Hepatitis A

Hepatitis is a general term used to describe inflammation of the liver. A variety of viruses and other substances, such as alcohol, can also cause hepatitis.

The hepatitis A virus is the most common virus that causes hepatitis.

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This virus passes through the digestive system of people with the infection and is spread when something contaminated with infected faeces is swallowed. Only a small amount of virus is necessary to spread the infection.

The virus can potentially survive on objects and in water for months.

The virus can be passed on:

  • by food, drink, eating utensils, toys or other objects that have been handled by an infected person
  • after touching infected nappies, linen and towels or someone else’s hands that have been in contact with faeces
  • by oro-anal sex.

Outbreaks have also been reported as a result of drinking or bathing in water contaminated by sewage, or by eating shellfish, particularly oysters contaminated by sewage.

The symptoms generally develop between two weeks and two months after infection. You will most commonly see symptoms one month after infection.

Hepatitis A is an acute illness. Symptoms include:

  • fever
  • loss of appetite
  • nausea
  • tiredness
  • abdominal discomfort
  • feeling generally unwell.

Urine may become dark in colour and poo, also known as faeces, may become pale.

Eyes and skin may become yellow (known as jaundice). Skin change is often difficult to see in dark skinned people. The skin may become itchy.

The symptoms are generally more severe in adults than children with a variable length and severity of illness. Complications are rare and most people will feel well again within a month.

Often children will not show any sign of the infection or have a mild illness without any jaundice.

Hepatitis A does not cause chronic liver disease and people do not become ‘carriers’, as can occur with hepatitis B or C.

After a person has recovered from hepatitis A they are immune and can't get it again.

Infected people can pass the virus to others from two weeks before feeling unwell until either:

  • one week after the appearance of jaundice
  • or two weeks after the person began feeling unwell if there is no jaundice.

Hepatitis A virus is worldwide and can affect anyone who is not immune.

People at higher risk of contracting the infection are:

  • International travellers and residents of areas with inadequate waste disposal, contaminated water and/or poor hygiene. This can include people returning from their home countries.
  • Household members and close contacts of an infected person.
  • People who have not had hepatitis A or have not received a vaccine against it.

There is no specific treatment for hepatitis A.

Good hygiene is the best way to prevent hepatitis A. In situations where good hygiene may be compromised hepatitis A vaccination is recommended.

To avoid spreading the virus you should wash your hands thoroughly with soap and warm running water for at least 10-15 seconds. Hands should be thoroughly dried with clean paper towel. You should wash and dry your hands:

  • before eating
  • after going to the toilet
  • before preparing or handling food
  • after handling objects that may have been contaminated with body fluids, such as nappies and condoms.

Other measures to avoid infecting others include:

  • don't share drinks and eating utensils
  • don't prepare food or drink for other people
  • wash eating utensils in warm soapy water and machine wash all linen and towels
  • don't share linen and towels with other people
  • don't have sex
  • clean floors and toilets regularly (including toilet door handles)
  • don't change nappies or let children sit on tables or counters where food is prepared or eaten
  • wash change mats with warm soapy water (use disposable wash cloth or launder cloth after use)
  • clean books, toys, equipment, furnishings

Child care centres should refer to the National Health and Medical Research Council's (NHMRC) publication Staying Healthy for further advice on prevention in a child care setting. You can get a copy from the NHMRC website.

Hepatitis A vaccine is available for both adults and children and is safe and effective in preventing disease.

Vaccination is recommended for people in the following at risk groups:

  • travellers to countries where Hepatitis A is common
  • Aboriginal and Torres Strait Islander children living in the Northern Territory (NT)
  • people who live and work in remote Aboriginal and Torres Strait Islander communities in the NT
  • child care and preschool workers
  • persons with developmental disabilities and their carers
  • health care providers in the NT
  • men who have sex with men
  • injecting drug users
  • people with chronic hepatitis B and C infections
  • people with chronic liver disease
  • solid organ transplant recipients
  • plumbers and sewage workers
  • people who are inmates of correctional facilities.

A pre-vaccination blood test to determine existing immunity is not routinely recommended. However, the following groups of people should be screened for natural immunity to hepatitis A to avoid unnecessary vaccination:

  • people born before 1950
  • people who grew up in areas with intermediate/high risk of hepatitis A infection such as Indigenous communities or countries in Africa and Asia
  • people with a previous episode of hepatitis or jaundice.

Vaccination schedule

The recommended vaccination schedule is one injection, followed by a booster dose 6 to 12 months later.

A combined hepatitis A and B vaccine is available if hepatitis B vaccination is also required. This is a series of three injections over a six month period.

The vaccine is effective by four weeks after the first vaccine.

These vaccinations are available on private prescription from a doctor. Some employers may fund hepatitis A vaccination for at risk workers.

As part of a national immunisation program free hepatitis A vaccine is offered to all Indigenous infants born on or after 1 May 2004.

In the NT this vaccine is offered routinely at 12 and 18 months. Since the introduction of this vaccine for Indigenous infants there have been very few cases of hepatitis A acquired in the NT.

Hepatitis A is a notifiable disease. This means that medical staff must notify the Centre for Disease Control (CDC) if they diagnose or suspect someone of having hepatitis A.

The local public health unit will follow up on cases and take appropriate action to minimise the risk of transmission to others.

To prevent disease in the individual and further transmission, good hygiene and appropriate vaccination are the best methods to control hepatitis A.

If hepatitis A does occur in a food handler or child care worker they should be excluded from work until seven days after the onset of jaundice. People with hepatitis A should not prepare food for others while infectious.

Children with hepatitis A should be excluded from school or child care until a medical certificate of recovery is received and until seven days after the onset of jaundice.

For more information call your nearest Centre for Disease Control.

Last updated: 06 September 2019

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