Hepatitis A - Do I need a vaccine?

Hepatitis A is endemic (present all the time) in many poorer parts of the world, especially where there is a low standard of food and water hygiene. These areas include India, Pakistan, Bangladesh, Nepal, Sub-Saharan Africa and North Africa, parts of the Far East (except Japan), South and Central America and the Middle East.

There are about 1.5 million cases of hep A reported each year and the death rate is about 2% in those over 50 years of age.

Hepatitis A is acquired through food or water that is contaminated by infected human faeces; this method is called the faecal-oral route of infection.   It is spread by drinking contaminated water or eating food that has been washed in it.

Some sexual practices that increase faecal-oral transmission can also increase the risk of catching hepatitis A.

Hepatitis A is often subclinical (the patient doesn’t show outward symptoms) in young children but is more serious in older travellers (age 50+).

The incubation period (time from infection to showing symptoms) is 15-50 days.  After this, symptoms such as malaise, anorexia and fever occur, and then jaundice – yellowing of the eyes and skin.

Recovery takes about a month in younger people but you could be ill for many weeks.

Because hepatitis A is a disease affecting the liver, complications are more likely if you already a have liver condition.

There is no anti-viral treatment for hepatitis A and doctors can only offer supportive measures to relieve symptoms.

There are several highly effective hepatitis A vaccines available and you should discuss your need for vaccination with your travel health expert.  The vaccination schedule is here.

Your risk will depend on

• your food, water and personal hygiene while you’re in the risk area,
• your length of stay
• your vaccination status.

Vaccination is recommended for

• travellers who are visiting friends and relatives in an endemic country
• those with liver problems or haemophilia
• travellers whose sexual practices put them at greater risk.  There is a higher incidence in homosexual men
• those with occupational risk – if you’re working with the local population.

Hep A vaccination side effects are mild and pass off quickly.  They include soreness or redness at the injection site and, less commonly, tiredness, fever, malaise.