The Hepatitis A virus (HAV) is primarily transmitted from person to person via the fecal-oral route and through contaminated water and food such as shellfish and uncooked vegetables or fruit prepared by infected food handlers.
The virus is present worldwide, but the level of prevalence depends on local sanitary conditions. HAV circulates widely in populations living in areas with poor sanitation infrastructure. In these areas, persons usually acquire the virus during childhood when the illness is asymptomatic (but still infective to others) or mild, and end up developing full immunity. Large outbreaks in these countries are rare. In contrast, a large number of non-immune persons are found in highly industrialized countries where community wide outbreaks can occur when proper food handling or proper hygiene practices are not maintained including in daycare centres, prisons, or mass gatherings.
In many cases, the infection is asymptomatic – persons do not exhibit symptoms. Those with symptoms usually get ill 15 to 50 days after exposure to the virus. Symptoms include malaise, sudden onset of fever, nausea, abdominal pain, and jaundice after a few days. The illness can range from mild to severe lasting from one to two weeks or several months. Severe cases can be fatal especially in older persons. Most infections are asymptomatic in children under six years of age, but infants and children can continue to shed the virus for up to six months after exposure to the virus, spreading the infection to others. Many countries are now including vaccination against Hepatitis A in their childhood vaccination schedules.
Wash your hands thoroughly and frequently with soap and water. If not available, use an alcohol-based hand sanitizer. Practice good body hygiene.
Drink boiled or treated water.
Eat well cooked foods and peel your own fruits.
Recommended for all travellers over 1 year of age.
There are two inactivated vaccines available in Canada and the USA, including a combined Hepatitis A and Hepatitis B vaccine. A combined Hepatitis A and Typhoid Fever vaccine is also available in Canada and Europe. Hepatitis A vaccines provide long-term protection and can be given in accelerated schedules. Discuss your options with your healthcare provider if you cannot finish the series prior to your departure. Immune Globulin may be recommended for some last-minute travellers.
Information last updated: January 10, 2019
Strickland G T, El-Kamary S. Viral Hepatitis. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 9th ed. New York: Saunders Elsevier; 2013: 290-305.