What Is Hepatitis A?

Hepatitis A is a viral infection that affects the liver. The virus causes the liver damage. Liver function is reduced. Waste that is normally eliminated by the liver builds up in the blood. Jaundice, a yellowing of the skin and eyes, usually results.

Hepatitis A is passed from person to person through contact with infected stool. You can get the virus from an infected child by changing a diaper or by having sexual contact with an infected person. Contaminated food and water can also spread the virus.

The virus is very common in developing countries. It also occurs in the United States.

Symptoms include:

• Fever
• Yellowing of the eyes and skin—jaundice
• Tiredness
• Abdominal pain or soreness
• Lack of appetite
• Nausea and vomiting
• Headache
• Chills

If you have been in contact with the virus and have not been vaccinated, a shot of the vaccine or immune globulin (IG) can prevent you from getting sick. It can also prevent you from spreading the virus. Either shot should be given as soon as possible.

If you do get sick, usually symptoms will resolve after rest, drinking plenty of fluids. You should also avoid medication that can damage the liver and alcohol.

At times, people with hepatitis A need to be hospitalized. Rarely, the infection can be fatal if the liver is severely damaged.

What Is the Hepatitis A Vaccine?

The vaccine contains an inactivated form of the hepatitis A virus. It is given as an injection in the arm.

A combined vaccine that protects against both hepatitis A and hepatitis B is also available.

Who Should Get Vaccinated and When?

The vaccine is recommended for all children aged 12-23 months. The 2 doses of the series are given 6-18 months apart. Children who have not been vaccinated can receive the shot at their next doctor’s visit.

The following people should also get vaccinated:

• Children aged 24 months or older who are at high risk and have not been previously vaccinated.
• People traveling to areas where hepatitis A is prevalent. The CDC’s http://wwwnc.cdc.gov/travel shows which areas have high rates hepatitis A.
• Men who have sex with men.
• Injection drug users.
• People who are at risk because of their job.
• People with chronic liver disease.
• People treated with clotting factor concentrates.
• People who will have close contact with an adopted child from a medium- or high-risk area.
• People who want immunity to hepatitis A.

In general, people who are traveling should get the first dose at least one month before leaving the United States. Getting the vaccine anytime before traveling may also result in some protection.

What Are the Risks Associated With the Hepatitis A Vaccine?

There is a very small risk of severe allergic reaction, with symptoms such as:

• Difficulty breathing
• Skin rash
• Rapid heartbeat
• Lightheadedness
• Wheezing

Moderate side effects include:

• Soreness at the site of injection
• Headache
• Loss of appetite
• Fatigue

Who Should Not Get Vaccinated?

The following people should not get vaccinated:

• Children under one year of age
• Anyone who has already had hepatitis A
• Anyone who has previously had a severe allergic reaction to the hepatitis A vaccine
• Anyone who has previously had a severe allergic reaction to any component of the hepatitis A vaccine, (including alum or 2-phenoxyethanol)
• Anyone who is very ill

What Other Ways Can Hepatitis A Be Prevented Besides Vaccination?

• Wash your hands with soap and water, especially after using the restroom or changing a diaper.
• IG given before and after exposure is another way of preventing and treating the virus.
• Twinrix is another vaccine that protects against both hepatitis A and B.

What Happens in the Event of an Outbreak?

If a food-borne outbreak occurs, the source of the contaminated food will be identified and eliminated. In any hepatitis A outbreak, the affected community will get vaccinated to prevent the virus from spreading.

Hepatitis Foundation International http://www.hepfi.org

Canadian Liver Foundation http://www.liver.ca

Hepatitis A FAQ’s for health professionals. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/hepatitis/HAV/HAVfaq.htm
Updated June 6, 2013. Accessed February 4, 2015.

Hepatitis A information for health professionals. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/hepatitis/HAV/index.htm
Updated April 14, 2014. Accessed February 4, 2015.

Hepatitis A virus vaccine inactivated. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated January 18, 2013. Accessed February 4, 2015.

Immunization schedules. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/schedules/index.html
Updated January 26, 2015. Accessed February 4, 2015.

Workowski KA, Berman S, et al. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

9/25/2009 DynaMed’s Systematic Literature Surveillance http//www.ebscohost.com/dynamed:

Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR Morb Mortal Wkly Rep. 2009;58:1006.