Hepatitis A
A liver infection caused by the hepatitis A virus
Overview
Hepatitis A, caused by the hepatitis A virus (HAV) is a highly contagious infection that affects the liver. HAV spreads from the stool (poop) of an infected person through close person-to-person contact and by eating or drinking anything contaminated with the virus. Hepatitis A is usually mild and resolves on its own without lasting liver damage, but rare cases can result in liver failure or death.
Though Hepatitis A is rare in Alaska, with fewer than three cases per year since 2001, it is more common in other countries and can affect international travelers. Vaccination is the best way to prevent Hepatitis A, followed by diligent hand hygiene by caretakers or those infected with HAV.
Symptoms & Diagnosis
Hepatitis A symptoms usually start 2-7 weeks after exposure to HAV and can last a few weeks to months. Symptoms are more common in adults than young children. Anyone infected with HAV can spread the virus, even if they don’t show symptoms.
Symptoms may include:
- Fatigue (feeling tired)
- Stomach pain
- Nausea
- Vomiting
- Diarrhea
- Loss of appetite
- Joint pain
- Fever
- Dark urine (tea or cola-colored)
- Pale or grey-colored stool (poop)
- Yellowing of the eyes or skin (jaundice).
Hepatitis A is diagnosed with a blood test. Please see a healthcare provider if you have symptoms of hepatitis A or suspect you have been exposed to HAV.
Treatment
Hepatitis A usually lasts a short time and resolves on its own without causing lasting liver damage. There are no medicines that treat hepatitis A, but eating well, getting enough rest, and drinking fluids can help with recovery. Some people may need to be hospitalized but death is rare.
Prevention
The best way to protect against hepatitis A is by completing the hepatitis A vaccine series. Vaccination is recommended for:
- Children 1 year or older and adolescents
- Adults at increased risk for hepatitis A infection and severe disease
- Unvaccinated people in Hepatitis A outbreak settings
- People who have been exposed to hepatitis A in the past two weeks (some may also need immune globulin)
Talk to your health care provider about the vaccine and your individual risk factors. Please also see Hepatitis A Vaccine information from the CDC. Vaccines are available at low or no cost through programs such as Vaccines for Children and the Alaska Vaccine Assessment Program (AVAP).
Washing hands with soap and water also helps to prevent HAV infection and transmission. This is recommended:
- before preparing or eating food
- after using the toilet or changing diapers
- after caring for someone with diarrhea
- after caring for or being near someone infected with HAV
- if you are currently infected with HAV
People with hepatitis A should follow strict hand hygiene (handwashing, gloves) for the first two weeks of symptoms and up to 1 week after jaundice (yellow skin or eyes) starts. They should not handle food for other people until 1 week after jaundice starts.
Food handlers, children, and school or daycare staff with hepatitis A should not go to work, daycare, or school for 1-2 weeks after jaundice starts or until symptoms resolve.
If you were exposed to hepatitis A, or think you may have been exposed, please contact a healthcare provider as soon as possible for testing and follow-up care.
Reporting
Healthcare providers and laboratories are required to report all cases of suspected hepatitis A and any lab results indicating hepatitis A infection, including all positive or negative results for HAV RNA, within two working days.
Report a Health ConditionFor providers
Clicical overview
Clicical overview
Testing and Diagnosis
Testing and Diagnosis
- Testing for acute hepatitis A is by IgM antibody testing or nucleic acid amplification (NAA) for HAV RNA.
- The Alaska State Virology Lab (ASVL) in Fairbanks can test for hepatitis A IgM antibody and total antibody. Total antibody or IgG-only testing indicates exposure to HAV or the hepatitis A vaccine, and not acute infection.
- Symptom screening, liver function tests, exposure risk review, and lab testing should be included in diagnosing acute hepatitis A. See Clinical Screening and Diagnosis for Hepatitis A (CDC)
Clinical Care and Post-Exposure Prophylaxis (PEP)
Clinical Care and Post-Exposure Prophylaxis (PEP)
A single case of hepatitis A in Alaska should prompt an investigation to identify the source and close contacts, and consideration of post-exposure prophylaxis (PEP) for those contacts, particularly household members and sexual contacts. PEP may include administration of the hepatitis A vaccine and/or immune globulin depending on factors such as age, risk for serious illness (e.g., immunocompromised or underlying liver disease), prior hepatitis A vaccination, and involvement in settings such as day care or food handling.
- See CDC guidelines for clinical care of hepatitis A including PEP and considerations for international travel.
- Please contact Alaska Section of Epidemiology for the most updated guidelines and outbreak response information.
Work/School Exclusions
Work/School Exclusions
Food handlers, children, and school or daycare staff with hepatitis A should not go to work, daycare, or school for 1-2 weeks after jaundice starts or until symptoms resolve. People with hepatitis A should not handle food for others and should follow strict hand washing and glove use if caring for others for the first 2 weeks of symptoms and until 1 week after jaundice starts.
Surveillance Resources
Surveillance Resources
- Hepatitis A – Chapter 3, Manual for the Surveillance of Vaccine-Preventable Diseases (CDC)
- Viral Hepatitis Surveillance and Case Management (CDC)
- Case definition for public health surveillance of acute hepatitis A from the Council of State and Territorial Epidemiologists (CSTE)
Outbreak Considerations
Outbreak Considerations
Precautions should be taken to prevent and/or minimize outbreaks in the following settings and populations:
- Higher risk groups (e.g., people experiencing homelessness),
- Congregate living settings (shelters, correctional facilities, fish processing plants, other dormitory style employee housing)
- Settings with decreased availability of sanitation
- Two or more cases among patrons at the same store or food service establishment who do not share a household.
Please contact Alaska Section of Epidemiology for the most updated outbreak response information and guidance in Alaska.