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What is hepatitis A and how can I protect my family?
Hepatitis A is a liver infection spread by contaminated food, water and dirty hands, but it usually gets better on its own.
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What it is
Hepatitis A is an inflammation of the liver caused by the hepatitis A virus [2]. It can cause mild to severe illness [2]. The virus spreads mainly by the faecal-oral route: a person swallows food or water contaminated with the faeces of an infected person [2][5]. In families, this can happen through dirty hands when an infected person prepares food [5]. Waterborne outbreaks are usually linked to sewage-contaminated or poorly treated water [5]. The virus can also pass through close physical contact, such as oral-anal sex, but casual contact does not spread it [2][5]. Food can carry the virus too, typically raw or undercooked seafood or contaminated fresh or frozen produce such as berries [6]. Almost everyone recovers fully and keeps lifelong immunity, but a very small number of people can die from fulminant hepatitis, a rare form of acute liver failure [2]. Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease [2]. Risk is linked to unsafe water, poor sanitation and poor hygiene, such as contaminated and dirty hands [2]. Contaminated water and poor sanitation are also linked to other diseases, including cholera, diarrhoea, dysentery, typhoid and polio [4].
What you can do at home
According to WHO, these measures reduce the spread of hepatitis A [1]:
- Make sure drinking water is safe [1].
- Dispose of sewage properly in your community [1].
- Wash your hands regularly with soap, before meals and after using the bathroom [1].
- Practise safer sex, including condoms, dental dams and good hygiene [1].
- Keep food and personal hygiene good [8].
For diarrhoea, which shares the same faecal-oral spread, WHO lists these measures [8]:
- Give oral rehydration salts (ORS) solution, a mix of clean water, salt and sugar [8].
- Give zinc supplements, which shorten a diarrhoea episode [8].
- Keep giving nutrient-rich foods, including breast milk, during the illness [8].
- Seek intravenous fluids if there is severe dehydration or shock [8].
Several injectable inactivated hepatitis A vaccines are available internationally, and all give similar protection with comparable side effects [1]. No vaccine is licensed for children under 1 year of age [1]. In China, a live attenuated vaccine is also available [1]. Ask your doctor whether vaccination is right for your family.
When to see a doctor or go to the emergency department
Seek care if you or your child has signs of dehydration, persistent diarrhoea, or blood in the stool [8]. Hepatitis A can rarely cause fulminant hepatitis, which is often fatal, so do not wait if someone becomes very unwell [2]. If you are unsure, contact your doctor or your local emergency number.
Common questions
How does hepatitis A spread? Mainly when someone swallows food or water contaminated with the faeces of an infected person, or through close physical contact such as oral-anal sex [2][5].
Can my child get a hepatitis A vaccine? Vaccines are available, but none is licensed for children younger than 1 year [1]. Ask your doctor about your child’s age and your local schedule.
Does hepatitis A become a long-term illness? No. Unlike hepatitis B and C, it does not cause chronic liver disease, and almost everyone recovers fully with lifelong immunity [2].
Which foods are risky? Raw or undercooked seafood and contaminated raw fresh or frozen produce such as berries [6].
Is it dangerous? Most people recover fully, but a very small proportion can die from fulminant hepatitis [2]. In 2023, an estimated 35 569 people died from hepatitis A worldwide [2].
Sources
[1] WHO — “Hepatitis A”, section “Prevention”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/hepatitis-a [2] WHO — “Hepatitis A”, section “Key facts”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/hepatitis-a [4] WHO — “Drinking-water”, section “Water and health”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/drinking-water [5] WHO — “Hepatitis A”, section “Transmission”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/hepatitis-a [6] WHO — “Food safety”, section “Viruses”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/food-safety [8] WHO — “Diarrhoeal disease”, section “Prevention and treatment”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
This guide summarises published paediatric guidelines. It is not medical advice and does not replace your paediatrician. In an emergency, call your local emergency number.
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