Disease

Hepatitis A is an infection of the liver caused by hepatitis A virus (HAV).

Transmission

• HAV is spread by the faecal-oral route through contaminated water and food, especially shell fish.
• HAV can also be spread via person to person contact when personal hygiene is poor.

Vaccine schedule

Hepatitis A Adults

Children

Hepatitis A Paediatric

Hepatitis A + Typhoid combined

Hepatitis A + Hepatitis B Combined

* Full protection not given until final dose at 1 year. Will give adequate protection if leaving sooner.

Epidemiology + Risk areas

• Found worldwide but is more common where sanitary conditions are poor.
• Most cases in the UK are imported from the Indian subcontinent (India, Pakistan, Bangladesh and Nepal) where the density of population and poor sanitation combine to make this disease common. Risk areas also extend to the Far East and Eastern Europe.
• Many people living in areas with a high incidence of Hepatitis A will develop natural immunity in childhood. (HAV infection induces lifelong protection against re-infection).
• Travellers from countries with good hygiene are at risk because few are immune from previous infection.

HEPATITIS A Risk Area Map

Signs and symptoms

• Children often asymptomatic.
• Symptoms are common in adults and severity tends to increase with age.
• Onset of illness is usually abrupt with:
  • headache
  • nausea/vomiting
  • diarrhoea and abdominal pain.
  • jaundice may follow often associated with uncomfortable itching
  • duration of jaundice is usually 7-14 days