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Hastings and Prince Edward Public Health

Hepatitis A FAQs

What is hepatitis A?

Hepatitis A is an infection of the liver caused by the hepatitis A virus (HAV). The infection is self-limiting and varies from one to two weeks, to several months. The severity of the infection increases with a person’s age. Recovery often takes 4-6 weeks but may take months. Recurrent hepatitis for up to a year occurs in about 15% of cases. Individuals who have chronic liver disease are at increased risk of serious complications.

Immunity increases with age. About 3% of children younger than 13 years of age, and more than 60% of adults older than 60 years of age are immune to HAV.

What are the symptoms?

Younger children often are not ill. Infection usually causes symptoms in adults and school-aged children. Typically these include:

  • loss of appetite
  • fever
  • nausea or vomiting
  • abdominal pain
  • fatigue and weakness
  • followed within a few days by jaundice (yellow skin and eyes) and dark urine

How is it spread?

It is spread person-to-person by the fecal-oral route. It is usually spread by eating or drinking contaminated beverages, water or food. Some uncooked foods are especially hazardous, i.e. shellfish or food harvested from waters contaminated by human waste. The virus may persist for days or weeks in the environment. It can also be spread by sexual contact.

What is the incubation period?

The incubation period ranges from 15 to 50 days with an average of 20 to 30 days.

When is it contagious?

Shedding of the virus in feces occurs during the latter part of the incubation period. The peak level of infectivity is in the two weeks before symptoms appear. The risk of transmission goes down after the symptoms start, and ends a few days after jaundice appears.

Who gets hepatitis A?

The most common risk factor is close personal or intimate contact with a recent case. Other people at increased risk include:

  • residents in certain communities in rural or remote areas with inadequate sanitation or no secure supply of safe water
  • residents of certain institutions such as correctional facilities and those for developmentally-challenged individuals
  • oral or intravenous drug users
  • men who have sex with men
  • people with multiple sex partners
  • people traveling to or residing in countries with inadequate sanitation

How can you protect yourself?

  • Wash your hands before eating or preparing food.
  • Wash fruits and vegetables prior to preparation and consumption.
  • Protect food and water supplies from fecal contamination.
  • Wash your hands after using the bathroom or changing a diaper.
  • Do not prepare or serve food to others if you are infected with hepatitis A.
  • Remember that uncooked food (e.g. shellfish) is especially hazardous. Oysters, clams and other shellfish from contaminated areas should be heated to a temperature of 85º-90ºC (185º-194ºF) for four minutes, or steamed for 90 seconds before eating.

Four types of vaccine are licensed for use in Canada. They are all effective in preventing illness if given before exposure. Protection occurs within three to four weeks after immunization.

Household and sexual contacts of a case should be given post-exposure immunization against hepatitis A. It is effective if given within two weeks after exposure.

Two doses of vaccine are recommended. The first dose provides immunity for a year. The second dose given 6 to 12 months later induces long-term immunity for at least 20 years.

Immune Globulin (IG): This is a preparation of antibodies taken from human blood which may be used for short-term protection against HAV in infants and in people who are immuno-compromised who would not respond fully to the vaccine. This is also available in limited quantities for people who should not receive the vaccine. It can be used for treatment if exposure has occurred.

Who should not receive the vaccine?

The vaccine should not be given to any person who has had an anaphylactic reaction to any part of the vaccine preparation. Since each HAV vaccine has different components, it is important to determine the specific cause of previous reaction, if possible, and refer to the manufacturer’s description of the vaccine.

References

  • Heymann, D. L., (2008). Control of Communicable Diseases Manual (19th Ed.). Washington, DC: American Public Health Association.
  • Public Health Agency of Canada, (2006). Canadian Immunization Guide (7th Ed.). Ottawa, ON: Public Works & Government Services.

Hepatitis A Fact Sheet printable pdf

Need More Information About Hepatitis A FAQs?

Talk to your health care provider or call our Communicable Disease Program at 613-966-5500 or 1-800-267-2803, ext. 349.

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COVID-19 vaccines in HPE

Eligible individuals can receive their vaccination at many participating local pharmacies by contacting the pharmacy directly. Please visit covid-19.ontario.ca/vaccine-locations for location and registration information.

Vaccine ordering for health care providers

Vaccine orders for routine immunizations and STI medications continue to be available through HPEPH by using our vaccine order forms; however, please note that our vaccine delivery/pickup procedure has changed. For the most up to date pick up schedule please visit hpePublicHealth.ca/vaccine-orders-info-healthcare-providers/.