HEPATITIS A

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What is it

Hepatitis A is a viral disease that affects the liver. It occurs worldwide and is common in countries where hygiene and sanitation standards are low, representing a potential risk to the health of Canadian travellers.1 It is one of the most common vaccine preventable diseases in travellers.1

Who is at risk

Anyone who comes into contact with contaminated food or water is at risk, although adults tend to suffer more severe symptoms than children. The disease initially incubates for a period of 15 to 50 days (28 days on average).1 Certain people may be at increased risk of infection or severe hepatitis A:1,2

  • Travellers to Hepatitis A-endemic countries
  • Individuals with chronic liver disease
  • Men who have sex with men (MSM)
  • Injectable and non-injectable illicit drug users
  • Individuals living in communities at risk of hepatitis A outbreaks or in which hepatitis A is endemic
  • Household or close contacts of children adopted from hepatitis A-endemic countries

What are the symptoms

The first symptom is a general feeling of unwell followed by fever, headaches, muscle aches, fatigue and gastrointestinal disorders. Jaundice, which is the yellowing of skin and eyes, is a symptom for many adults. The acute phase of hepatitis A lasts for approximately one month although it can take up to six months to recover completely. Hepatitis A may be asymptomatic in younger children.1,2

How is it spread

Hepatitis A is primarily spread when an uninfected (and unvaccinated) person ingests food or water contaminated with faeces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation and poor personal hygiene.1

How is it prevented

Pre-exposure Hepatitis A immunization is recommended for people at increased risk of infection or severe hepatitis A (see above “who is at risk”).3,4,5 Travellers are advised to consult a healthcare provider or travel clinic 6 weeks before travelling overseas to discuss suitable vaccination options1

Travellers should always drink bottled water and avoid ice in drinks where possible. Raw foods like salad and fruits that can’t be peeled should also be avoided in case of water contamination6

How is it treated

Doctors can diagnose Hepatitis A with blood tests and a physical examination. There is no specific treatment for hepatitis A. Recovery from symptoms can take several weeks and, in some cases, even months; about 25% of adult cases require hospitalization. A focus is placed on nutritional balance and replacement of fluids lost from vomiting and diarrhoea.2 Medical advice is recommended for the onset of symptoms. For further information regarding Hepatitis A and immunization, please speak with your healthcare provider.

REFERENCES

  1. Public Health Agency of Canada. Hepatitis A (2016). https://travel.gc.ca/travelling/health-safety/diseases/hepatitis-a
  2. World Health Organization. Hepatitis A Fact Sheet (2016). http://www.who.int/mediacentre/factsheets/fs328/en/
  3. GSK Havrix Product Monograph. (2017). https://ca.gsk.com/media/590706/havrix.pdf
  4. Sanofi Pasteur Avaxim Product Monograph (2015) https://www.vaccineshoppecanada.com/document.cfm?file=avaxim_e.pdf
  5. Sanofi Pasteur Avaxim Pediatric Product Monograph (2015) https://www.vaccineshoppecanada.com/document.cfm?file=Avaxim_Ped_E.pdf
  6. Government of Canada. Eat and Drink Safely. (2016). https://travel.gc.ca/travelling/health-safety/food-water