#Hepatitis A

How important is it to get vaccinated with the Hepatitis A vaccine?

Hepatitis A disease occurs worldwide. The incidence in the United States has substantially decreased since vaccination was recommended. Studies have shown a 92% decline in Acute Hepatitis A since 1995 and 2007 since vaccine administration.

Hepatitis A is spread through the fecal-oral route. It is more prevalent is low socioeconomic areas where there is a lack of adequate sanitation and the practice of poor hygiene. In the United States, the most common reported risk factor was international travel, mainly to Mexico and Central/South America, but also to Asia, Africa and Eastern Europe. Other risk factors include sexual and household contact with another person with Hepatitis A, homosexual activity with men, food or water-borne outbreaks, and daycares.

Hepatitis A is acute, self-limited, rarely leading to liver failure. The incubation period averages about 30 days. Symptoms include fatigue, malaise, nausea, vomiting, lack of appetite, fever, and right upper abdominal pain. Within a few days to one week, dark urine, light-colored stools, jaundice (yellowish hue to the skin), and itching is noted.

The diagnosis is made by detecting Hepatitis A virus antibodies in the blood. Treatment is supportive care, rarely does it require hospitalization. Recovery can take anywhere from 3-6 months. In more severe cases with liver failure, aggressive supportive care is required and transfer to a facility that is capable of liver transplantation.

To prevent the spread of disease, adhere to sanitary practices, such as handwashing (the virus can survive up to four hours on the fingertips), heat foods appropriately, avoid water and food from endemic areas, and consider vaccination. 

The Hepatitis A vaccine can be administered above 12 months of age. It is a 2 step vaccine, with a 6 month gap between the first and second doses. After just the first dose, immunity increases to 94-100% within 4 weeks of vaccination. Immunity can persist for up to 8 years. Consult your physician prior to vaccination if you have any acute illness, bleeding disorder, a current Hepatitis infection, a past allergic reaction to the vaccine, or an immunocompromised state. The vaccine is not safe for children under the age of 12 months.
(cdc and uptodate.com)