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Hand Washing Prevents Hepatitis A Infection

Hepatitis A is a preventable disease. A vaccine is currently available for people at risk for hepatitis A. It is also recommended as a routine childhood immunization. Hepatitis A, at the top of the alphabet of viruses causing liver disease, puts travelers at risk and, until recently, worried parents of children in day care.

Aside from immunization, hand washing before eating or preparing food and after using the bathroom or changing a baby's diaper, remains one of the best preventions against getting or spreading hepatitis A virus (HAV).

The disease is spread by feces-to-mouth contact. The virus can be carried on an infected person's hands and spread by direct contact or by consuming food or drink the infected person handled. HAV also can be spread through oral-anal sex or by consuming water or raw shellfish contaminated by sewage.

How is it spread?

HAV is not spread by coughing, sneezing, or other casual contact, such as sitting next to a person or being in the same room.

People at increased risk for hepatitis A include travelers to developing countries, injecting drug users, men who have sex with men, and possibly children and workers in day care centers where outbreaks occasionally occur.

What are the symptoms?

Symptoms of HAV include:

  • Fatigue (tiredness)

  • Mild fever

  • Flu-like illness

  • Nausea and vomiting

  • Stomach ache

  • Loss of appetite

  • Jaundice (yellow eyes and skin)

  • Dark urine

  • Light-colored bowel movements

Children, especially young ones, may have few if any symptoms. Diagnosis is made through a blood test.

The average time between exposure and symptom development is 30 days, but it can range from 15 to 50 days. People can be contagious up to 14 days before symptoms appear.

What is the treatment?

Treatment is mainly supportive care by resting, eating a low-fat diet and drinking plenty of liquids. Antibiotics aren't useful, because hepatitis A is a virus. This is not a chronic disease; once you get it, you will never get it again. People who have recovered from hepatitis A do not continue to carry the virus.

Healthy people rarely die from hepatitis A, and most people recover in a few weeks. People who already have a chronic liver disease when they get hepatitis A are at higher risk of developing liver failure.

Immunization

The hepatitis A vaccine has become part of the routine childhood immunization schedule, and, as of 2006, is recommended for all children, not just those at risk.

These adults should consider immunization:

  • Travelers who will be visiting or living in high-risk areas, including countries in Latin and South America and many parts of Africa and Asia

  • Men who have sex with men

  • Injecting drug users

  • People working in institutions and day care centers

  • Food handlers

People with chronic liver disease or who have clotting-factor disorders also may want to get the vaccine.

Tips for prevention

If you are not immunized against hepatitis A, here are suggestions on how to avoid infection:

  • Wash hands thoroughly with soap and running water after using the bathroom, changing diapers, and before preparing or eating food. This is the most important step in preventing hepatitis A.

  • Teach children to wash their hands.

  • Change diapers on surfaces that can be cleaned and disinfected after each use. A good disinfectant is one tablespoon liquid household bleach to one quart of water.

  • Never change diapers on eating or food preparation surfaces.

  • Cook shellfish thoroughly before eating, especially if you already have a chronic liver disease.

  • Drink water from approved sources only.

  • Let your doctor or health department workers know if someone in your family has hepatitis A.

  • Get the vaccine if you are in a high-risk group or are planning an extended trip to a country with a high rate of hepatitis A.