Hepatitis A: How the Virus Spreads, Who Is at Risk and How to Prevent It

Hepatitis means inflammation of the liver: the swelling that follows when tissue is injured or infected. That swelling can damage the liver and get in the way of the work it does. Several viruses cause it, and hepatitis A is one of them.

Hepatitis A causes an acute infection, meaning a short-term one. Most people get better on their own within a few weeks, without treatment. Because a vaccine exists, the disease is not very common in the United States.

How it spreads

The hepatitis A virus travels in the stool of an infected person, and it reaches someone else when traces of that stool get into their mouth. In practice that happens when a person:

• eats food prepared by someone who has the virus and did not wash their hands properly after using the bathroom;
• drinks contaminated water, or eats food rinsed in it; or
• has close personal contact with someone who has hepatitis A — through certain kinds of sex, such as oral-anal sex, while looking after someone who is ill, or by using illegal drugs with others.

Who is at higher risk

Anyone can catch hepatitis A, but the risk is higher for people who:

• travel to developing countries;
• have sex with someone who has hepatitis A, or are men who have sex with men;
• use illegal drugs;
• are experiencing homelessness;
• live with or care for someone who has hepatitis A; or
• live with or care for a child recently adopted from a country where hepatitis A is common.

Symptoms

Not everyone who is infected feels ill, and adults are more likely than children to have symptoms. When symptoms do appear, they usually begin 2 to 7 weeks after infection and can include:

• fever, fatigue and joint pain;
• loss of appetite, nausea or vomiting, diarrhea and abdominal pain;
• dark yellow urine and gray or clay-colored stools; and
• jaundice, a yellowing of the eyes and skin.

The illness usually lasts less than 2 months, though some people are sick for as long as 6 months. A person who also has HIV, hepatitis B or hepatitis C is at higher risk of a more severe infection.

In rare cases hepatitis A leads to liver failure. That outcome is more common in adults over age 50.

Diagnosis and treatment

A health care provider diagnoses hepatitis A from a medical history, including questions about symptoms, a physical exam, and blood tests, among them tests for viral hepatitis.

There is no specific treatment. Recovery comes from rest, plenty of liquids and healthy food, and a provider may suggest medicines to ease the symptoms. Severe cases may need care in a hospital.

Prevention

The best protection is the hepatitis A vaccine. Good hygiene matters too — above all, washing hands thoroughly after using the bathroom, which is how the virus is kept out of food and off of hands.

Sources

Based on "Hepatitis A," MedlinePlus, National Library of Medicine, with information from the National Institute of Diabetes and Digestive and Kidney Diseases; a work of the United States government in the public domain.