How Does Hepatitis A Spread?

Caucasian woman washing her hands
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Hepatitis A spreads by ingesting the hepatitis A virus (HAV) and passing it along to others by contact through infected stool. This mode of transmission, known as the fecal-oral route, is also how hepatitis E spreads. There were an estimated 3,473 acute hepatitis A infection in the United States during 2013.

Fortunately, although hepatitis A infection can range from a mild illness lasting just a few weeks to a more severe illness lasting several months, the virus is an acute, self-limited disease.

That means people almost always improve on their own and don't usually require treatment, and the disease does not progress to a chronic form. 

The other good news about viruses that spread through the fecal-oral route is that they can be effectively prevented by frequent hand washing (there is also a vaccine available for hepatitis A).

Learn more about hepatitis A at Hepatitis A Virus and Infection.

What Is Fecal-Oral Spread?

If you're infected with hepatitis A virus, you can shed virus in your stool for a period of time during the illness. This means that during this time your stool contains active HAV capable of infecting other people. If you correctly wash your hands after using the toilet, you'll lower this risk of spread. However, if during this time of shedding you don't wash your hands correctly, then you're able to spread virus. More information about this type of viral transmission is available in "What Is the Fecal-Oral Route?

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What Are Common Examples of How Hepatitis A Is Spread?

The hepatitis A virus usually spreads from person to person contact or from contaminated food or water. According to the Centers for Disease Control and Prevention, here are common examples:

  • When an infected person touches objects or food after using the toilet without proper hand washing
  • When changing the diaper of someone infected but not washing hands afterwards
  • During some sexual practices, such as oral-anal contact
  • By eating or drinking something contaminated with HAV

How Is Hepatitis A Spread by Food or Water?

Food and water can be contaminated by food handlers who have hepatitis A but don't wash their hands well after using the toilet. Usually this type of spread is limited to family members or their dinner guests. However, when a restaurant food handler spreads hepatitis A, thousands of people can be exposed. More information is available in "Can I Catch Hepatitis A From Restaurant Food?".

In developing countries, or those with unstable water supplies, the public water supply can become contaminated. This can happen if drinking water comes into contact with hepatitis A-infected sewage. The foods most likely to be contaminated with HAV are fruits, vegetables, shellfish, ice and water.

High-Risk Populations

Given the way it is spread, almost anyone can become infected with hepatitis A.

However, certain people are at higher risk of contracting the disease than others. These include people who:

  • Travel to countries where hepatitis A is common
  • Are male and have sexual contact with other males
  • Are illegal drug users 
  • Have blood clotting issues such as hemophilia
  • Live with another person who is infected with hepatitis A
  • Have oral-anal sexual contact with someone infected with hepatitis A

Prevention is Key

Hepatitis A spread can be significantly reduced by using correct hand washing techniques and prevented by using the hepatitis A vaccine. More information about this safe and effective approach to prevention is in "Why You Need the Hepatitis A Vaccine."

Sources:

Centers for Disease Control and Prevention. Hepatitis A. http://www.cdc.gov/hepatitis/HepatitisA.htm. Accessed July 31, 2009.

Dienstag, JL. Acute Viral Hepatitis. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds), Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008.

Pickering, LK (ed), The Red Book: Report of the Committee on Infectious Diseases, 26th e. American Academy of Pediatrics, 2003. 311-313.

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