Hepatitis A: Symptoms, How It Spreads and How to Lower Your Risk

What it involves

MedlinePlus explains that hepatitis A is inflammation of the liver caused by the hepatitis A virus. It is the mildest of the common hepatitis infections, but it can still be dangerous, especially in older adults and people with chronic liver disease. The virus does not stay in the body after the infection is gone, and nearly everyone gets better, although recovery can take weeks to months.

Who this is for

• Adults with yellow skin or eyes, dark urine or pale stools who need to be seen quickly.
• Patients with nausea, fatigue and right upper belly pain after travel or a risky meal.
• People living with, or recently exposed to, someone who has hepatitis A.
• Adults with chronic liver disease or hepatitis B or C who want to understand their risk.

What to expect

• Questions about symptoms, recent travel, what you have eaten, and anyone around you who has been sick
• An exam that checks the belly for liver tenderness and the skin and eyes for yellowing
• Blood work, including liver tests and a hepatitis panel that can show a new infection
• Advice on rest, fluids, medicines to avoid, and protecting people you live with

Symptoms and when they appear

MedlinePlus says symptoms most often show up two to six weeks after exposure and are usually mild, though they can last for up to several months in adults. They include dark urine, fatigue, itching, loss of appetite, low-grade fever, nausea and vomiting, pale or clay-colored stools, yellow skin, and pain in the right upper belly. Not everyone has symptoms, so many more people are infected than are diagnosed. The jaundice guide explains the yellow skin sign in more detail.

How the virus spreads

The virus is found mostly in the stool and blood of an infected person. MedlinePlus says you can catch it by eating or drinking food or water contaminated with stool, such as unpeeled and uncooked produce, shellfish, ice and water, by touching the stool or blood of an infected person, or from an object or food handled by someone who did not wash their hands after using the toilet. The virus is present in an infected person for about 15 to 45 days before symptoms start, so someone can spread it before they feel sick. The stomach flu and dehydration guide covers other infections spread by contaminated food.

Who is at higher risk

MedlinePlus lists overseas travel, especially to Asia, South or Central America, Africa and the Middle East, injection drug use, living in a nursing home, working in health care, daycare, food service or sewage work, and eating raw shellfish. Hepatitis B and C are different infections, covered in the hepatitis B screening guide and the hepatitis C screening guide. People who already have chronic liver disease face a higher risk of serious illness from hepatitis A.

How the diagnosis is made

A provider examines the belly, which may show a tender, enlarged liver, and orders a hepatitis viral panel. MedlinePlus says IgM antibodies to hepatitis A appear during an acute infection and that liver enzymes are usually elevated. Serenity By A Dr. Sareen lists blood work among its services, and the liver function tests guide explains the enzyme results. A fever with these symptoms is covered in the adult fever guide.

Treatment is rest, fluids and caution

MedlinePlus says there is no specific treatment for hepatitis A. People should rest and stay well hydrated when symptoms are worst, avoid fatty foods that can trigger vomiting, and avoid alcohol and medicines that are toxic to the liver, including acetaminophen, during the illness and for several months after. Most people recover within three months and nearly all within six, with no lasting damage and no second infection. The fatty liver guide explains why liver protection matters.

Prevention and protecting your household

MedlinePlus advises washing hands well after using the restroom and after contact with an infected person's blood or stool, avoiding unclean food and water, and washing thoroughly before serving food and after diaper changes. It also says to ask a provider about immune globulin or the hepatitis A vaccine if you are exposed and have not had either. Serenity By A Dr. Sareen does not list vaccines among its services, so ask when you call where that care is available.

Sources

• MedlinePlus: Hepatitis A (health topic)
• MedlinePlus: Hepatitis A (medical encyclopedia)