Hepatitis A (HepA)
What is Hepatitis A?
Hepatitis A is a viral infection that causes inflammation of the liver. The severity of illness ranges from a mild illness, lasting 1-2 weeks, to severe illness, lasting several months. Older children and adults are more likely to have symptoms, while young children may have mild symptoms or no symptoms at all. A blood test for hepatitis A antibodies (IgM) is needed to diagnose this infection.
Animals do not carry or spread this virus.
Signs and symptoms
- Yellow skin and eyes (jaundice)
- Dark, tea-colored urine
- Pale white or clay-colored stools
- Abdominal cramps
- Nausea
- Vomiting
- Diarrhea
- Joint pain
- Loss of appetite (anorexia)
- Low-grade fever
Incubation period
2-6 weeks but, usually within 4 weeks of initial infection to initial symptom onset and typically five weeks to jaundice onset
Contagious period and spread
- The disease is spread through the fecal→oral route (through consumption of contaminated food and water or through close or intimate person-to-person contact and can be spread by people who do not have symptoms.
- A person is most contagious in the two weeks before symptoms begin and remains contagious for a week after jaundice begins.
- Young children are much less likely to develop symptoms when they are infected with the hepatitis A virus than adults. These children can still spread the virus to others.
Public health reporting requirements
- Report the infection to the local or state health department within one working day of a suspected or confirmed diagnosis.
- Notify local or state public health departments if the hepatitis A case handles prepares food for others, or attends or works in a child care facility.
Control of spread
- Consult immediately with local or state public health for implementation of control measures.
- Unvaccinated people who are exposed to someone with hepatitis A (through close contact or eating food prepared by the ill person) can be given vaccine and/or immune globulin (IG) in the two weeks after exposure in order to prevent illness or lessen the severity of symptoms. The local public health agency will evaluate whether anyone should receive IG or hepatitis A vaccine. Parents/guardians, siblings, or close playmates may need IG/vaccine.
- Schools: In most instances, teachers and classmates are not at risk of becoming infected.
- Child Care: Consult with public health as soon as possible to determine risks of transmission and people who may require IG/vaccine.
- Encourage frequent handwashing, especially after using the toilet, changing diapers, and before eating.
- Promptly sanitize contaminated surfaces (like diaper-changing areas) and other commonly touched surfaces (like toys), and discard food or water if it is thought to be contaminated. See Disease Prevention: The Facility Environment.
Vaccination
Routine child/adolescent recommendations:
- Hepatitis A vaccination is routinely recommended as a 2-dose series for all children at age 12-32 months.
- Unvaccinated persons through age 18 years should complete a 2-dose series.
Colorado school-required vaccines:
- There is no vaccine requirement for hepatitis A vaccine.
Routine adult/other recommendations:
- Any person who is not fully vaccinated and requests hepatitis A vaccination may be vaccinated. Note that identification of risk factors is not required.
Treatment
There is no specific treatment for hepatitis A after symptoms have developed. Vaccination for hepatitis A is effective in preventing the disease.
Exclusion
- Exclude all infected children and/or staff until cleared by public health.
- Child Care: Ill children should not go to another facility during the period of exclusion.
- Exclude affected individuals from food preparation until cleared by the state or local public health agency.
Role of teachers, caregivers, and family
- Follow instructions of health care providers for treatment and care.
- Practice good hand hygiene at all times.
- Clean and disinfect potentially contaminated surfaces and objects frequently.
- Encourage routine vaccination and routinely check that children in the facility are vaccinated.