Hepatitis A

Infectious Disease

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Hepatitis A is an infection of the liver caused by the hepatitis A virus. The infection is generally mild, but the severity can increase with age or in those who already have liver disease. Most people who catch hepatitis A make a full recovery within a couple of months and afterwards have lifelong immunity from the disease.

The virus is usually spread through food and water that has been contaminated with human faeces (poo), either through drinking unclean water, eating food that’s been grown or washed using unclean water, eating food that has been handled by a person with hepatitis a, or close contact (including sexual contact) with someone who is already infected.

Hepatitis A is most common in parts of the world without access to clean water and good sanitation, such as parts of Africa, the Indian subcontinent, the Far East, the Middle East, Central America and South America.

It is not common in the UK, but some groups are at increased risk. This includes men who have sex with men and drug users who inject drugs, as well as people who travel to countries where the disease is common.

In Europe and the UK, there is currently an increase in the number of cases of hepatitis A, mainly among men who have sex with men (MSM). Over 60% of UK cases so far have been in London. Public Health England is encouraging MSM to practice good personal hygiene and ask about hepatitis A vaccination at their sexual health clinic appointments.

 

Some people, particularly young children, may not show any symptoms.

Symptoms of hepatitis A develop about four weeks after becoming infected, and they can come and go for up to six months. Other serious liver conditions can have similar symptoms.

Initial symptoms last from a few days to a couple of weeks. They can include:

  • feeling tired and generally unwell
  • joint and muscle pain
  • fever (usually no higher than 39°)
  • headache, sore throat and cough
  • loss of appetite or sickness
  • constipation or diarrhoea
  • pain in the upper-right part of the stomach
  • an itchy rash (hives)

Symptoms which develop later can include:

  • yellowing of the skin and eyes (jaundice)
  • dark urine and pale stools
  • itchy skin
  • swelling and tenderness in the upper-right part of the stomach

In rare cases (fewer than 1 in 250 people) hepatitis A can lead to liver failure. Signs of liver failure can include:

  • sudden and severe vomiting
  • bruising or bleeding easily (for example, nosebleeds or bleeding gums)
  • becoming irritable, drowsy or confused
  • problems with memory and concentration

 

The virus is usually spread through food and water that has been contaminated with human faeces (poo), either through drinking unclean water, eating food that’s been grown or washed using unclean water, or eating food that has been handled by a person with hepatitis A.  

You can also catch hepatitis A if you have close contact with someone who has the disease.

It is also possible to catch hepatitis A by having sex with someone who has the disease. This is particularly a risk for men who have sex with men. It can also be passed on by injecting drugs using contaminated equipment.

Infection does not always cause symptoms, so it is possible to carry and pass on the disease without being aware of it.

 

There are three types of hepatitis A vaccines; a vaccine for hepatitis A only, a combination vaccine to protect against hepatitis A and hepatitis B, or a combination vaccine to protect against hepatitis A and typhoid.

Hepatitis A vaccines are not part of the routine UK vaccine schedule because the risk of getting infected is low. You only need to get a vaccine if you are at high risk of catching or getting seriously ill from hepatitis A.

If your vaccination is because you plan to travel to a high-risk country, then you may need to visit a private travel clinic to receive the vaccine. Ideally, the vaccine should be given two weeks before departure.

See the hepatitis A vaccine page for more information.

 

Page last updated Tuesday, November 07, 2023