Hepatitis A

What is hepatitis A?

Hepatitis A is a viral disease of the liver and is the most frequently occurring infection in travellers that may be prevented by immunisation. Each year some 10 millions cases occur worldwide.

How is hepatitis A transmitted?

The virus is transmitted person-to-person by the faecal-oral route particularly in areas with poor sanitation and overcrowding. It is linked with eating and drinking contaminated water or food — for example, raw or undercooked shellfish and raw vegetables.

What are the symptoms of Hepatitis A?

Hepatitis A is infectious for 2-4 weeks before symptoms develop and for a few days afterward. Symptoms include:

  • Fever.
  • Chills.
  • Weakness.
  • Loss of appetite.
  • Nausea and abdominal discomfort.
  • Jaundice (yellowing of the skin and eyes).
  • Urine becomes dark and stools pale.

Many infections, particularly in children, are often without specific symptoms. In others, jaundice may be severe and prolonged and complete liver failure may occur. Past infection with hepatitis A virus gives life-long immunity.

How can hepatitis A infection be prevented?

Vaccination

The World Health Organisation (WHO) recommends that travellers be immunised against hepatitis A prior to travelling to areas outside Australia, Canada, Western Europe, Japan, New Zealand and the US. Adverse reactions to vaccines are usually mild and include redness and swelling at the injection site and headache.

Make sure to ask your doctor about this well before you travel.

Be careful

Most cases of hepatitis A among travellers can be prevented by the avoidance of potentially contaminated food and drink. However, tourists regularly succumb to such temptations and often eat and drink food purchased from street vendors. Many travellers falsely assume that food served in expensive resort hotels must be safe; however, this is not always the case. While people travelling to rural areas of developing countries are at particularly high risk of infection, most cases actually occur among people staying in resorts and middle and upper-level hotels. People born and raised in developing countries, and those born before 1945 in industrialised countries, have usually been infected in childhood, and are likely to be immune.

How is hepatitis A diagnosed?

Your doctor will talk to you about when and how your symptoms developed. They will examine your skin, eyes, and especially your abdomen to see if your liver is enlarged or tender. The doctor may use a urine test, stool test and blood test to diagnose your condition.

How is hepatitis A treated?

The usual treatment is bed rest, a balanced diet, and avoiding alcohol for at least six months. Hospitalisation is required only for more serious cases. Antibiotics are not useful in treating hepatitis. As soon as hepatitis is diagnosed, you should stop taking all drugs, except those your doctor specifically prescribes. You should abstain from alcohol and sexual contact. Utensils used for eating and cooking should be kept separate to prevent infection from spreading, and infected individuals should be careful not to become overly tired or dehydrated.

What can I do if I have hepatitis A?

  • See your doctor to confirm the diagnosis and seek advice on how to avoid infecting others.
  • Rest in bed until your fever is gone, urine colour is normal, and jaundice lessens.
  • Ask the doctor how much bed rest you need.
  • As your symptoms improve, you may gradually increase your level of activity. However, it is best to avoid too much physical exertion until your doctor gives you the all-clear.
  • Eat small, balanced meals, even when you feel nauseous, but avoid foods that do not appeal to you. Soft drinks, juices, and hard candy may help reduce nausea.
  • Follow your doctor's instructions for taking medicine to relieve your symptoms.
  • Avoid taking certain drugs that are processed in the liver — ask your doctor which drugs these are.
  • Avoid alcohol until your doctor says it's safe.

How long will the effects of hepatitis A last?

Recovery from hepatitis A usually takes 4—8 weeks. The disease rarely has lasting effects such as permanent liver damage. Hepatitis that lasts more than six months usually is not likely to have been caused by hepatitis A infection.

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