Hepatitis A - including symptoms, treatment and prevention

Hepatitis A is an infection of the liver caused by the hepatitis A virus.

Hepatitis A is a notifiable condition¹

How hepatitis A is spread

The infection is spread when faeces (poo) containing the hepatitis A virus contaminate hands, objects, water or food and the virus enters the mouth. Hepatitis A virus can survive in the environment for a long time.

In Australia, most cases of hepatitis A are associated with the following situations and/or activities:

• childcare centres caring for children who are not yet toilet trained
• household contacts of people infected with hepatitis A
• overseas travel to high risk countries
• injecting and non-injecting drug use
• sexual contacts especially men who have sex with men.

Signs and symptoms of hepatitis A

Symptoms include:

• abdominal pain
• loss of appetite
• nausea (and sometimes vomiting)
• fever and chills
• mild headache
• tiredness
• yellow skin and/or eyes (jaundice - see image)
• dark urine and pale faeces.

Adults and older children are more likely to have symptoms lasting 1 to 2 weeks, or in severe cases, up to several months.

Young children may have few or no symptoms.

Most people recover fully and subsequently will have life-long immunity. Death from hepatitis A is rare.

Image Courtesy Public Health Image Library (PHIL), Department of Health and Human Services, Centers for Disease Control and Prevention (CDC-USA) CDC,Dr. Thomas F. Sellers / Emory University

Diagnosis of hepatitis A

The diagnosis is made by a blood test.

Incubation period

(time between becoming infected and developing symptoms)

Generally 28 days, with a range of 15 to 50 days.

Infectious period

(time during which an infected person can infect others)

A person is considered infectious from:

• 2 weeks prior to the onset of illness to 2 weeks after the onset of illness,
• Or, 1 week after the onset of jaundice if it occurs.

Treatment for hepatitis A

• There is no specific antiviral treatment for hepatitis A
• Rest, good fluid intake and a change in diet may decrease symptoms
• Severely ill patients require admission to hospital
• Certain medications and alcohol can worsen the stress on the liver and should be discussed with your doctor.

Prevention of hepatitis A

• Exclude people with hepatitis A from childcare, preschool, school and work for 7 days after the onset of jaundice (if present) or 2 weeks from the onset of illness if there is no jaundice.
• Follow good personal hygiene practices, especially thorough hand washing.
• Good food handling procedures should always be followed.
• A single dose of hepatitis A vaccine provides protection within 2 weeks of having the vaccine. A second dose 6 months later gives long lasting protection. See Hepatitis A vaccine for detailed information on people for whom the vaccine is recommended.

Immunisation and immunoglobulin

The Public Health unit will identify close contacts at risk of infection and arrange for those at risk to receive information and necessary preventative treatment.

• Hepatitis A vaccine can prevent infection if given within 2 weeks of contact with an infectious person in a contact of a person who has hepatitis A if it is given no later than 14 days after the onset of symptoms in the person with hepatitis A infection. The vaccine is offered to household contacts and/or sexual contacts of the person with hepatitis A who are not already immune to hepatitis A.  A contact is any person who has been close enough to an infected person to be at risk of getting the infection from that person.
• The vaccine is offered to household contacts and/or sexual contacts of the person with hepatitis A who are not already immune to hepatitis A.
• A contact is any person who has been close enough to an infected person to be at risk of getting the infection from that person.
• If contacts are under 1 year of age, have a lowered immune system, have chronic liver disease, or any another reason that the hepatitis A vaccine is not recommended, hepatitis A immunoglobulin can be offered.  Immunoglobulin is a solution containing human antibodies that is made from blood products.
• Contacts (including those given vaccine or immunoglobulin) may remain infectious to others even if they do not develop symptoms themselves and should therefore continue to follow good personal hygiene practices.

Useful links

• Hand hygiene
• Immunisation
• Protecting yourself and your health whilst travelling overseas
• Hepatitis A, B, C, D and E summary
• Vaccines
• When you have a notifiable condition
• Immunisation programs
• Exclusion periods from childcare, preschool, school and work

1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.