Hepatitis A is an inflammation of the liver caused by the hepatitis A virus. It usually causes a mild course of illness. Hepatitis A is not common in the Netherlands.
What are the symptoms of hepatitis A?
In children up to 6 years old, the hepatitis A virus causes almost no symptoms. Adults can also have a very mild case of hepatitis A, which may go unnoticed.
If a person does become ill, symptoms could include:
- tiredness
- weight loss
- feeling ill
- loss of appetite
- nausea
- diarrhoea
- fever
- abdominal pain
An adult with hepatitis A usually also has jaundice:
- yellow discolouration of the skin and eyes;
- dark urine (‘cola-coloured’);
- pale, greyish-white stool.
Not everyone with hepatitis A will have all these symptoms. In very rare cases, the virus can cause life-threatening illness.
Hepatitis A does not usually last longer than six weeks. Somewhere between 1 in 10 patients and 1 in 7 patients have symptoms for as long as six months, or temporarily see their symptoms flare up again. If that happens, they may be tired and listless, and may have difficulty tolerating fatty foods, alcohol and tobacco. Hepatitis A never progresses into a chronic illness.
Who has a higher risk of becoming very ill from hepatitis A?
Some people have a higher risk of becoming seriously ill from hepatitis A:
- People who already have liver disease;
- People who have a chronic illness, such as diabetes or cardiovascular disease;
- People with HIV.
How does hepatitis A spread?
Hepatitis A is very contagious. The virus is found in the stool of an infected person.
After using the toilet, the person may leave traces of the virus on the toilet seat, flush button or doorknob. Hand contact with these surfaces can transfer the virus to the mouth. Hand contact can also transfer the virus to food, utensils, dishes and toys.
You could also be infected by eating contaminated foods that are uncooked (raw), such as fruit, vegetables or shellfish, such as shrimp or mussels.
The virus can also be transmitted through sexual contact (including anal intercourse) or contaminated sex toys.
People with hepatitis A can infect others from one week before they develop jaundice or fever, until one week after the onset of jaundice or fever. People who are infected but do not become ill from the virus can also infect others. The time between exposure and illness is about 14 to 50 days, with an average of 28 days.
Once a person has had hepatitis A, they cannot get it again.
How can I prevent hepatitis A?
There is a vaccine against hepatitis A. It is mainly given to people who will be travelling to countries where hepatitis A is common. It may sometimes be useful to vaccinate close contacts of a hepatitis A patient, such as people living in the same household. The vaccine is safe and effective. More information about this is available from the National Coordination Centre for Travellers Advice (LCR) or a travellers advice clinic and vaccination centre near you.
Good hygiene can also help to limit the spread of the virus.
Is there any treatment for hepatitis A?
Hepatitis A goes away on its own, without medicine. You will feel tired for a very long time. As long as you still have symptoms, it is advisable not to drink any alcohol at all.
If you or others in your household have symptoms that look like hepatitis A, go to the GP. Your doctor can check if you have hepatitis A.
How common is hepatitis A in the Netherlands?
About 10% of young adults in the Netherlands have been infected with the hepatitis A virus at some point in their lives. After an infection, they are protected against the disease for the rest of their lives. Adults usually contract an infection through children or while travelling in a country where hepatitis A is common, such as the Mediterranean (especially in Egypt and Turkey) and developing countries. The risk of hepatitis A is much higher in these countries than in the Netherlands.
Can a person with hepatitis A go to childcare, school or work?
Did your child (aged 0–4 years) contract hepatitis A while travelling abroad? And was your child absent from childcare between the exposure and the first symptoms? Then your child should stay home until one week after the onset of the jaundice symptoms.
If your child has already been to childcare during hepatitis A, then your child does not need to stay home. The rest of the group is probably already infected. Please do notify the childcare worker and the GP.
Does your school-aged child have hepatitis A? Then your child should stay home until one week after the onset of the jaundice symptoms.
Do you work in healthcare and have direct contact with patients? Or do you work in food preparation? Then you should stay home from work until one week after the onset of the jaundice symptoms. Discuss the options with your company doctor or the Municipal Public Health Service (GGD).