Hepatitis A is a liver disease caused by the hepatitis A virus.

Hepatitis A can affect anyone. Hepatitis A is still a common disease in the United States. Young children can be infected with the virus but not show symptoms. These children often spread the illness to older children and adults.

Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis A virus infection in persons 2 years of age and older. Immune globulin is available for short-term prevention of hepatitis A virus infection in all ages.

How Do You Get Hepatitis A?

Hepatitis A virus (HAV) is found in the stool (poop) of persons with hepatitis A. HAV is spread from person to person by putting anything in the mouth that has been contaminated with the stool of a person with hepatitis A. The virus is easily spread in areas where there is poor sanitation or poor personal hygiene.

Persons with hepatitis A can spread the virus to household members or to sexual partners. Casual contact as in the usual office, factory or school setting, does not spread the virus.

Who Is More Likely to Get Hepatitis A?

• Persons who share a household or have sexual contact with someone who has hepatitis A
• Men who have sex with men
• Persons who use street drugs
• Children and employees in child care centers (especially centers that have children in diapers) where a child or an employee has hepatitis A
• Travelers to countries where hepatitis A is common
• Persons with clotting factor disorders who receive factor concentrates
• Residents and staff of institutions for developmentally disabled persons when a resident or an employee has hepatitis A
• Workers who handle HAV-infected animals or work with HAV in a research laboratory setting (This does not include laboratories doing routine testing.)

How Do You Know If You Have Hepatitis A?

Children who are infected often have no symptoms. Three of every four adults who get hepatitis A have symptoms. Symptoms usually develop over a period of several days.

Symptoms may include:

• yellow eyes
• tiredness
• dark urine
• loss of appetite
• nausea
• stomach ache
• fever
• vomiting

A person can spread HAV about one week before symptoms appear and during the first week of symptoms. Persons with no symptoms can still spread the virus. This often happens with young children who unknowingly spread HAV to older children and adults.

Hepatitis A usually does not cause death. There is no chronic (long-lasting) infection with hepatitis A. Recovering from the disease produces lifelong immunity from future HAV infection. Once a person recovers from hepatitis A, he/she will never get it again.

How Can You Prevent Hepatitis A?

You should always wash your hands after using the bathroom, changing a diaper, or before preparing or eating food.

Hepatitis A vaccines provide long-term protection against hepatitis A and can be given to persons 2 years of age and older.

Children and adults need hepatitis A vaccine for long-term protection. You will either need two shots of hepatitis A vaccine or three shots of the combination hepatitis A and hepatitis B vaccine. After getting your first shot, your doctor or nurse will tell you when to return for the second shot.

Immune globulin, (IG) might be used for short-term protection in two situations:

• for travelers instead of, or in addition to hepatitis A vaccine
• for unvaccinated persons, who have recently been exposed to HAV.

Immune globulin must be given within two weeks of exposure to HAV in order to work.

Can You Get Hepatitis A From Food or Water?

In addition to getting hepatitis A directly from infected people, you can get hepatitis A by:

• eating fruits, vegetables, or other food that may have become contaminated during handling
• eating raw shellfish harvested from sewage-contaminated water
• swallowing contaminated water or ice.

Can HAV Be Killed?

The virus is killed by heating to 185 degrees Farenheit (85 degrees Celsius) for 1 minute. However, the virus can still be spread by cooked foods if they are contaminated after cooking. Adequate chlorination of water, as recommended in the United States, kills HAV.

Who Should Receive Hepatitis A Vaccine?

• Children in states and counties with consistently increased rates of hepatitis A (County and state health departments can tell you whether your areas have these higher hepatitis A rates.)
• Men who have sex with men
• Persons who use street drugs
• Persons who work in or travel to countries where infection with hepatitis A virus is common (For the most protection, first dose should be given at least 4 weeks before travel.)
• Persons with chronic liver disease
• Persons with clotting factor disorders, such as hemophilia
• Persons who work with HAV-infected animals or work with HAV in a research setting (Hepatitis A vaccine is not generally recommended for health care workers.)

For more information on hepatitis A:

• access our website at www.cdc.gov/hepatitis
• call the hepatitis information line at 1-888-4HEPCDC (1-888-443-7232)
• access international travel website at www.cdc.gov/travel
• call the international travel information 1-877-FYITRIP (1-877-394-8747)
• write: Centers for Disease Control and Prevention
  Division of Viral Hepatitis
  Mailstop G37
  1600 Clifton Road
  Atlanta, GA 30333
• contact your state or local health department.