The Most Common Vaccine-Preventable Travelers Disease – Hepatitis A

According to the CDC and other medical sources, the hepatitis A virus is the most common vaccine-preventable infection picked up by travelers from the U.S. Transmission occurs through direct person-to-person contact, through exposure to contaminated water or ice, or through shellfish harvested from or washed in contaminated water. Hepatitis A can also be contracted by eating uncooked fruits or vegetables washed in contaminated water or handled by those with poor hygiene.

Hepatitis A can be difficult to recognize and diagnose, so it’s important to be clear with your doctor about where you’ve traveled recently. The virus reaches peak levels between 1 and 2 weeks before the onset of symptoms, but a few people (primarily very young children) remain asymptomatic. Symptoms for everyone else vary, but are generally described as much like having a severe case of the flu with fatigue, nausea, abdominal pain, fever and poor appetite.

A few people, most notably the elderly or those with a pre-existing liver disease, are at risk of experiencing severe symptoms of acute hepatitis, which may attack their liver and require a transplant. These cases are rare.

Quick Facts about Hepatitis A

• Since 1980, when the total number of new infections was 234,000 in the U.S., the incidence of Hep A has gone way down – just 21,000 cases reported in 2009. (Per CDC data: http://www.cdc.gov/hepatitis/HAV/StatisticsHAV.htm)
• The illness that occurs with hepatitis A lasts about two months, but between 10 and 15% of people have relapses of the disease and that can last for as long as six months.
• Asymptomatic infections – that is, infections that result in no noticeable symptoms – occur more commonly in children and they can pass the hepatitis A on to non vaccinated adults, resulting in potentially serious illness.

What are the Risk Factors for Hepatitis A?

The risk factors for contracting hepatitis A include:

• Living in a household with someone who has hepatitis A, or living in a community where hepatitis A is common.
• Eating raw or uncooked shellfish, such as oysters or clams. That means avoiding the ceviche on your trip.
• Eating uncooked or unpeeled fruits and vegetables.
• Drinking tap water or well water while traveling in areas where hepatitis A is common.
• Eating any food that has been prepared by someone infected with the virus (remember, some people are infected by remain asymptomatic) and who has poor hygiene.

Who are the Best Candidates for the Hepatitis A Vaccine?

While military personnel, hospital and volunteer workers, as well as laboratory workers who handle live hepatitis A or animals infected with hepatitis A for the purposes of study are typically automatically vaccinated, most Americans are not simply because the disease currently has very little hold in the U.S.

The following people, however, are good candidates for receiving the hepatitis A vaccine:

• Anyone traveling to or living in an area where hepatitis A is common should get the vaccine before they travel.  See the CDC’s Hepatitis A map for more information.
• Travelers with chronic liver disease or compromised immune systems.
• Anyone who must receive blood products as a result of clotting disorders.

The best prevention for avoiding hepatitis A is practicing good hygiene, avoiding uncooked or undercooked shellfish, avoiding unpeeled fruits and vegetables, and getting a vaccine before you travel to an area of risk.

See the CDC’s materials for hepatitis A patients for more details, including hepatatis A vaccination information.