Hepatitis A – FACT SHEET

Hepatitis A, which infects up to 200,000 Americans each year, is a highly contagious virus that attacks the liver. It is spread by the fecal-oral route through close person-to-person contact, or by ingesting contaminated food or water. Symptoms can be debilitating and include fever, fatigue, loss of appetite, nausea, abdominal discomfort, jaundice, and dark urine. Infected individuals can unknowingly infect others 2 weeks prior to feeling ill themselves. Up to 22 percent of adult hepatitis A patients require hospitalization and approximately 100 people in this country die every year from the disease.

The Facts about Hepatitis A

  • Hepatitis A is a viral infection of the liver spread by the fecal-oral route through close person-to-person contact or ingestion of contaminated food or water
  • Hepatitis A is the most common type of hepatitis reported in the United States
  • Each year, hepatitis A infects at least 1.4 million people worldwide, and cases are underreported. In the United States, there are an estimated 134,000 cases annually ¬∑ Appetite loss¬∑ Jaundice¬∑ Dark urine

· In the United States, those at increased risk include:

  • Travelers to areas of high incidence for hepatitis A
  • People living in, or relocating to, areas of a high incidence
  • Certain ethnic and geographic populations that experience cyclic hepatitis A epidemics, such as native peoples of Alaska and the Americas
  • Persons engaging in high-risk sexual activity (such as men having sex with men)
  • Residents of a community experiencing an outbreak of hepatitis A
  • Users of illicit injectable drugs
  • Persons who have clotting-factor disorders (hemophiliacs and other recipients of therapeutic blood products)
  • Certain institutional workers (e.g., caretakers for the developmentally challenged)
  • Employees of child day-care centers
  • Laboratory workers who handle live hepatitis A virus
  • Handlers of primate animals that may be harboring hepatitis A virus
  • Hepatitis A vaccination is also indicated for people with chronic liver disease (including alcoholic cirrhosis, chronic hepatitis B, chronic hepatitis C, autoimmune hepatitis and primary biliary cirrhosis)
  • Outbreaks have also been attributed to food handlers who can contract hepatitis A and transmit the hepatitis A virus to others. The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) states that to decrease the costs associated with outbreaks, vaccination of food handlers may be considered where it is deemed cost-effective


· Fever
· Nausea
· Vomiting
· Diarrhea
· Fatigue
· Abdominal pain
· Appetite loss
· Jaundice
· Dark urine

Infection has been shown to be spread:

  • by ingestion of contaminated drinking water or ice, uncooked fruits or vegetables grown with or washed in contaminated water, or raw or uncooked shellfish (oysters, clams or mussels)
  • in day-care centers where children have not been toilet-trained
  • by infected food handlers
  • after breakdowns in usual sanitary conditions, such as after floods and other natural disasters
  • through blood transfusions or by sharing contaminated needles and syringes

Travelers at Risk

The U.S. Centers for Disease Control and Prevention (CDC) recommends hepatitis A vaccination for travelers going to hepatitis A endemic areas

Endemic Regions

· Mexico
· Hepatitis A endemic regions include, but are not limited to, Mexico, parts of the Caribbean, South America, Central America, Africa, Asia (except Japan), the Mediterranean basin, Eastern Europe and the Middle East
· Parts of the Caribbean
· South America
· Hepatitis A is the most common vaccine-preventable disease in travelers to endemic regions
· Travelers to endemic areas can contract hepatitis A even in the best hotels, resorts and restaurants
· Central America
· Africa
· Asia (except Japan)
· Mediterranean
· In unprotected travelers, hepatitis A occurs 100 times more often than typhoid fever and 1,000 times more often than cholera basin· Eastern Europe· Middle East
· Experts estimate that 30-35 million travelers from industrialized nations annually visit regions, where their risk of contracting hepatitis A is 3 to 6 per 1,000, per month of stay. Under poor hygienic conditions, this risk may be increased up to six times

Consequences of Infection

  • Symptoms of hepatitis A include a flu-like illness with chills and high fever, nausea, vomiting, diarrhea, fatigue, abdominal pain, loss of appetite, jaundice (yellowing of the skin and eyes) and dark urine
  • In the United States, the annual cost associated with hepatitis A is estimated at more than $450 million. Medical care alone can cost $2,800 for each hospitalized case and $700 for non-hospitalized cases. In addition to medical expenses, infection with hepatitis A leads to an average of five missed weeks of work, resulting in approximately $2,600 in lost wages
  • The infection in young children is often mild or asymptomatic, while more than 70 percent of older children and adults develop symptoms of clinical hepatitis
  • Since those with hepatitis A are typically contagious for at least two weeks before symptoms appear, they may spread the virus to others unknowingly
  • While most patients begin to recover from the acute illness within two months, in up to 15% of patients, relapses may occur and symptoms may persist for up to 6 months
  • Approximately 100 people in the United States die annually from severe hepatitis A
  • Although discomfort can be relieved to some extent by rest and proper nutrition, there is no medical therapy available to treat hepatitis A infection, but vaccines are available to prevent it

Source: Cohn & Wolfe Healthcare

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