Hepatitis A

What Is It?

Hepatitis A is an infection of the liver caused by the hepatitis A virus. It can last from one week to several months.

What Are the Symptoms?

Young children often have no symptoms or very mild symptoms of disease. Adults and older children are more likely to have typical symptoms, which include fever, loss of appetite, nausea, abdominal pain, diarrhea and general ill feeling (malaise).

The skin and whites of the eyes take on a yellow color (jaundice). A person who has no symptoms is still infectious to others.

Who Gets It and How?

Anyone who has not had a Hepatitis A immunization can get this infection, which spreads quickly in groups of small children who are not yet toilet-trained and who cannot wash their own hands well.

Hepatitis A is spread through stool (by the fecal-oral route). This means the disease is spread by putting something in the mouth that has been contaminated with the stool of an infected person. It can also be spread when a person eats food or drinks beverages which have been handled by a person infected with hepatitis A and not subsequently cooked. 

Outbreaks of hepatitis A among children attending child care facilities and persons employed at these facilities have been recognized since the 1970s. Because infection among children is usually mild or without symptoms and people are infectious before they develop symptoms, outbreaks are often only recognized when adult contacts (usually parents) become ill. Poor hygienic practices among staff who change diapers and also prepare food contribute to the spread of hepatitis A. Children in diapers are likely to spread the disease because of contact with contaminated feces.

Outbreaks rarely occur in child care settings serving only toilet-trained children.

There is no treatment that cures hepatitis A. However, because the incubation period is so long, in cases of outbreaks the illness can be prevented by giving persons in the facility and households a protective shot of immune globulin within two weeks of their exposure to the virus.

When Should People with this Illness Be Excluded?

If a child or adult in your child care facility is diagnosed with hepatitis A:

• Exclude the child or adult from child care until one week after the onset of symptoms.
• Immediately notify your local health department and request advice. Gamma globulin, if administered within the first two weeks after exposure, can prevent the infection from spreading to other children and families.

How Can I Limit the Spread of Hepatitis A?

• Strictly enforce hand washing and universal precautions.
• Make sure all parents and staff notify the facility if any person in their household is diagnosed with hepatitis A.
• A vaccine is available to prevent hepatitis A, and is recommended for child care providers and for all children at age one year. There are two doses and they should be given at least six months apart.
• When outbreaks occur in child care settings, gamma globulin may be administered to unimmunized children, providers and families of child care attendees to limit transmission of hepatitis A.