Hepatitis A is a viral infection of the liver. It is mainly transmitted in areas where poor hygiene, inadequate sanitation and contaminated water are a problem.

Hepatitis A is rare in developed nations such as the United Kingdom and United States, but is more common in developing and under-developed regions in Africa and Asian countries, for example.

Some of the initial symptoms of hepatitis A include:

• Slight fever, not usually higher than 39.5ºC (103.1ºF)
• Diarrhea
• Nausea and vomiting
• Joint and muscle pain

Around ten days after these initial symptoms begin, they may start to improve and symptoms directly related to the liver start to develop instead. These include jaundice, itchy skin, dark urine, pale stools and pain in the liver.

In most cases, symptoms resolve within two to six months and people usually make a full recovery.

Causes

Hepatitis A is usually spread through the fecal-oral route. Hepatitis A can therefore be transmitted if a person eats food prepared by an infected person who has not washed their hands after using the bathroom, for example. Poor sanitation and hygiene are often responsible for hepatitis A outbreaks. Less commonly, hepatitis A is transmitted when drug users share infected needles and through sexual intercourse, particularly anal sex. The risk of spread is also increased when people live in close proximity to each other such as at boarding schools or army barracks.

Regions where hepatitis A is most common include sub-Saharan and north Africa; areas of the Indian subcontinent including India, Pakistan, Bangladesh and Nepal; parts of the Far East; the Middle East and South and Central America.

Treatment

There is no specific treatment for hepatitis A and therapy is aimed at making the patient as comfortable as possible until the infection resolves. Some measures that may be taken to achieve this are described below:

• The use of painkillers
• Bed rest
• Medication to prevent nausea and vomiting
• Avoiding alcohol and certain medications so the liver can rest

Prevention

Measures that can be taken to prevent the spread of hepatitis A include hand washing after using the toilet and not sharing toothbrushes, cutlery or towels. In addition, infection can be prevented if a vaccination and antibody are provided within two weeks of exposure to the virus.