What is hepatitis A?

Hepatitis A is a disease caused by the hepatitis A virus that results in inflammation of the liver.

Hepatitis used to be known as infectious hepatitis.

In children the disease is usually mild, but most adults who develop hepatitis are sick enough to miss four to six weeks of work.

Who gets hepatitis A?

Anyone can get hepatitis A. It is usually transmitted from person-to-person.

How is the virus spread?

• The hepatitis A virus is found in the feces (stool) of people who have the disease and is usually spread by the fecal-oral route.
• Hepatitis A may be spread by food prepared or handled by a person with the disease who does not wash his/her hands carefully.
• Hepatitis A may be spread by water contaminated with human feces or by consuming raw oysters.
• It may also be spread by close personal contact (household or sexual) and by changing the diaper of an infected child.

What are the symptoms of hepatitis A?

The first symptoms are usually:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Diarrhea
• Clay-colored stools
• Joint pain
• Jaundice

This is usually followed by dark colored urine and jaundice (yellowing of the skin and the whites of the eyes).

In general, the severity of illness increases with age and children under age three may not have symptoms, though they can still spread the infection.

Most people feel better after one to two weeks but may continue to feel tired for a few more weeks.

How soon do symptoms appear?

Usually the first symptoms appear about four weeks after exposure, but they can develop anytime between two and seven weeks after exposure to the virus.

How long do hepatitis A symptoms last?

Symptoms usually last less than two months, although some people (10 percent – 15 percent) with hepatitis A can have symptoms for as long as six months.

How long can a person with the disease spread the virus?

People are most infectious in the two weeks before their symptoms appear and remain somewhat infectious about one week after jaundice.

People can spread hepatitis A even if they have no symptoms, especially children.

Can a person get hepatitis A again?

After one infection with hepatitis A, a person cannot get it again. However, there are different types of viral hepatitis, and infection with hepatitis A will not protect against other types of hepatitis.

What is the treatment for hepatitis A?

There is no specific treatment for hepatitis A. People who have not been vaccinated against hepatitis A who have been exposed to the virus should talk to a health care provider about getting the hepatitis A immunization or a shot of immune globulin to prevent severe illness.

Rest, adequate nutrition and fluids are recommended by health care providers. People with hepatitis A should also avoid alcohol, drugs, or medicines (including aspirin and Tylenol). Some people might need medical care in a hospital.

It can take a few months before people with hepatitis A start to feel better.

What should I do if I was exposed to hepatitis A?

If you were recently exposed to hepatitis A virus and have not been vaccinated against it, you might benefit from an injection of either immune globulin or hepatitis A vaccine. However, the vaccine or immune globulin must be given within the first two weeks after exposure to be effective. A health care professional can decide what is best on the basis of your age and overall health.

How can the spread of hepatitis A be stopped?

• Children should be taught to wash their hands with soap and warm water after using the bathroom.
• Washing hands thoroughly with soap and warm water before preparing food is very important.
• Washing hands thoroughly with soap and warm water after using the bathroom or changing diapers.
• Get a hepatitis A vaccine. Children in Nevada who attend public or private school are required to be vaccinated against hepatitis A and B. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends the vaccine for anyone who wants to be protected against the infection, especially for the following:
  • All children at age one year
  • Travelers to countries where hepatitis A is common
  • Family and caregivers of adoptees from countries where hepatitis A is common
  • Men who have sexual encounters with other men
  • People who use recreational drugs, whether injected or not
  • People with unstable housing or who are homeless
  • People with chronic or long-term liver disease, including hepatitis B or hepatitis C
  • People with clotting-factor disorders
  • People with direct contact with others who have hepatitis A

To be fully immunized, a person needs a second injection of vaccine six to 12 months after the first injection.

What are the recommendations for hepatitis A vaccine?

Centers for Disease Control and Prevention (CDC) routinely recommends hepatitis A vaccination for all children, for people who are at increased risk for infection, and for any people who want to obtain immunity.

Who should get vaccinated?

During this current hepatitis A outbreak, the Health District is working with community partners to vaccinate people who are more likely to be infected including people who use injection or non-injection drugs (legal or illicit), people who are experiencing homelessness, and people who have recently been in jail or prison.

The CDC recommends hepatitis A vaccination for the following people:

• All children at age of 1 year
• People who are traveling to or working in countries where hepatitis A is common
• Family and caregivers of adoptees from countries where hepatitis A is common
• Men who have sex with men
• Users of recreational drugs, whether injected or not
• People with unstable housing or experiencing homelessness
• People with chronic or long-term liver disease, including cirrhosis, hepatitis B or hepatitis C
• People with clotting-factor disorders
• People with direct contact with others who have hepatitis A
• Any person wishing to obtain immunity (protection)

Does the vaccine work if I only get one dose?

Two shots of the hepatitis A virus vaccine are recommended. Although the first dose of the vaccine is considered to be around 95 percent effective, that protection will eventually begin to decrease and a second shot boosts immunity for between 20 and 40 years, according to the CDC.

You can get a combination vaccine to protect you against both hepatitis A and B. Check with your health care provider.

Can I get my hepatitis A shot when I get other immunizations?

You can receive the hepatitis A vaccine when you receive other immunizations. The injection site will be different.

Is the hepatitis A vaccine effective?

Yes, the hepatitis A vaccine is highly effective in preventing hepatitis A virus infection. A second hepatitis A shot results in long-term protection.

Is the hepatitis A vaccine safe?

Yes, the hepatitis A vaccine is safe. No serious side effects have been reported from the hepatitis A vaccine. Soreness at the injection site is the most common side effect reported. As with any medicine, there is always a small risk that a serious problem could occur after someone gets the vaccine. However, the potential risks associated with hepatitis A are much greater than the potential risks associated with the hepatitis A vaccine. Since the first hepatitis A vaccine was licensed in 1995, millions of doses have been given in the United States and worldwide.

Who should not receive the hepatitis A vaccine?

If you have any questions about receiving the hepatitis A vaccine, talk to your health care provider. Anyone who has had a serious allergic reaction to any of the vaccine or its components should not get the vaccine. Tell your doctor if you have any severe allergies. Also, the vaccine is not licensed for use in infants under age 1 year.

Will the hepatitis A vaccine protect me from other forms of hepatitis?

No, the hepatitis A vaccine will only protect you against hepatitis A. There is a separate vaccine available for hepatitis B. There is also a combination hepatitis A and hepatitis B vaccine that offers protection for both viruses. There is no vaccine for hepatitis C at this time.

Can I get my hepatitis vaccine during pregnancy?

If you are pregnant, check with your health care provider about getting a hepatitis A vaccine. The Health District will not administer hepatitis A vaccine to a pregnant woman without a prescription from her health care provider.

Can I get a hepatitis A vaccine if I have HIV or AIDS or if I have a compromised immune system?

Yes. The hepatitis A vaccine is an inactivated vaccine, like a flu shot. If you have any questions, you should check with your health care provider.

Do food handlers have to get vaccinated?

People who are applying for the Health District’s Food Handler Safety Training Card are not currently required to receive the hepatitis A vaccine.

Is it recommended that food handlers get vaccinated?

The Centers for Disease Control and Prevention (CDC) does not recommend vaccinating all food handlers because it is not an effective way to stop an outbreak. The hepatitis A outbreak that is happening in Clark County is primarily affecting people who report using injection or non-injection drugs and people who are experiencing homelessness.
The hepatitis A vaccine is available for individual food handlers who have not been previously vaccinated and would like to be protected from hepatitis A. Food facilities, such as restaurants, can also offer the vaccine to their staff.

Why isn’t it recommended that food handlers get vaccinated?

Food handlers are not at an increased risk for hepatitis A infections because of their occupation. Food handlers are required to use safe hand hygiene practices in their jobs. These practices help prevent the spread of hepatitis A, even in the case of food handlers who are infected with the virus. Very few hepatitis A outbreaks are associated with food handlers.

Is the vaccine required for school?

Two doses of hepatitis A vaccine are required for students in the Clark County School District. Parents should check their children’s immunization records prior to enrollment because the hepatitis A vaccine might not be required in other jurisdictions. For additional information about school immunizations, visit our Back to School Vaccine Clinics page.

Where can I get vaccinated

Hepatitis A vaccine is available at the Southern Nevada Health District, at health care provider offices and clinics, and pharmacies.

Are there other ways to prevent the spread of hepatitis A?

Getting vaccinated is the most effective way to prevent the spread of hepatitis A.

People should avoid having sex with someone who has hepatitis A infection. In addition, don’t share food, drinks, cigarettes, towels, toothbrushes or eating utensils with other people.

Wash your hands thoroughly after going to the bathroom. Use plenty of soap and running water for at least 20 seconds (long enough to sing the “Happy Birthday” song twice).

Contamination can occur when people who are infected do not wash their hands properly after going to the bathroom and then touch other objects or food items. Surfaces that are frequently touched that should be cleaned and sanitized often include:

• Toilet Room Surfaces
• Light Switch Plates
• High Chairs
• Kitchen Surfaces
• Phones
• Tables and Chairs
• Doorknobs
• Recreation Equipment
• Computer Keyboards
• Railings
• Wheelchairs and Walkers
• Remote Controls

Are hand sanitizers as effective as regular handwashing?

Washing hands with soap and water is recommended when possible as it is more effective than hand sanitizers.

Most alcohol-based hand sanitizers are effective against bacteria, but they don’t do as well against viruses like the hepatitis viruses, mainly hepatitis A, or norovirus. It is recommended that you check the hand sanitizer label to see if it is effective against hepatitis A.

How should I disinfect my home or business for hepatitis A?

Maintain routine and consistent cleaning of bathrooms for employees, public, and personal use. Using a chlorine-based disinfectant (bleach) with a ratio of 1 and 2/3 cup of bleach to one gallon of water (5000 ppm). Mix and use the chlorine solution promptly. Allow 1 minute of contact time. Due to the high bleach concentration of this mixture, rinse surfaces with water after 1 minute of contact time and wear gloves while cleaning. Use for stainless steel, food/mouth contact items, tile floors, nonporous surfaces, counters, sinks, and toilets.

For additional information about how to properly clean and disinfect against hepatitis A: http://media.southernnevadahealthdistrict.org/download/Hepatitis-update-20190228/PDFs/SNHD-hepatitis-A-cleaning-instructions.pdf

Where can I get more information?

Contact your health care provider or the Southern Nevada Health District Office of Epidemiology and Disease Surveillance at (702) 759-1300.

For additional information about hepatitis A, visit the Centers for Disease Control and Prevention’s (CDC) Hepatitis A Questions for the Public webpage.