Hepatitis A is on the Rise: Here’s What You Need to Know

Hepatitis A is a viral infection that causes liver inflammation and damage. Following the broad introduction of the hepatitis A vaccine in 1995, the rate of US infections declined by 95%. Researchers estimate that about 2,500 cases of hepatitis A occurred in the US in 2014. According to the Centers for Disease Control and Prevention (CDC), the rate of hepatitis A infections in the US has increased recently. As of July 19, 2019, the CDC identified 22,295 cases of hepatitis A (including a high hospitalization rate of 59%) from 25 states. [i]

Hepatitis A is highly contagious. While past outbreaks had been attributed to contaminated food sources, the recent US outbreak occurred mainly among those in close contact with infected individuals.

Most at Risk for Contracting Hepatitis A

• People who are likely to get hepatitis A are those who [ii]
• travel to developing countries
• are physically intimate with an infected person
• are men who have sex with men
• use illegal drugs, including drugs that are not injected
• live with or care for someone who has hepatitis A

People with hepatitis A are most contagious during the 2 weeks before they exhibit symptoms, and they can continue to infect others for 3 weeks after developing symptoms. Children are often contagious longer than adults.

Symptoms typically appear 2 to 6 weeks after contact with the virus, though some individuals show no symptoms, especially infected children under 6 years of age. Symptoms of hepatitis A can include:

• dark yellow/brown urine
• fatigue
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea or vomiting
• abdominal pain
• jaundice (yellowish eyes and skin)

Because hepatitis A is such a contagious disease, it is important to be aware of those who may be at risk and the ways in which it is spread. If you see someone with these symptoms, let them know about hepatitis A, and recommend they see a doctor to prevent liver damage or widespread contamination.

The hepatitis A virus is transmitted through contact with an infected person’s stool, which can occur: when eating food prepared by an infected person who did not wash their hands after using the bathroom; drinking untreated water or eating food washed in untreated water, placing a finger or object in your mouth that was in contact with an infected person’s stool; or having close personal contact with an infected person such as through sex or caring for someone who is ill.

According to The National Institute of Diabetes and Digestive and Kidney Diseases
Health Information Center, you will not get hepatitis A by:

• being coughed on or sneezed on by an infected person
• sitting next to an infected person
• hugging an infected person

Protect Yourself with the Hepatitis A Vaccine. If you think you have come in contact with the hepatitis A virus, a dose of the hepatitis A vaccine or hepatitis A immune globulin may protect you from getting the infection. See your doctor right away because these must be administered shortly after contact with the virus. All children between 12 and 23 months of age should receive the hepatitis A vaccine as part of their regular vaccination program. Also, people how are travelling to developing countries or who interact with others who are likely to be infected with Hepatitis A should receive the vaccine, as well as people with chronic liver disease. [iii] The hepatitis A vaccine is administered in two separate shots. The first shot provides more limited short-term protection, and the second dose provides long-term protection. You can also reduce your risk of contracting of hepatitis A by washing your hands with soap and warm water for 15 to 30 seconds after going to the bathroom, after changing diapers, and before cooking or eating.

Healthcare workers, too, are taking extra precaution following the news of the increased infection rate. “Our staff has been informed about the nationwide increase and we continue our diligence with contact precautions and preventive medical measures,” says Providence Health’s Chief Nursing Officer Maria Calloway.

Because hepatitis A is an acute or short-term infection, most people recover without treatment after a few weeks, however, a small number of people (0.3-1.3%) can develop severe liver damage that can result in liver failure or death.

Call your doctor immediately if you think you have hepatitis A or have been in contact with someone with hepatitis A and you have not received the vaccine. Call 800-424-DOCS [800-424-3627] to locate a provider near you.

[i] Centers for Disease Control and Prevention. Increase in hepatitis A virus infections—United States, 2013-2018. MMWR. May 10, 2019. cdc.gov/mmwr/volumes/68/wr/mm6818a2.htm?s_cid=mm6818a2_w

[ii] Hepatitis A. The National Institute of Diabetes and Digestive and Kidney Diseases
Health Information Center website. May 2017.
https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a

[iii] Centers for Disease Control and Prevention. Chapter 9: Hepatitis A. In Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:135–148.