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Hepatitis A

Hepatitis is an inflammation of the liver caused by one of many hepatitis viruses. In British Columbia, the most common types are hepatitis A, B and C.

Causes

Hepatitis A virus (HAV) is found in the stool of a person who has a hepatitis A infection. It is passed when a person eats or drinks something that has come in contact with stools. This is called ‘oral-fecal’ transmission. Common ways the virus can be passed include:

  • Person to person contact, such as not washing hands after using the bathroom then preparing or sharing food
  • During sex the virus can be passed through oral-anal sex (rimming)
  • Contaminated water or ice
  • Undercooked oysters and other shellfish harvested from sewage-contaminated waters
  • Fruits or other foods contaminated during handling or harvesting

If you plan to travel to a country where hepatitis A is common, you should get the hepatitis A vaccine before you go. You can also lower your chances of getting hepatitis A by avoiding uncooked foods and untreated tap water.

Symptoms

Feces and body fluids have the highest levels of virus two weeks before symptoms start. During this time, it easiest to pass on HAV, although the virus can be still be passed after symptoms start.

Symptoms usually show up two to seven weeks after contact with the hepatitis A virus. The average time is four weeks. Symptoms usually last for about two months. Most of the time, hepatitis A goes away on its own and rarely causes long-term liver problems.

Common symptoms are:

  • Feeling sick to your stomach
  • Feeling very tired
  • No appetite and weight loss
  • Pain on the right side of the abdomen, under the rib cage (where your liver is)
  • Fever and sore muscles
  • Rashes or pain in the joints
  • Jaundice – yellowing of the skin and whites of the eyes
  • Dark urine and pale stools

Children under six years of age often have no symptoms, and only a few children will develop jaundice (yellowing of the skin and whites of the eyes). Older children and adults are more likely to have signs and symptoms when they have hepatitis A.

See your doctor right away if you have any of the above symptoms, you live with someone who has hepatitis A, you have eaten in a restaurant that has had a hepatitis A outbreak or your child goes to a daycare where hepatitis A has been reported.

Complications

  • Some people may experience a relapsing form of hepatitis A: the symptoms come back after they have resolved, usually in a milder form
  • Unlike other hepatitis virus infections, hepatitis A does not cause long-term (chronic) illness
  • In very rare cases, liver failure and even death may occur

Tests and Diagnosis

All forms of hepatitis can have similar symptoms. Only a blood test can tell which kind of hepatitis you have.

Your health provider will ask questions about your symptoms and where you have eaten or travelled. You may have blood tests to tell if your liver is inflamed and whether you have antibodies to the hepatitis A virus. Antibodies show that you have come in contact with the virus.

Treatment

In most cases, hepatitis A clears from the body on its own and most people get well within a few months. This type of hepatitis virus rarely leads to long-term illness or serious liver damage.

Although there is no specific medical treatment for hepatitis A, home treatment can help relieve symptoms and prevent the spread of the virus:

  • Rest and reduce your activity, take time to get better
  • Eat well
  • Drink a lot of fluids
  • Avoid alcohol and drugs
  • Try to control itching

Prevention

You can protect yourself from hepatitis A by getting a vaccine. A combination vaccine is available that protects against both hepatitis A and hepatitis B. Hepatitis A immunoglobulin (IG) may be given to prevent hepatitis A in infants younger than one year, people with weak immune systems, and others who should not get the vaccine.

If you have hepatitis A, there are steps you can take to avoid passing it to people you are in close contact with:

  • Tell those you live with or have sex with that you have hepatitis A so they can talk to their health care provider about getting vaccinated
  • Wash your hands with soap and hot water immediately after using the toilet or changing a diaper, and before preparing food
  • Avoid any anal contact with a sex partner when you are ill with hepatitis A

In some provinces, people with hepatitis A may not be able to work as food handlers or in daycares or health care facilities for two weeks after becoming sick or for at least one week after the appearance of jaundice.

Resources

BC Centre for Disease Control – Hepatitis A
HealthLink BC – Hepatitis A vaccine
CATIE.ca – Hepatitis A factsheet
 

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