Hepatitis A is a viral infection of the liver spread through contaminated food and water and poor sanitation. Travellers prevent it through good food and water hygiene combined with a highly effective vaccine, which gives long-lasting protection.
How it spreads
Through the faecal-oral route, usually by swallowing food or water contaminated with the virus, and through close personal contact with an infected person.
Where it occurs
Worldwide but most common where sanitation and clean water are limited, including much of Africa, the Indian subcontinent, the Middle East, Asia and Latin America.
Main symptoms
Fever, tiredness, loss of appetite, nausea and abdominal discomfort, often followed by jaundice, dark urine and pale stools.
Who is most at risk
Travellers to areas with poorer hygiene, those visiting friends and relatives, people on longer or rural trips, and those with existing liver disease.
Is a vaccine available
Yes. A safe and highly effective hepatitis A vaccine is available and is recommended for most travellers to affected regions.
How to reduce your risk
Have the hepatitis A vaccine and follow careful food and water precautions, with thorough hand hygiene before eating and after using the toilet.
Hepatitis A is a viral liver infection spread through food and water contaminated with the virus, common in parts of Africa, Asia, the Middle East and Latin America. Travellers avoid it by practising good food and water hygiene and, most importantly, by having the highly effective hepatitis A vaccine, which gives long-lasting protection. Crewe Travel Clinic in Crewe, Cheshire offers hepatitis A vaccination and tailored travel health advice to help you stay well abroad.
Hepatitis A is a viral infection that affects the liver, caused by the hepatitis A virus. It is one of the most common vaccine-preventable infections in travellers and is found throughout much of the world, particularly in regions where sanitation and access to clean water are limited. The virus is passed out in the stool of an infected person and is usually spread when traces of contaminated faeces are swallowed, most often through contaminated food or water or by close contact with someone who is infected.
Most people recover completely from hepatitis A within a few weeks to a few months, and unlike some other forms of viral hepatitis it does not cause long-term liver disease or a chronic carrier state. However, the illness can be unpleasant and prolonged, sometimes keeping people unwell for weeks, and the risk of serious illness rises with age and in those with existing liver problems. Occasionally hepatitis A can cause severe, even life-threatening, liver inflammation. There is no specific treatment that cures the infection; care is supportive, with rest, fluids and avoidance of alcohol while the liver recovers.
The good news is that hepatitis A is highly preventable. A safe and very effective vaccine is available, and combined with sensible food and water precautions it offers travellers excellent protection. At Crewe Travel Clinic in Crewe, Cheshire, our travel health team can assess your destination and itinerary, advise on food and water hygiene, and provide hepatitis A vaccination as part of your pre-travel preparation.
Hepatitis A is spread by the faecal-oral route, meaning the virus is shed in the stool of an infected person and is passed on when tiny, often invisible, amounts are swallowed. This commonly happens through eating food or drinking water that has been contaminated, including raw or undercooked shellfish from polluted water, salads, uncooked vegetables and fruit washed or prepared in unsafe conditions, and ice or drinks made with contaminated water. The virus can also spread through close personal contact with an infected person, such as within households or through certain sexual practices, and where hand hygiene after using the toilet is poor. Infected people can pass on the virus before they feel unwell and for a week or two after symptoms appear. The virus is hardy and can survive for some time on surfaces and in water, which is why outbreaks can occur where sanitation is inadequate.
Symptoms of hepatitis A usually appear around 2 to 6 weeks after exposure, although many people, especially young children, have few or no symptoms. When illness does develop, it often begins with a flu-like phase including fever, tiredness, loss of appetite, nausea, vomiting, diarrhoea, and discomfort in the upper right side of the abdomen where the liver lies. This is commonly followed by jaundice, a yellowing of the skin and the whites of the eyes, along with dark urine, pale stools and itchy skin. The illness can be mild and short-lived or may drag on for several weeks or months, with tiredness often lingering. Most people make a full recovery and develop lifelong immunity. Severe illness is uncommon but more likely in older adults and people with pre-existing liver disease. Anyone who develops jaundice or persistent symptoms during or after travel should seek medical assessment and mention where they have been.
Hepatitis A occurs worldwide but is most common in regions with poorer sanitation and limited access to safe drinking water. The risk to travellers is higher across much of Africa, the Indian subcontinent, the Middle East, Central and South America, parts of the Caribbean, and parts of Asia and the Pacific. Popular destinations such as India, Egypt, Morocco, Thailand, Indonesia, Mexico and many countries in Africa and Latin America carry an appreciable risk. The chance of infection depends on the standard of food and water hygiene rather than on staying in luxury accommodation, so even travellers on well-organised trips can be exposed. Risk tends to be greater on longer trips, when visiting friends and relatives, in rural or remote areas, and where someone eats and drinks outside controlled hotel or resort settings. Hepatitis A is much less common in the UK, Western Europe, North America, Australia, New Zealand and Japan, where sanitation standards are high.
Hepatitis A is largely preventable through a combination of vaccination and careful food and water hygiene. A safe and highly effective hepatitis A vaccine is available and is recommended for most travellers to areas where the infection is common. A single dose provides protection for around a year, and a booster given 6 to 12 months later extends protection for up to 25 years in most people. The vaccine can also be given in combined forms, such as with typhoid or with hepatitis B, which may be convenient depending on your itinerary. Ideally the vaccine is given at least two weeks before travel, although it can still offer useful protection if given closer to departure. Alongside vaccination, travellers should follow good food and water precautions: drink only bottled, boiled or otherwise treated water; avoid ice unless made from safe water; eat food that is freshly cooked and served hot; avoid raw or undercooked shellfish; be cautious with salads, uncooked vegetables and unpeeled fruit; and wash hands thoroughly with soap and water before eating and after using the toilet. These measures also help protect against other food- and water-borne illnesses such as travellers' diarrhoea and typhoid.
Hepatitis A is spread by the faecal-oral route, which means the virus is shed in the stool of an infected person and is passed on when tiny, often invisible, amounts are swallowed. For travellers this most often happens through contaminated food or drinking water, but the virus can also spread through close personal contact and poor hand hygiene. Infected people can pass on the virus before they feel unwell and for a week or two after symptoms appear.
The risk of hepatitis A can be greatly reduced by combining vaccination with careful food and water hygiene. These everyday precautions also help protect against other food- and water-borne illnesses such as travellers' diarrhoea and typhoid, so they are worth following throughout your trip.
Symptoms usually appear around 2 to 6 weeks after exposure, although many people, especially young children, have few or no symptoms. The illness often begins with a flu-like phase before jaundice develops, and tiredness can linger for several weeks. Most people recover fully and develop lifelong immunity, but severe illness is more likely in older adults and those with existing liver disease. Anyone who develops jaundice or persistent symptoms during or after travel is advised to seek medical assessment and mention where they have been.
Yes. A safe and highly effective hepatitis A vaccine is available and is recommended for most travellers to areas where the infection is common. A single dose provides protection for around a year, and a booster given 6 to 12 months later extends protection for up to 25 years in most people. The vaccine can also be given in combined forms, such as with typhoid or with hepatitis B, which may be convenient depending on your itinerary.
The following vaccinations can help protect against Hepatitis A.
Book an appointment with our travel health team for tailored advice on protecting against Hepatitis A.