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Hepatitis A

Hepatitis A is a viral disease that affects the liver. There are several types of viral hepatitis, designated A, B, C, D, and E. Hepatitis A virus is transferred through contact with contaminated food and water or with an infected person. The illness is self-limiting and does not cause a chronic infection.

Cases of hepatitis A are reported in New Zealand across all age groups. The majority, but not all, cases report overseas travel immediately prior to symptoms (i.e. during the disease incubation period). A small cluster of cases in 2015 were linked to a batch of imported frozen berries.

How you get it

The hepatitis A virus is transmitted through the faecal-oral route by consumption of contaminated food, including raw shellfish, water or milk or close contact with an infected person.

Certain people are at higher risk from infection, these include:

  • Injecting drug users
  • People with chronic liver disease or who are at risk of developing chronic liver disease, e.g. people who are hepatitis B or hepatitis C positive, people who misuse alcohol
  • Occupational groups exposed to faeces, for example:
    • Employees of early childhood services
    • Healthcare workers, including cleaners, exposed to faeces
    • Sex industry workers
    • People who work with sewerage
    • Members of the armed forces
  • Travellers to moderate and high-risk countries
  • Men who have sex with men

Symptoms

Symptoms are usually seen in older children and adults from 15-50 days after infection (on average 28-30 days); young children may not have any symptoms. Symptoms include:

  • Fever
  • Tiredness
  • Nausea
  • Loss of appetite
  • Abdominal pains
  • Dark urine
  • Pale coloured faeces
  • Jaundice (yellow colour of the skin and eyes), rare in young children

Symptoms usually last for several weeks but less than two months. For 1–2 people in 10 the symptoms will last or come and go for up to six months.

Treatment

There is no specific treatment for hepatitis A infection. Advice from a doctor should be obtained before using medication to relieve pain or fever.

Risks

It is rare for very severe liver problems to develop following hepatitis A but the risk of complications increases with advancing age and is higher in those with pre-existing liver disease.

Unlike other hepatitis viruses, the hepatitis A virus does not cause a chronic infection.

Prevention

Thorough hand-washing using soap and water is necessary to reduce the risk of spread of hepatitis A virus:

  • After using the toilet or changing nappies
  • Before and after preparing food
  • Before eating

Infected people are excluded from early childhood centres, school or work for one week after the start of symptoms or jaundice.

A vaccine is available, but not funded, for people at risk of infection. However, it may be funded for close contacts of hepatitis A cases during an outbreak. It is also recommended for overseas travellers.

Hepatitis A

Complications of disease

  • Liver inflammation (hepatitis)
  • Fever
  • Nausea
  • Loss of appetite
  • Although rare, hepatitis can be severe
  • Complications related to a hepatitis A infection increases with age and with pre-existing liver disease

Responses to vaccine

Common responses

  • Mild pain or swelling at the injection site
  • Fatigue
  • Irritability
  • Nausea, vomiting, loss of appetite
  • Headache
  • Mild fever

Adverse reactions

  • Muscle and joint pain (1 in 1000 )
  • Dizziness (1 in 1000)
  • Rash / itching (1 in 1000)

As with any medicine, very rarely, severe allergic reactions occur following immunisation (< 1 in 4 million doses)

 

Hepatitis B

Complications of disease

  • Infants and children are less likely to have symptoms than adults, but infants are more likely to become chronically infected and develop complications later in life
  • Liver inflammation for around 8 out of 10 adults; around 2 adults out of 10 will not have symptoms
  • Acute liver failure can require liver transplantation or lead to death
  • Chronic infection can lead to cirrhosis and liver cancer

Responses to vaccine

Responses are more common in adults than in children

Common responses

  • Nausea or diarrhoea

Rare responses

  • Hives
  • Itching
  • Temporary low platelet count
  • Muscle or joint pain
  • Abdominal pain and vomiting

As with any medicine, very rarely, severe allergic reactions occur following immunisation

Last updated: Apr 2017