Hepatitis A is an acute infection that causes inflammation (swelling) of the liver. In most cases it does not lead to long-term liver disease. It is sometimes called hep A or HAV.
As hepatitis A is an acute (short-term) infection most people experience symptoms which last for one to three weeks, and in some cases up to eight weeks. Some people, especially young children who are exposed to hepatitis A may have no symptoms at all. Once you have had hepatitis A and developed antibodies, you will have a life-long immunity from re-infection to the virus. Additionally, having the hepatitis A vaccination will give you life-long immunity.
How do you get hep A?
- From person to person by contaminated faeces which enters your mouth (faecal-oral contact)
- By consuming contaminated food and water
- Through contaminated hand-to-mouth contact
- Consuming food prepared by someone with hepatitis A who hasn’t washed their hands
- Drinking water that might be contaminated by faeces or sewage
- Having oral/anal sex
- Not washing your hands properly after handling nappies, used condoms, linen or soiled towels
- Travel to developing countries (where there is a higher risk of exposure to hep A)
How do you know if you have hepatitis A?
The only way to confirm if you have hepatitis A is to have a blood test but it is often not required for a diagnosis.
People often don’t go to the doctor because they think they just had a bad case of gastro (gastroenteritis).
Symptoms of hepatitis A are:
- Yellowing of the eyes and skin (jaundice)
- Abdominal pain (especially in liver area)
- Aches and pains
- Fatigue and weakness
- Nausea and vomiting
- Loss of appetite
- Light coloured faeces and dark urine
How long will it take to show symptoms?
The incubation period (time between being exposed to getting sick) is about 15 to 50 days. Hepatitis A will be excreted (in faeces) for 2 weeks before you get sick. So, people are considered to be infectious for 1 week after the jaundice (yellowing of skin and eyes) starts.
How do you prevent hepatitis A?
- Being vaccinated. For long term protection you must complete the full vaccination schedule – two injections given over 6 months.
- Washing your hands with soap and water after going to the toilet, before eating or handling food, after handling soiled or used objects such as nappies and condoms.
- Seeking advice on food and water risks when travelling to developing countries.
If you are exposed to hepatitis A, you can be treated with the hep A immunoglobulin within two weeks of possible exposure. Talk to you doctor for more information.
What is involved in the vaccination?
The standard vaccination for hepatitis A is two injections which should be given six months apart. However, if you forgot to get the second injection, it is never too late. Once you have the second vaccination you will have long-term immunity.
The other option is to have the Twinrix vaccination that will provide immunisation for hepatitis A and hepatitis B. This vaccination is three injections given over six months. It is likely that you will have to pay for either type of vaccination.
Who should be vaccinated?
The following groups should consider getting vaccinated:
- People with chronic liver disease
- People who have had a solid organ transplant
- People living with hepatitis B and/or hepatitis C
- People who inject drugs
- People who are in Correctional Centres
- Travellers to endemic countries over the age of one
- Aboriginal and Torres Strait Islander children living in Queensland, Northern Territory, South Australia, and Western Australia
- People living and working in rural and remote Aboriginal and Torres Strait Islander communities in Queensland, the Northern Territory, South Australia, and Western Australia
- People with disabilities and people working in disability services
- People who have anal intercourse (including men who have sex with men, and people in the sex industry)
- People working in the plumbing or sewage industry
- People working in early childhood centres
See the Australian Immunisation Handbook https://immunisationhandbook.health.gov.au/ for more details.
There is no treatment for hepatitis A, the immune system will activate and will produce antibodies to fight off the virus, eliminating it from your body. These antibodies will give you life-long immunity to being re-infected. The following will help you manage the symptoms:
- drinking lots of fluids
- eating when you can
- only take medications that are essential
- do not drink alcohol or smoke cigarettes.
If you have hepatitis A you are infectious and can spread the illness to others. The infectious period lasts from about two weeks before the symptoms appear to a week or so after they go away.
Vaccination of people in close contact with you may prevent the illness if given within two weeks of transmission.
Under the food safety standards, food handlers must tell their supervisors if they have hepatitis A or if they may have contaminated food with hepatitis A. While the symptoms are short term, they can sometimes be quite severe. Most people will require sick leave. Employers need to minimise risks and hazards in the workplace as well as providing the employee with privacy and confidentiality.
If a person is working in an area where hepatitis A may cause a risk to others, (such as food handling) then employers need to review safety standards and minimise any potential risks. During the acute phase of hepatitis A, the employee should not work in any area where there is a risk of transmission.
Returning to work after hepatitis A infection
According to Queensland Health “people with hepatitis A should not return to work, school or childcare until they are no longer infectious which is at least seven days after the onset of jaundice. Please seek professional medical advice.