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Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus (HAV).1 The hepatitis A virus replicates in the liver, transports through the bile, and is excreted into the feces via the biliary system.2
Hepatitis A can cause mild illness lasting a few weeks to a severe illness lasting several months.1
Lasting a few
Humans are the only natural host for the hepatitis A virus.2
The likelihood of symptomatic illness from the hepatitis A virus (HAV) is directly linked to age. Adults with HAV infection usually experience symptoms; however, hepatitis A in children under 6 years of age is largely asymptomatic. In fact, nearly 70% of children under 6 years of age with HAV infection show no symptoms.2,3
For those who experience symptoms, the onset is typically abrupt and includes2:
Most people who get hepatitis A recover completely; however, in rare cases, hepatitis A can cause liver failure and death. This is more common in people older than 50 and in people with other liver diseases.1
The transmission of the hepatitis A virus infection occurs from person-to-person contact through the fecal-oral route or by consuming contaminated food or drink. In very rare instances, the transmission of HAV infection can occur through the use of contaminated blood and blood products.2
Depending upon environmental conditions, HAV can live outside the body for months. Heating food at temperatures >185oF(>85oC) for 1 minute or disinfecting surfaces with chlorine can inactivate HAV; however, the virus is still capable of being spread if food contamination occurs after cooking.1,2
Waterborne outbreaks of HAV in developed countries are rare; occurrences of this nature are generally attributed to sewage contamination and inadequately treated water.2,4
HAV can live for months on common objects such as toys and crayons.1
In 2016, a total of 2,007 cases of hepatitis A were reported to CDC from 50 states and the District of Columbia. The overall incidence rate in 2016 was 0.6 reported cases per 100,000 population. After adjusting for under-ascertainment and under-reporting, an estimated 4,000 hepatitis A cases (95% CI=2,800–4,400) occurred in 2016.5
Actual hepatitis A cases are ~2X the number reported in any year.5
People who have recently been exposed to the hepatitis A virus and who have not previously received the hepatitis A vaccine, should be administered a single dose of single-antigen hepatitis A vaccine or immune globulin (IG) as soon as possible.6 For treating symptoms, doctors usually recommend rest, adequate nutrition, and fluids. They also recommend avoiding alcohol and using medication with care as the liver heals.1,7
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Centers for Disease Control and Prevention (CDC). Hepatitis A Questions and Answers for the Public. https://www.cdc.gov/hepatitis/hav/afaq.htm. Accessed July 10, 2018.
Centers for Disease Control and Prevention (CDC). Hepatitis A. In: Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:135–148. http://www.cdc.gov/vaccines/pubs/pinkbook/index.html. Accessed July 6, 2018.
Centers for Disease Control and Prevention (CDC). Viral Hepatitis. http://www.cdc.gov/hepatitis/hav/. Updated September 29, 2017. Accessed July 6, 2018.
Centers for Disease Control and Prevention (CDC). Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006;55(RR-7):1–23.
Centers for Disease Control and Prevention (CDC). Viral hepatitis surveillance—United States, 2016. https://www.cdc.gov/hepatitis/statistics/ 2016surveillance/pdfs/ 2016HepSurveillanceRpt.pdf. Updated April 16, 2018. Accessed July 6, 2018.
Centers for Disease Control and Prevention (CDC). Update: Prevention of Hepatitis A After Exposure to Hepatitis A Virus and in International Travelers. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007;56(41):1080–1084.
Mayo Clinic. Hepatitis A Diagnosis & Treatment. https://www.mayoclinic.org/diseases-conditions/hepatitis-a/diagnosis-treatment/drc-20367055. Updated October 26, 2017. Accessed July 10, 2018.