Information on Hepatitis A
Introduction
Hepatitis A is a viral infection of the liver. Most people acquire the disease by drinking contaminated water, by eating contaminated food (especially shellfish caught in contaminated water), or by ingesting the virus directly off of their own hands after touching a contaminated object (like a dirty diaper) or the hands of an infected person who failed to wash them after having a bowel movement.
Symptoms associated with hepatitis A include: Fever, general malaise, lack of appetite, nausea, abdominal discomfort, dark urine, and jaundice.
The severity of hepatitis A increases with the age of the infected individual, particularly for those over age 50. Most children have few or no symptoms and rarely develop jaundice. About 0.3% of all reported hepatitis A cases are fatal; however, 1.8% of reported cases are fatal in persons aged 50 years and older.
Risk to travelers
Your risk of acquiring hepatitis A while traveling abroad depends upon your living conditions, length of stay and the incidence of hepatitis A infection in the areas visited. In general, travelers to industrialized countries with low rates of transmission are at little to no risk of infection.> The risk of infection increases with duration of travel and is highest for those who live in or visit rural areas, trek in back country, eat or drink under unsanitary conditions, or have close contact with local persons (especially young children) in settings of poor sanitation. However, many cases of travel-related hepatitis A occur in travelers with "standard" or all inclusive tourist itineraries, accommodations and food consumption behaviors.
Prevention
Only use safe drinks such as canned or bottled carbonated drinks, beer, wine, and beverages made with boiled water. In some places the possibility exists that commercial water bottles may have been filled with tap water and recapped; therefore, carbonated bottled water is the safest option (although be aware that some brands may be high in sodium).
Always avoid ice cubes, and remember that alcohol will not make mixed drinks made with plain tap water safe. Consider non-disposable glasses and cups unsafe, too. Use straws.
Use safe water for brushing your teeth, washing near your mouth and so on. You may want to take along an inexpensive immersion coil for boiling.
An alternative is to treat water with Pristine (Chlorine Dioxide) with or without the use of a good mechanical water purifier. Removing sediment can be made easier with a pinch of alum.
You should avoid leafy and uncooked vegetables and salads. Peel fruits yourself, taking care not to contaminate the inside.
Order meats, fish, and other seafood cooked well done and served piping hot. Bread is safest when served fresh from the oven. Avoid moist grain dishes (like rice) that have been allowed to sit at room temperature for prolonged periods.
Always avoid cold meat platters, mayonnaise, and creamy desserts, as well as buffets and products from street vendors. Don't eat or drink unpasteurized dairy products, including cheese and yogurt. To protect against any attempts by local vendors to "stretch" pasteurized milk by adding water or unpasteurized milk to cartons or bottles, stick to canned milk.
Don't swim or fish in polluted waters, and don't eat fish or shellfish that may have been caught in such waters.
Always wash your hands or use a hand sanitizer such as Purell or Isagel before eating.
Vaccination
Hepatitis A vaccine became available (for persons over 2 years of age) in the early 90s, and it is highly effective. You should consider getting it if you frequently travel developing countries or plan to reside in or visit developing countries for extended periods.
A combinaion hepatitis A/hepatitis B vaccine is also available (Twinrix) and requires a series of 3 injections.
Immune globulin (IG), a human blood-derived product, is being used less and less and has been replaced by the vaccine.
Who should consider vaccination?
Hepatitis A vaccination is recommended for all susceptible travelers to intermediate or high-risk areas, especially frequent, short-term or long-term international travelers. It is of special importance for persons who have another form of Hepatitis.
All of the Hepatitis A and combined A/B vaccines are safe for pregnancy, however most woman will want to wait until after delivery to be vaccinated.
Risks and side effects
The most common side effect of hepatitis A vaccination is soreness at the site where the shot is given. Sometimes headache and fatigue may occur, and some children may have temporary loss of appetite. Serious side effects are rare.
Vaccination schedule
Hepatitis A vaccine is given as 1 INJECTION before departure, with the second shot given 6 to 12 months after the first shot. Although it is recommended to get the first injection 30 days before leaving, it can be given any time before departure and will still be protective. The vaccine most likely gives protection for life.
The combined hepatitis A/hepatitis B vaccine is given in a series of 3 shots; the second shot is given 1 month after the first and the third shot is given 6 months after the first. An accelerated schedule consists of 4 doses. The second dose is given 7 days after the first dose, and the third dose is given 21 days after the first dose (14 days after the second dose); a fourth dose is given 12 months after the first dose.
Vaccine Prices
Click here to see our Hepatitis A and Hepatitis A/B combination vaccination prices.