Hepatitis A
What is hepatitis A?
Hepatitis A is a viral liver infection caused by the hepatitis A virus. Symptoms may
include diarrhea, fever, lack of energy, nausea, abdominal discomfort and jaundice (yellow
color to the whites of the eyes or skin and darkening of urine). Not all symptoms are
experienced by infected persons. Many cases in children have no symptoms. In adults, the
infection usually causes severe illness that can last several months. There are no long
term complications.
Who gets hepatitis A?
The highest rates of hepatitis A are among children and young adults, but anyone can
get hepatitis A.
How common is it in Washington?
The last major outbreak in Washington was in the second half of the
1980s, peaking in 1989 with 70 cases per 100,000 people (3273 cases). In the past five years,
Washington’s rates have fallen from 18 to 3 cases per 100,000. This compares to rates of
5 to 10 per 100,000 nationally. Hepatitis A has long
term cycles with periodic increases in cases.
Where does it come from?
The virus is present in the feces of an infected person two weeks before and up to two
weeks after symptoms begin. The person is most infectious a week before to a week after
symptoms appear. However, an infected person with no symptoms can still infect others.
Animals do not transmit hepatitis A.
How is a person exposed?
Most infections are the result of eating something contaminated with the feces of an
infected person. People may become infected after they eat uncooked food prepared by an
infected person with poor personal hygiene, especially improper hand washing after using
the bathroom or changing a baby’s diaper. Although uncommon in Washington,
contaminated water and raw shellfish can also spread the virus.
How soon do symptoms appear?
Symptoms typically appear 30 days after exposure, but can occur between 15 and 50 days.
Is there a vaccine available?
Yes. The hepatitis A vaccine can provide long-term protection against the disease.
Consult your doctor about dose and vaccination schedule, which vary depending on age.
Immune globulin can also be useful in preventing hepatitis A. When given within 14 days of
exposure, it can provide short term protection for persons with hepatitis A exposure who
have not been vaccinated.
Who needs to be vaccinated against hepatitis A?
- Persons 2 years of age and older traveling or working in countries with high or
intermediate rates of hepatitis A (Central and South Americas, the Middle East, the
Caribbean, Mexico, Asia excluding Japan, Africa, and southern or eastern Europe).
- Men who have sex with men.
- Persons who use street drugs.
- Persons with chronic liver disease.
- Persons who have occupational risk for infection.
- Persons who have clotting-factor disorders.
- Children who live in states, counties, or communities where the average
annual hepatitis A rate during 1987 - 1999 was 20 or more cases per 100,000
people. In Washington State, children living in 13 high rate counties should
be immunized routinely: Asotin, Chelan, Clark, Cowlitz, Douglas, Grays
Harbor, King, Klickitat, Mason, Skamania, Spokane, Thurston and Yakima.
How can I protect my family?
Pay careful attention to cleanliness. Always wash your hands with soap and water after
using the bathroom, after changing diapers, and before handling food or beverages. Do not
prepare food for others if you have diarrhea. Don’t drink contaminated water. If you
eat raw molluscan shellfish, purchase them from reputable commercial sources or harvest
them from an approved beach.
What should I do if I suspect someone I know has hepatitis A?
Identification and reporting of hepatitis A cases is critical to prevent further spread
of the disease. If you or your family has been in contact with an infected person, or if
you think symptoms indicate hepatitis A, contact your doctor or local health department.
What are health departments doing to control the spread of the virus?
Control of hepatitis A is possible through proper hand washing, immunization with the
hepatitis A vaccine, the administration of immune globulin to people who have been exposed
to the virus, and by providing safe drinking water. The state Department of Health and
local health departments help the food service industry, child care providers, and the
public to understand the importance of proper personal hygiene. When a food handler
becomes infected, health departments take the appropriate steps to control further spread
of the disease.
Where can I get more information?
For more information call Communicable Disease Epidemiology (206) 418-5500 or
toll free 877-539-4344, the
Immunization Program (360) 236-3595 or the Food Program (360) 236-3330.
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