Highland Travel Medicine

Hepatitis A

Hepatitis A

 is a viral infection that affects the liver. It is caused by the Hepatitis A Virus (HAV). This virus is shed in the waste of people infected with the virus. HAV can spread from person to person, but is usually transmitted as a result of consuming contaminated food or water. Sources of infection include polluted water, ice or shell fish harvested from sewage-contaminated water; or from produce or other foods that are raw that have been infected during harvesting. The result of an infection from the HAV may either be asymptomatic, or range in a mild symptomatic illness that lasts for 2weeks up to a severe illness that is persistent for months. Symptoms include: fever, malaise, poor appetite, nausea, abdominal pain followed within days by jaundice (yellowing of the skin). There is a high prevalence of hepatitis A in Mexico, South America, Africa and Asia. It is not prevalent in developed regions of Europe, North America (except Mexico), Japan, Australia and Europe.

Hepatitis A is easily preventable with vaccination. When traveling to North America (with the exception of travel to Mexico), Japan, Australia, New Zealand, and developed countries in Europe, there is no greater risk of infection from HAV than in the United States. For travelers going elsewhere, the risk increases with duration of the visit, those traveling to rural areas, and partaking in foods in the settings of poor sanitation. Also, since 2005, the CDC recommends all children over 12months of age in the United States be vaccinated against Hepatitis A.

Vaccination is recommended for persons traveling to most areas, including Central and South America, Africa, Asia, Eastern Europe and Russia. The vaccination is a series of two injections. The first should be administered prior to travel. After one month from the first dose, 94% of adults will have immunity. The second injection is given anytime 6-12months from the initial shot, to give lifelong immunity against the HAV. For this reason it is highly recommended that travelers visit their travel medicine clinic at last 1month prior to departure. Reported adverse reactions to the immunization include pain at the injection site and headache. The risk of Hepatitis A vaccination has not been established in pregnancy, though the vaccine is not a live vaccine, and in theory the risk should be low for mother and baby. Other ways to avoid contracting HAV is by cooking or boiling foods for at least one minute to inactivate the virus. Avoid potentially contaminated water and uncooked shellfish or produce that has not been handled by the traveler personally. Remember, if you can’t cook it or peel it, don’t eat it!