Hepatitis A

Symptoms and Causes

What are the symptoms of hepatitis A infection?

Symptoms in adults and children over six include:

• Stomach pain, especially in the upper right quadrant.
• Loss of appetite.
• Nausea and vomiting.
• Diarrhea.
• Weakness and fatigue.
• Fever.
• Jaundice (yellowing of your skin and eyes).
• Joint pain.
• Itchy skin.
• Light-colored poop and dark-colored pee.

Younger children may not show signs or symptoms of infection. About 10% develop jaundice.

When do symptoms develop?

Symptoms appear between two to five weeks after contracting the virus. This is the incubation period when the virus is busy replicating in your body. When the virus has replicated enough to register as a threat, your immune system launches an attack against it. This is where the symptoms come from.

How long do symptoms last?

The symptoms last as long as it takes for your immune system to defeat the virus. It takes at least a few weeks. Most people recover in less than two months, but a small number of people have symptoms for up to six months. Sometimes, symptoms appear to be gone but then return for another round (relapse).

Are you contagious even if you don’t have symptoms?

Yes. You may be contagious for up to two weeks before symptoms develop, and up to three weeks afterward. Some people, including most children, never develop symptoms, but they can still spread the virus. Even after the peak contagious period, the virus may survive on surfaces in your environment.

How do you get hepatitis A?

Hepatitis A transmission commonly occurs through food poisoning. It can also occur through close personal contact with a person who is infected. The virus lives in the blood and poop of people who’ve been infected. Transmission occurs when it enters the body of an uninfected person, often by mouth.

Trace amounts of poop containing the virus can contaminate food at any stage of production, from harvesting to storage to cooking or preparation. Freezing doesn’t kill the virus, and it can live in temperatures of up to 185 degrees Fahrenheit (85 degrees Celsius). It can survive for months outside of a body.

Without rigorous handwashing, a person who’s infected can easily contaminate their environment or food with trace amounts of poop. They can also transfer it to you through physical contact. A person who’s infected and uses needles can spread the virus by sharing them or not disposing of them safely.

Is hepatitis A an STD (sexually transmitted disease)?

It can be transmitted through oral-anal sex, or through kissing if the infected person is bleeding. It’s easy to have a minor bleed from a cracked lip, mouth sore or bleeding gums without being aware of it. Statistically, men who have sex with men are more likely than average to be infected with hepatitis A.

Who is most at risk of hepatitis A infection?

You’re more at risk of infection when your local community is more extensively infected. That may be the case if you live in a community with lower levels of sanitation, or if the social groups or places you spend time in are more widely infected. People with weaker immune systems are also more at risk.

Communities more at risk include:

• Lower-income countries and communities with poor sanitation.
• Children living in infected communities.
• People experiencing homelessness.
• People who inject drugs.
• People living with HIV.
• People living with, caring for or having sex with a person who’s infected.

What are the possible complications of hepatitis A infection?

Complications are rare, but people with weakened immune systems are more at risk of having a severe reaction to hepatitis A infection. The most serious risk is acute liver failure. That means that your liver reacts by suddenly shutting down. This requires emergency care, and in some cases, a liver transplant.

People more at risk of acute liver failure include:

• Older adults.
• People with HIV.
• People taking immunosuppressants.
• People with preexisting chronic liver disease.