Although not normally fatal, hep A can lead to death for those with liver disease

Throughout the United States, there have been multiple outbreaks of hepatitis A (HAV), especially among people who inject drugs (PWID) and those who are homeless. Hepatitis A is not normally fatal, but for individuals with pre-existing liver disease, it can lead to death. Consequently, these recent outbreaks have led to a significant number of deaths. This box is designed to give you very basic information about HAV, including ways to prevent it so we can avoid this unnecessary loss of life from a vaccine-preventable disease.

What is hepatitis A?

Hepatitis A is a type of viral hepatitis. While it’s a virus that infects the liver, it differs from hepatitis B (HBV) and C (HCV), in that it doesn’t become chronic: Once infected, people will likely feel symptoms for around 2 months, with some people experiencing them for as long as 6 months. Like HBV, HAV is vaccine preventable.

Hepatitis A is transmitted from fecal to oral contact: When poop is inadvertently eaten. It is commonly a food-borne illness, where someone eats something that has not been properly cleaned or cooked, but it can be sexually transmitted as well through oral to anal contact.

What are the symptoms of hepatitis A?

Once infected with HAV, it usually takes about 4 weeks for the symptoms to arise. Whereas hepatitis B and C are usually asymptomatic (no symptoms), hepatitis A almost always has symptoms, some that can feel quite severe:

  • Jaundice (yellowing of skin and eyes)
  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea and/or vomiting
  • Abdominal pain
  • Joint pain
  • Dark urine
  • Clay-colored stools (poop)

These symptoms can last for 2–3 months, with some people experiencing them as long as 6 months. There is no treatment for hep A to get rid of these symptoms, but there are ways to help manage them. Don’t take any medications—either over-the-counter or prescribed—to deal with your symptoms without consulting your medical provider. You don’t want to put any added pressure on your liver and some medications can do that.

How is hepatitis A prevented?

There are two ways to absolutely prevent HAV: Get vaccinated or do post-exposure prophylaxis after getting exposed to it (if you have not been vaccinated).

The HAV vaccine is a safe and effective way to prevent infection. The vaccine is a two shot sequence: You get the first one and then follow up with the second one 6 months later. Depending upon the brand of vaccine used, the second dose can happen as long as 12–18 months later. There are also vaccines that have both HAV and HBV in them. If a person misses the vaccination within the allotted time period, its safe to start over as extra doses are not harmful. The HAV vaccine is safe for people with HIV, as well as those with HBV or HCV. Indeed, people living with any of these infections should be vaccinated against HAV.

If have not been vaccinated, but think you’ve been exposed, call your medical provider immediately. You can do immune globulin or the HAV vaccine. It has to be administered within the first two weeks of an exposure.

Other ways to prevent HAV include good hand washing, cooking food and boiling water (note, we treat drinking water in the U.S. to kill HAV), and minimizing oral to fecal contact during sex.

Once a person has been infected with HAV, she/he will have natural immunity and does not need to worry about future infections.

Who should be vaccinated?

In the U.S., all children have been vaccinated since 2005. Some states started earlier. The following people should be vaccinated against HAV:

  • All children at age 1 year
  • People traveling to countries where hepatitis A is common
  • Family and caregivers of adoptees from countries where hepatitis A is common
  • Men who have sex with men
  • People who use drugs, both injected and non-injected
  • People who are homeless
  • People with chronic or long-term liver disease, including hepatitis B or hepatitis C
  • People with clotting-factor disorders
  • People with direct contact with others who have hepatitis A
  • Any person wishing to obtain protection from the virus

Hepatitis A is a preventable disease. Talk with a medical provider to see if you need to be vaccinated.

For more information, check out the CDC’s website on hepatitis A: