Hepatitis A is a liver disease caused by Hepatitis A virus (HAV), and is spread by putting anything in the mouth that has been contaminated with the feces of an infected person. HAV-infected persons can spread the virus to household members or to sexual partners.

Others who are more likely to contract HAV:

• men who have sex with men (MSM)
• people who use street drugs (IV - contaminated needles)
• children and employees in child care centers if a child or employee is HAV-infected
• travelers to countries where HAV is common
• those who work with HAV in research labs

HAV can also be contracted by:

• eating fruits, vegetables, or other food that may have been contaminated during handling
• eating raw shellfish harvested from sewage-contaminated water
• swallowing contaminated water or ice

There are often no symptoms found in children, while 3 of 4 infected adults have symptoms; symptoms usually develop over a period of days.

SYMPTOMS

• yellow eyes
• dark urine
• nausea
• vomiting
• fever
• tiredness
• loss of appetite
• stomach ache

A person can spread HAV approximately 1 week before symptoms appear. People with no symptoms can still spread the virus.

Hepatitis A usually does not cause death, and there is no chronic infection with HAV. Once a person recovers from HAV, he/she will never contract it again.

Good personal hygiene and proper sanitation can help prevent HAV. Wash your hands after using the bathroom, changing diapers, and before preparing food.

[excerpts from "Prevent Hepatitis A", HHS, CDC, 11/2002]

 Hepatitis A

Hepatitis A vaccine is recommended for persons at increased risk for hepatitis A (e.g., international travelers, men who have sex with men [MSM], injection drug users [IDUs], and non-IDUs) and also for children in states and counties that historically have had consistently elevated rates of hepatitis A.

Since routine childhood vaccination was recommended in 1999 in states where hepatitis A rates were consistently elevated, the overall hepatitis A rate has declined dramatically. In 2004, the rate (1.9 per 100,000 population) was the lowest yet recorded, with 5,683 cases reported. Declines have been greater among age groups and regions where routine vaccination of children is recommended, likely reflecting the result of the current vaccination strategy. To maintain and further reduce the current low rates, the strategy was expanded in October 2005 to include routine vaccination nationwide of children aged 12--23 months (3).

Although rates among children have declined among all races and ethnicities, the decline among Hispanic children has been less than that among non-Hispanics. The highest rates among children are now among non-Hispanics in states not covered by recommendations for routine childhood hepatitis A vaccination.

The decline in rates among children, particularly those in vaccinating states, has resulted in a substantial shift in the epidemiologic profile of this disease in the United States. Rates in the western states, which historically have been higher than in other regions, are now similar to rates in the rest of the country, and rates among adults are higher than those among children. In addition, the pattern of reported risk factors has shifted, with an increasing proportion of cases occurring among adults in persons at high risk, including MSM and illegal drug users. In addition, as transmission of hepatitis A virus (HAV) has declined within the United States, the proportion of cases attributed to travel to countries in which hepatitis A is endemic has increased for all age groups and is now the most frequently reported risk factor among persons with hepatitis A virus aged <15 years.

CDC. Prevention of hepatitis A through active or passive immunization. MMWR 1996;45(No. RR-15).
CDC. Prevention of hepatitis A through active or passive immunization. MMWR 1999;48(No. RR-12).
Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2006;55(No. RR-7). In press. 
[CDC, MMWR, June 16, 2006 / 53(53);1-79 Summary of Notifiable Diseases --- United States, 2004]