Hepatitis A is an infection of the liver caused by the hepatitis A virus. It leads to inflammation (swelling) of the liver.
Some people with hepatitis A do not have any symptoms. Others have flu-like symptoms, loss of appetite, abdominal pains or jaundice (see Symptoms of hepatitis A for more information).
Hepatitis A is the most common type of viral hepatitis.
Who is affected by hepatitis A?
Hepatitis A is not very common in Ireland. It is more common in countries where sanitation and sewage disposal are poor, particularly countries in Africa, northern and southern Asia, central America and southern and eastern Europe.
Vaccination against hepatitis A is recommended if you are travelling to countries in these areas.
Hepatitis A can occur at any age but mostly affects children and young adults.
How do you catch hepatitis A?
The hepatitis A infection is usually caught by putting something in your mouth that has been contaminated with the stools (faeces) of someone with hepatitis A.
The incubation period (the time from coming into contact with the virus to developing the infection) is approximately two to six weeks.
Hepatitis A is usually an acute (short-term) infection. Many people recover within a couple of months without treatment. Though the symptoms can be unpleasant, hepatitis A is rarely serious.
Once you have recovered from hepatitis A, you are immune from it and can never catch the infection again.
Hepatitis A is a notifiable condition. This means that when the condition is diagnosed, the doctor making the diagnosis must inform the Medcial Officer of Health. Read more about notifying infectious diseases here on the Health Protection Surveillance Centre Website.
The liver is the body’s ‘factory’, carrying out hundreds of jobs that are vital for life, including:
- storing glycogen (carbohydrate that produces short-term energy)
- making bile, which helps digest fats
- making substances that clot the blood
- processing and removing alcohol, toxins and drugs
You only have one liver, but it is very tough. It keeps going even when badly damaged, and it can keep repairing itself until it is severely damaged.
Some people with hepatitis A, particularly young children, do not show any symptoms.
Otherwise, the symptoms you need to be aware of are:
- flu-like symptoms, such as tiredness, general aches and pains, headaches and fever
- loss of appetite, nausea or vomiting, and diarrhoea
- abdominal (tummy) pains
- jaundice (see box, right)
The length and severity of hepatitis A varies. You may experience flu-like symptoms for a week with the jaundice gradually improving, or you may feel tired for up to a month or two.
It is likely you will completely recover within a couple of months, although a small number of people have relapses and symptoms may persist for up to six months.
Once you have recovered from hepatitis A, you are immune from it and can never catch the virus again.
Jaundice is when the skin and the whites of the eyes become yellow.
It occurs because your damaged liver is unable to remove bilirubin, a yellow substance in the blood that is a by-product of red blood cells. Bilirubin may also turn your urine very dark, and you may have pale stools (faeces).
The hepatitis A virus is in the stools (faeces) of infected people. The disease is easily spread in areas where there is overcrowding and poor sanitation.
Poor personal hygiene
The most common cause of hepatitis A is eating food that is contaminated with the stools of an infected person as a result of poor personal hygiene. For example, you may get hepatitis A if you eat food prepared by an infected person who has not properly washed their hands.
Contaminated drinking water
It is also possible to become infected with hepatitis A by drinking contaminated water that has not been treated properly. This includes using ice cubes made from contaminated water and eating raw fruit or vegetables washed in contaminated water.
Also, shellfish can be infected if it comes from sea contaminated with sewage.
If you have been in contact with someone with hepatitis A or you begin to have symptoms, see your GP.
Your GP will be able to diagnose hepatitis A with a blood test. If this shows a positive reaction to antibodies (proteins produced by your immune system to fight disease), it means your body is making antibodies to fight the hepatitis A virus present in your blood.
There is no specific treatment for hepatitis A and most people recover completely within a couple of months.
It is sensible to rest and avoid fatty foods if you feel sick. Try to eat a normal healthy diet. Avoid alcohol while you are ill as your liver will be inflamed (swollen). After you have recovered, limit your alcohol intake to sensible levels.
You may need to be admitted to hospital for a few days. You will probably be given fluids straight into your body through a drip and medication if your symptoms are more severe.
Severe itching caused by jaundice can occasionally require hospital treatment.
Complications of hepatitis A are rare. The viral infection can be unpleasant, but most people make a full recovery within two months with no permanent liver damage.
Older people and people with other medical conditions, such as diabetes, anaemia or congestive heart failure, may take longer to recover from the infection.
Occasionally, the infection can be fatal due to severe liver inflammation (swelling) that leads to liver failure. Liver failure usually happens in people with a weakened immune system, such as the elderly or people with a medical condition that affects the immune system (for example, HIV).
Vaccination against hepatitis A is recommended if you are travelling to countries where the virus is common, such as the Indian subcontinent, Africa, central and south America, the Far East and eastern Europe.
Your GP or a Travel health clinic can give this vaccination, but you can expect that there will be a charge.
You should have one injection 4 to 6 weeks before you travel. A booster dose can be given 6 to 12 months later.
Hepatitis A vaccine is also recommended for some other groups of people, for example those with certain occupations that put them at risk, clients or residents of institutions for people with learning disabilities, men who have sex with men and people who inject drugs.
The vaccine may also be recommended if you have had close contact with a person who has Hepatitis A infection.
Protection against hepatitis A begins two weeks after the first dose of hepatitis A vaccine. An initial vaccination plus booster dose is believed to give protection for over 10 years.
If you have been in close contact with a person infected with hepatitis A, you can get short-term protection (lasting three to six months) from an injection of antibodies called immunoglobulin. Immunoglobulin must be given within two weeks of exposure to the hepatitis A virus for maximum protection.
An important prevention against hepatitis A is good personal hygiene. Washing your hands well and frequently can help protect you against a number of infections, viruses and bacteria.
It is essential to wash your hands after using the toilet and before preparing or eating food. Extra precautions include not sharing towels, eating utensils or toothbrushes.