccine (Havrix® or Vaqta®) within 2 weeks after exposure.
    • The combined hepatitis A/hepatitis B vaccine (Twinrix®) is not recommended for protection after exposure.
  • Infants and anyone for whom hepatitis A vaccine is contraindicated should receive a medicine called immune globulin within 2 weeks after exposure to prevent infection.
  • People who already received the 2-dose hepatitis A vaccine series prior to exposure do not need additional vaccination.

If you have questions about protection against hepatitis A or you think you may be at risk for hepatitis A, contact your health care provider. You can find a location for hepatitis A vaccination by visiting the NYC Health Map.

Symptoms

Symptoms of hepatitis A can appear between two and seven weeks after exposure. Most people start experiencing symptoms about one month after being exposed.

Symptoms may include:

  • Fatigue (feeling tired)
  • Jaundice (yellowing of eyes and skin)
  • Fatigue
  • Stomach pain
  • Nausea
  • Diarrhea
  • Dark-colored urine
  • Joint pain

Not everyone with hepatitis A will have these symptoms.

Symptoms can become severe and lead to hospitalization or death, but most people get better within a few weeks. Less than 1% of cases result in death. People who have chronic liver disease or a weakened immune system are at a higher risk for serious illness.

Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than older children and adults.

If you think you may have hepatitis A, see a health care provider for testing.

Treatment

There is no treatment for hepatitis A once symptoms appear, but most people fully recover on their own by resting and not drinking alcohol. People with hepatitis A should also avoid taking drugs that can hurt their liver, such as acetaminophen or Tylenol.

If you have had hepatitis A and recovered from the disease, you are now immune and can never get infected again or spread the virus.

Additional Resources

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