Hepatitis A

September 2009

What is Hepatitis A?

Hepatitis A is a disease that occurs worldwide. It is common in developing countries and is generally associated with poor sanitation and poor hygiene. The hepatitis A virus attacks the liver and can cause mild to severe illness. It is one of the most common vaccine-preventable illnesses in travellers.

 

 

 

Symptoms

• Can take from 15 to 50 days to occur (average 28 days).
• In children are mild to non-existent. Severity increases with age.
• Often start suddenly, and can include:
  • fever
  • fatigue
  • loss of appetite
  • nausea
  • abdominal discomfort
  • dark urine
  • jaundice (yellowing of skin and whites of eyes)

• In severe and rare occasions, can include liver damage, liver failure, or death. Those with pre-existing chronic liver disease or recipients of a liver transplant are most at risk for this.
• Most people recover without consequences. Recovery generally takes about four to six weeks, but can take months.

Transmission

• Hepatitis A is spread from the feces of an infected person.
• People can catch hepatitis A by drinking untreated water, eating contaminated uncooked foods (i.e.: shellfish), or eating foods prepared in unsanitary conditions.
• Can be transmitted person to person when poor fecal hygiene is practiced, i.e.: between children or during certain sexual practices.  
• Infection with the virus gives life long immunity (protection) against the virus.

Where is Hepatitis A is a concern?

• Worldwide but most common in regions with poor food and water hygiene.
• Regions where there is a high risk of hepatitis A transmission include:
  • Indian sub-continent (especially India, Pakistan, Bangladesh and Nepal)
  • Africa
  • the Middle East
  • parts of the far east (excluding Japan)
  • Central and South America
  • Mexico

A map of countries and areas of risk for hepatitis A is available on the World Health Organization website .

Related Travel Health Notices

None

Recommendations for Travellers

1. Practice safe food and water precautions
   • Boil it, cook it, peel it or forget it!
   • Always wash your hands before eating and drinking.
   • Only eat food that has been well cooked and is still hot when served. Avoid uncooked foods, especially shellfish and salads.
   • eat hot foods hot and cold foods cold
   • Drink and use ice from only purified water that has been boiled or disinfected with chlorine or iodine, or commercially bottled water in sealed containers. Carbonated drinks, including beer, are usually safe.
   • Avoid unpasteurized dairy products.
   • Avoid food from street vendors.
   • Avoid swimming in polluted or contaminated water.
   • Brush your teeth with purified or bottled water.
2. Get vaccinated
   
   You should get vaccinated if you are:
   
   
   • travelling to countries where Hepatitis A occurs; and
   • visiting areas where drinking water may be unsafe and poor sanitation and hygiene conditions exist.

Don't Forget …

1. Consult a health care provider or visit a travel health clinic at least six weeks before you travel.
2. What to do if you get sick when you are travelling.
3. What to do if you get sick after you return to Canada.
4. Know what vaccines you need and when to get them.

Other Related Information

• The Committee to Advise on Tropical Medicine and Travel (CATMAT) - Statement on HepatitisVaccines for Travellers

• Public Health Agency of Canada (PHAC) - Hepatitis A Fact Sheet

• PHAC - Vaccine-Preventable Diseases / Hepatitis A

• World Health Organization (WHO) – Hepatitis A