Hepatitis A (also known as infectious hepatitis) is an acute infection of the liver caused by the hepatitis A virus.
The symptoms of hepatitis A are fever, generalised aches and pains, nausea, lack of appetite and abdominal discomfort. Dark urine is usually the first specific sign of acute hepatitis A, followed a day or two later by jaundice (yellow skin and eyes) and pale coloured bowel motions.
The severity and duration of the illness is varies, however, most people feel better by the third week. The disease is usually more serious in adults than in children. In adults, hepatitis A occasionally presents as a serious, disabling disease lasting several months.
There is no specific treatment for hepatitis A. Management of people infected with the virus is aimed at treating the symptoms of the infection. People with hepatitis A are sometimes sick enough to be admitted to hospital although this is rare.
The virus is usually spread when faeces from an infected person contaminates something which is transferred to another person's mouth. The virus can be passed on by:
- food that has been handled by or shared with an infected person
- drinking contaminated water
- hands after touching infected faeces, nappies, linen and towels
- oral or anal sex.
The virus can survive in a dried form at room temperature for several weeks and in water for longer periods. It usually takes about 28 to 30 days from contact with the virus until a person starts to feel unwell. However, it can take up to 50 days.
Infected people can pass on the virus to others from about two weeks before and up to one week after the appearance of dark urine or jaundice. Some people, especially small children, may not show any symptoms even though they may have the virus and can pass it onto others.
People with hepatitis A should not return to work, school or child care until they are no longer infectious which is at least seven days after the onset of jaundice.
Hand washing and good hygiene practices are essential and are the most effective ways of reducing the spread of hepatitis A infection. Hands should be washed thoroughly in soap and water for at least 15 seconds and then dried thoroughly. It is important to wash hands after going to the toilet, touching soiled linen or articles and before preparing or eating food.
Close contacts of an infectious person may need vaccination. This may prevent illness if given within two weeks of contact with the infectious person. Contacts who need vaccination generally include household members, sexual partners, other people in the same child care group or preschool classroom, and anyone who has eaten uncooked food prepared by the infected person.
There is a safe and effective vaccine that provides protection against hepatitis A infection for children and adults.
As part of the National Immunisation Program Schedule, immunisation is provided free of charge to all Aboriginal and Torres Strait Islander children in Queensland at 12 months of age, with a booster at 18 months of age. This is due to a high incidence of hepatitis A infection in these communities.
The vaccine is also recommended (but not funded) for people at high risk of exposure to the disease, such as:
- Australians living in and travelling to countries where hepatitis A is common
- people working in rural and remote Indigenous communities
- child care and preschool staff
- intellectually disabled people and their carers
- healthcare workers regularly caring for Aboriginal and Torres Strait Islander children
- plumbers or sewage workers
- sex workers
- men who have sex with men
- injecting drug users
- people with chronic liver disease
- people chronically infected with either hepatitis B or hepatitis C viruses.
To ensure full protection, adults require two doses of vaccine. To avoid unnecessary vaccination, it is recommended that the following groups of people have a blood test to check for a pre-existing natural immunity to hepatitis A:
- those born before 1950
- those who spent their early childhood in areas where hepatitis A was common
- those with an unexplained previous episode of hepatitis or jaundice.
If the blood test shows that the person is already immune, hepatitis A vaccination is not needed.
Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects of the hepatitis A vaccine may include redness and soreness where the injection was given, headache, fatigue and tiredness. More serious side effects are extremely rare and can include severe allergic reactions. Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.
There are usually no long term effects as a direct result of hepatitis A infection. Unlike hepatitis B or C, people cannot become chronic carriers of hepatitis A virus. Complications of hepatitis A are uncommon, but on rare occasions can include liver failure resulting in death.
For further assistance, please contact your local doctor, community health centre, sexual health clinic or nearest public health unit. You can be immunised at your local doctor or medical centre, or check with your local council, community child health and/or community health centre about free immunisation clinics.
- Having a vaccination: what to expect
- Queensland Health hepatitis A – sexual health contacts fact sheet
Heymann D, ed. 2015. Control of Communicable Diseases Manual, 20th edition. Washington, DC: American Public Health Association, pp 253-257.
National Health and Medical Research Council. 2013. The Australian Immunisation Handbook 10th edition.