• Infectious Diseases A-Z: Hepatitis A outbreak

health care worker holding a blackboard on which the word hepatitis is written

Outbreaks of the highly contagious hepatitis A virus have public health officials concerned. An outbreak of hepatitis A in San Diego led public health officials to declare a public health emergency. Officials in San Diego say more than 65 percent of those affected have been homeless or illcit drug users, and the virus is being spread person-to-person and through contact with a fecally contaminated environment. Los Angeles County, and Santa Cruz County have also reported outbreaks.

Dr. Stacey Rizza, infectious diseases specialist at Mayo Clinic says hepatitis means inflammation of the liver. The most common forms of hepatitis are A, B, and C. Each is caused by a different virus, have different modes of transmission and can affect the liver differently.

"A is the first one and is the type of infection you get from eating contaminated water or foods," says Dr. Rizza. "It's an oral-fecal route, and it’s self-limited, meaning you could get very, very sick from it, but it doesn’t go on to be a chronic infection. You either clear the infection or you die."

Watch: Dr. Stacey Rizza explains hepatitis A.

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Hepatitis A transmission.

Hepatitis A is usually transmitted by contact with objects, food, or drinks contaminated by the feces (or stool) of an infected person. It can be spread person-to-person when a person does not wash his or her hands after going to the bathroom or touches other objects of food. It can also be spread through contamited drinkinng water and food.

"It can be linked to any kind of oral-fecal route," says Dr. Rizza. "If somebody eats food that has contamination in it, if they drink water that had contamination or had it on their hands and it somehow got into their mouth, if they were health care works or if they were food prep, worked in the food preparation field, anything that causes what we call oral-fecal, so contaminated fluid gets onto their hands, into their water or on their food and then they ingest it."

Hepatitis A prevention

"We have a very effective vaccine." Dr. Rizza says, "Anybody who travels to areas where hepatitis A is endemic, or works in the health care field where they may be exposed, or works in the food preparation field where may be exposed should be vaccinated. In the U.S., we now vaccinate all of our children for hepatitis A. Hopefully, the next generation will be far less vulnerable to the infection than previous generations."

The first vaccine for hepatitis A was licensed in 1995. The vaccine is given as two shots, six months apart and and is highly effective in preventing hepatitis A infection.

The Centers for Disease Control and Prevention says frequent hand washing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of hepatitis A.

Symptoms of hepatitis A may include the following:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice (a yellowing of the skin or eyes)

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