Hepatitis A is transmitted primarily through oral contact with feces (oral-fecal contact). This includes contaminated food or water sources and sexual contact, especially oral-anal sex.

Hepatitis A can easily spread among young children in day care settings because many are in diapers and cannot wash their own hands, and no one may know they have the disease since children normally do not have symptoms.

Hepatitis A has on rare occasions been transmitted through blood transfusion, use of blood products or sharing needles or other injecting equipment contaminated with HAV-infected blood. Transmission by blood is rare because the presence of virus in the blood occurs with the onset of infection and is not thought to be present long.

Most adults infected with hepatitis A usually develop some symptoms. Symptoms may develop about 15-50 days after exposure; the average is 28 days. These may include:

• Low-grade fever
• Malaise (feeling of ill-health)
• Fatigue (feeling tired all the time)
• Loss of appetite
• Nausea
• Abdominal discomfort
• Dark-colored urine
• Jaundice (yellowing of the skin and eyes)

Children under 6 years of age seldom develop symptoms, although some may experience diarrhea.

There are currently three blood tests available to detect HAV antibodies (disease-fighting proteins in the blood). Antibodies may be detected for up to six months after symptoms begin. HAV antibodies usually disappear after this time. Talk to your healthcare provider for more information about HAV testing.

There is no cure for hepatitis A. Most people with severe infection will experience short-term illness and then recover completely. They are often told to rest for one to four weeks and to avoid intimate contact with others. Some doctors recommend a high-protein, low-fat diet during recovery and suggest patients avoid alcohol, sedatives, or strong painkillers. Once recovered, an individual is immune and will not get hepatitis A again.

Fortunately, complications from hepatitis A are rare, and few deaths result from it. It is not known to cause chronic infections. However, it can make some people very sick, and it is easily preventable.

Yes! Hepatitis A is preventable by vaccination. Clinical trials have shown that the vaccine is effective in preventing infection in about 95% of people who were exposed. There are generally no side effects, except for soreness at the site of injection. Less than 10% of those vaccinated become tired and nauseous.

The Centers for Disease Control and Prevention (CDC) recommends hepatitis A vaccination for:

• All children
• Men who have sex with men
• Illegal drug users

Others recommended for hepatitis A vaccine:

• Anyone traveling to an area with a high prevalence of hepatitis A
• Those with hepatitis B or C

Besides vaccination, there are other ways to protect yourself against sexual transmission of hepatitis A:

• Abstinence (not having sex)
• Mutual monogamy (having sex with only one uninfected partner)
• Cut-up non-lubricated latex condoms or use of other moisture barriers, such as household plastic wrap or dams (square pieces of latex) can reduce the risk of transmitting HAV during oral-anal sex.

Other ways to prevent hepatitis A:

• Avoid sharing drug needles and other drug-injection equipment.
• Avoid contaminated food or water sources
• Practicing good personal hygiene, especially hand-washing after using the toilet or changing diapers
• To inactivate HAV, heat foods at temperatures above 185 degrees Fahrenheit for 1 minute or disinfect surfaces with a 1:100 dilution of household bleach in tap water (1 part bleach for 100 parts of water)

If you have tested positive for hepatitis A, you may want to tell to your sex partner(s) that you have the virus. As part of good partner communication, deciding to use latex condoms and moisture barriers during sexual contact helps reduce the risk of transmitting a sexually transmitted disease. Hepatitis A can be transmitted through oral-anal sex so it is recommended to always use safer sex methods to reduce the risk of transmission.