Introduction

Hepatitis A is a small, unenveloped RNA virus within the genus Hepatovirus. This disease is endemic in many low-income countries where food and water hygiene may be of a low standard. Hepatitis A causes acute inflammation of the liver. It is relatively uncommon in the UK and is usually associated with specific risk groups such as injecting drug users or those individuals who travel to an endemic country.

Risk for travellers

The risk of acquiring hepatitis A in highly economically developed countries is low. It depends on the living conditions, duration of stay and the standards of food and water hygiene. Travellers at higher risk include those visiting friends and family, long term travellers and those visiting poor sanitation

Transmission

Hepatitis A is usually spread through food or water that is contaminated by human faeces. Foods such as strawberries and lettuce that grow close to the ground can also be a risk. Human to human transmission in conditions of poor faecal hygiene is also a risk factor and this can occur during certain sexual practices ( for example, oral/ anal sexual contact), through unhygienic injection drug use and between children. Virus shedding in the faeces occurs during the incubation period of hepatitis A and may continue for a few days after the onset of jaundice, this is the stage that the patients are most infectious.

Signs and symptoms

Hepatitis A becomes more serious with age, with approximately 2% mortality rate in those over 50 years of age. The incubation period is around 28 days, although it can range from 15-50 days. Patients may experience early symptoms of general fatigue, anorexia, fever and nausea before developing jaundice. Jaundice is when your skin or the whites of your eyes turn yellow. Recovery can take up to a month in young people, however some patients are ill for many weeks. Patients with pre-existing chronic liver disease may be more susceptible to complications.

Prevention

The risk of acquiring hepatitis A can be reduced by ensuring good personal hygiene and by following good food and water hygiene. Furthermore, there are several safe and well- tolerated hepatitis A vaccines available for travellers who wish to visit an endemic area.

Hepatitis A vaccine information

Hepatitis A remains one of the most common travel- related vaccine preventable diseases. It is recommended for travellers who are visiting areas of hepatitis A risk, particularly those visiting friends and family, long- term travellers and those visiting areas of poor sanitation.

If you want more information or require the vaccine for travel purposes, please book an appointment to speak to our trained pharmacist.