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Hepatitis A Is A Widespread Virus That Is Mostly Treatable

Hepatitis A Is A Widespread Virus That Is Mostly Treatable


By Dr. Jessica Sapp, Associate Professor, School of Health Sciences
Pamela Schwartz, Master of Public Health Graduate Student, American Public University

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Hepatitis A outbreaks happen all over the United States. From August 2016 to October 2019, 30 states reported almost 27,000 cases of hepatitis A. Those cases resulted in 274 deaths and more than 16,000 hospitalizations. Despite the high incidence of outbreaks, there are ways you can prevent hepatitis A.

What Is Hepatitis A?

Hepatitis is the inflammation of the liver which is caused by different hepatitis viruses. In the United States, hepatitis A virus, hepatitis B virus, and hepatitis C virus are the most common. Hepatitis A infection is acute, meaning that it is short-term and generally requires no treatment.

Symptoms and Treatment of Hepatitis

Young children often show no symptoms when they contract the virus. Older children and adults also may not have any visible symptoms. But if they do appear, the symptoms are typically mild and appear suddenly. Symptoms include:

  • Fatigue
  • Nausea and vomiting that comes on suddenly
  • Loss of appetite
  • Pain on the right side of the abdomen
  • Dark urine
  • Joint pain
  • Jaundice (yellowing of the skin and eyes)
  • Clay-colored bowel movements
  • Intense itching

Symptoms usually appear between two and seven weeks after a person is exposed to the virus for the first time. (Once you recover from hepatitis A, you develop antibodies that protect you from the virus for life.) Usually it takes a few days for all the symptoms to show up and they often last less than two months. Some people, however, might have symptoms for up to six months.

A blood test will confirm the presence of the hepatitis A virus.  Since it’s an acute viral infection, it generally goes away on its own and in most cases the liver will heal within six months with no lasting damage.

Treatment focuses on relieving symptoms. That means rest, adequate nutrition and fluids, and abstaining from alcohol.

Patients should discuss with their healthcare provider all medications they are taking, including over-the-counter drugs, because the liver can have difficulty processing them while it is healing.

How Is Hepatitis A Transmitted?

Infected people are most contagious soon after infection but before symptoms appear. This phase lasts for about two weeks. Children and adults with weakened immune systems can be contagious for up to six months.

Here is how hepatitis A is transmitted:

  • Person-to-person contact: In the United States, hepatitis A is spread mostly through person-to-person contact. It is most commonly spread when someone consumes the virus from objects, drinks, or food contaminated by small, undetected amounts of fecal matter from an infected person. It is also spread through close personal contact such as sex or caring for someone who is ill.
  • Restaurants and food service workers: Although many news stories report outbreaks that originate in food service workers, this type of transmission accounts for only two to three percent of all hepatitis A cases. Food service workers must comply with food handling standards and safety precautions to prevent hepatitis A transmission.
  • Contaminated food or drinking water: Hepatitis A can also be transmitted by consuming contaminated food or water. Contamination can occur at any point in the food chain including growth, harvesting, processing, handling, and even after cooking. However, this kind of contamination is more likely to happen in countries where personal hygiene and sanitary conditions are poor.

Who Is at Risk for Hepatitis A?

Anyone can get hepatitis A, but certain groups are at higher risk. They include:

  • People in direct contact with a person infected with hepatitis A
  • Travelers to countries where hepatitis A is common
  • Men who have sexual contact with other men
  • People who use injection and non-injection drugs
  • People who live with, or who are taking care of, a recent arrival from a country where hepatitis A is common
  • People with clotting factor disorders like hemophilia
  • People who work with nonhuman primates
  • People who are currently or were recently incarcerated
  • People experiencing homelessness
  • People with chronic liver disease including hepatitis B or hepatitis C

How Can I Prevent the Transmission of Hepatitis A?

Wash your hands:  Practicing good personal hygiene can help reduce the transmission of hepatitis A. Washing your hands often with soap and warm water, especially after using the bathroom, after changing a diaper, before preparing food, or before eating will assure you that you haven’t ingested any small amounts of fecal matter.

Avoid touching your face: Hepatitis A is transmitted when fecal matter gets into your mouth.  You can reduce your risk of getting infected by not touching your face, especially after you’ve touched things that other people have touched.

Prepare your food safely: Wash your hands thoroughly before handling any food. The hepatitis A virus can’t survive in temperatures above 185 degrees Fahrenheit for more than about one minute. So most cooking will kill the virus. It is best not to handle ready-to-eat food directly after cooking; use utensils, deli paper or another device. Freezing won’t kill the virus, and it takes several days to kill it in the refrigerator.

Clean your home surfaces: Even though hepatitis A can live outside the human body and on surfaces for a long time, it cannot survive sanitizing solutions such as chlorine. Regularly clean the walls and shelves of your refrigerator and food preparation surfaces, such as countertops and cutting boards. Use a sanitizing solution of one tablespoon of chlorine bleach to one gallon of water. Then dry the surface with a clean cloth or paper towel.

Get vaccinated: The best protection against hepatitis A is to get vaccinated. For best outcomes, two doses, given six months apart, are recommended. The Centers for Disease Control and Prevention (CDC) strongly recommends vaccination for high risk individuals. In fact, the CDC has added the hepatitis A vaccine to the routine childhood immunization schedule. The CDC also recommends vaccination for anyone who wants protection against this virus. You can start the series even after you’ve been exposed to hepatitis A if you start it within two weeks of exposure.

Where Can I Learn More?

Your healthcare provider can provide additional information about hepatitis A or the hepatitis A vaccination. The American Academy of Family Physicians has more information about hepatitis A or visit vaccines.gov. You can also find locations near you that offer vaccinations.

For more tips and facts about hepatitis A, follow #StickItToHepA on the AMU & APU Public Health Facebook page.

About the Authors

Dr. Jessica Sapp is an associate professor in the School of Health Sciences at APUS. She has 15 years of experience in public health, working in various environments including government, hospitals, health insurance, communities, international, corporate and academia. Jessica earned her D.P.H. in health policy and management at Georgia Southern University and a M.P.H. in health promotion, education and behavior at the University of South Carolina. She also has a B.S. in health science education from the University of Florida.

Pamela Schwartz is a Master of Public Health graduate student at APU. She has been working in public health informatics for more than 15 years, specializing in immunization information and disease surveillance systems. She holds a B.S. in Business Administration from the University of North Carolina at Greensboro.