Hepatitis A

Cause: Hepatitis A virus.

Illness and treatment: Onset is usually abrupt with fever, nausea, and abdominal pain followed by jaundice. Cases may be asymptomatic, particularly in children. Almost all cases recover but rare infections are fatal or require liver transplantation. Treatment is supportive.

Sources: Acutely infected humans shed virus in the feces and transmit directly or through fecally contaminated food (produce, shellfish, uncooked items), water, and environment, often encountered during international travel. Recent outbreaks in this country have been associated with imported produce. Bloodborne transmission is very rare.

Additional risks: Infected young children may have no symptoms but can be communicable. Transmission can occur with groups having poor hygiene or fecal-oral sexual practices.

Prevention: To prevent infection, immunize all children and any adults with risks for exposure including travel to endemic areas.

Recent Washington trends: Since 1989 when there were 3,273 cases, hepatitis A incidence decreased to fewer than 100 cases a year with increased vaccination.

Purpose of Reporting and Surveillance

  • To identify individual cases, disease outbreaks and potential sources of ongoing transmission to prevent further spread of hepatitis A.
  • To identify contacts and assure timely prevention measures.
  • To educate contacts about signs and symptoms of disease, to facilitate early diagnosis.
  • To educate cases and contacts about transmission of hepatitis A and how to reduce their risk of infection.

Legal Reporting Requirements

  • Health care providers: notifiable to local health jurisdiction within 24 hours
  • Health care facilities: notifiable to local health jurisdiction within 24 hours
  • Laboratories: Hepatitis A virus (acute) by IgM positivity notifiable to local health jurisdiction within 2 work days (hepatocellular enzyme levels to accompany report).
  • Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.