Hepatitis A: symptoms, how it spreads, treatment and vaccine

The NHS lists these symptoms of hepatitis A infection and says that most children, and some adults, may have mild symptoms or no symptoms.

• A high temperature.

• Flu-like symptoms, such as tiredness, headache and muscle pains.

• Feeling sick or being sick.

• Pain in your upper tummy.

• Diarrhoea or constipation.

• Pale yellow or pale grey poo, and dark brown pee.

• Itchy skin, and possibly a raised rash (hives).

• Yellowing of the skin and the whites of the eyes (jaundice), which may be harder to see on brown and black skin.

The NHS says to see a GP if you have symptoms of hepatitis A and you have recently travelled to a country where it is common, have recently been in close contact with someone with hepatitis A, have a blood clotting disorder such as haemophilia, are a man who has sex with men, have shared needles when taking drugs, or your job puts you at risk. Tell the GP you think you might have hepatitis A.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you think you might have hepatitis A and you are pregnant, are aged over 60, or have a liver condition.

The NHS says most people who get it get better within a few months, and that it usually clears up on its own within 3 to 6 months. A small number of people may get further liver problems and may need blood tests to check the liver is working properly.

NICE Clinical Knowledge Summaries (CKS) describes hepatitis A infection as usually a self-limiting illness with a good prognosis. It lists complications including relapsing hepatitis in about 15% of people with symptoms and, rarely, acute liver failure in less than 0.1% of people.

The NHS says you are usually infectious for either 7 days after yellowing of the skin and eyes (jaundice) started, or 7 days after your symptoms started if you have not had jaundice. NICE CKS gives the same period and advises avoiding work, school or nursery until you are no longer infectious.

The NHS suggests the following to ease symptoms and stop infecting others:

• Limit contact with other people for 7 days after symptoms or jaundice started. Adults should stay off work and children off school or nursery.

• Rest and drink plenty of fluids.

• Ask a pharmacist or doctor about painkillers, including how much is safe to take.

• Keep your room well ventilated, wear loose-fitting clothing and avoid hot baths and showers if you feel itchy.

• Wash your hands thoroughly after going to the toilet.

• Do not drink alcohol, prepare food or drink for others, have sex without a condom or dam until you are no longer infectious, or share needles.

There is no specific treatment; it usually clears up on its own, according to the NHS. A doctor may offer medicines to help with symptoms, such as painkillers or medicines to stop you feeling sick or itchy.

NICE CKS says management includes hospital admission if someone is severely unwell, supportive care otherwise, prompt notification of the local Health Protection Unit, advice to avoid alcohol during the acute illness, and follow-up with liver function and clotting monitoring depending on clinical judgement.

The NHS says hepatitis A is caused by a virus that spreads in poo. It is more common in parts of Africa, Asia, the Middle East and Central and South America. You can get it from:

• Drinking unclean water.

• Eating food that has been washed or grown in unclean water.

• Eating food that has been handled by an infected person.

• Close physical contact with an infected person, including sex and sharing needles to take drugs.

The NHS says vaccination is the best way to prevent hepatitis A, but vaccines are not routinely offered in the UK because the risk of infection is low. You only need one if you are at high risk of catching or getting seriously ill from it:

The NHS suggests washing your hands thoroughly before preparing and eating food and after using the toilet, drinking bottled water, avoiding shellfish and uncooked fruit and vegetables, and using a condom or dam when having sex. You can check the risks of a country on the TravelHealthPro website.

On the NHS, hepatitis A is diagnosed and managed by your GP, with blood tests for liver function, and hospital care only for those who are severely unwell. Suspected cases are notified to the local health protection team.

Travel clinics and private services can provide the vaccine for travel, which the NHS says you may need to pay for. Ask which vaccine is recommended for your itinerary and when it needs to be given before departure.