Hepatitis A is a disease caused by the hepatitis A virus and affects mainly the liver. It causes liver inflammation which brings a range of symptoms that may include fever, loss of appetite, diarrhoea, nausea, general tummy discomfort, dark-coloured urine and jaundice (a yellowing of the eyes and skin). The time from infection to first symptoms (incubation period) is usually 14 to 28 days.
Interestingly, young children under six years of age usually don’t develop noticeable symptoms – some only have jaundice but no other symptoms.
Most people fully recover from hepatitis A and gain a lifelong immunity. There are exceptions, however – in very few people, the infection can cause fulminant hepatitis, which is acute liver failure that often results in death.
The hepatitis A virus spreads through contaminated food and water or through close contact with an infected person. The most common cause of contaminated water is faeces and so the risk of hepatitis A is highest in places with a lack of safe drinking water and inadequate sanitation. Poor personal hygiene, such as not washing hands, also increases the risk and so does oral and anal sex but casual contact among people does not spread the virus.
Some health bodies advise washing fruit and vegetables in bottled water or peeling them yourself and avoiding raw or undercooked meat and fish.
Hepatitis A virus can survive in the environment for a long time and it also withstands high temperatures so it makes it more persistent. However, boiling food or water for at least one minute kills it.
Infection is common in countries with lacking sanitation and unsafe drinking water which usually leads to most children under 10 being infected and gaining immunity for the future. In countries with good sanitary conditions and hygienic practices, the disease is quite rare and occurs mainly in teenagers and adults or it affects people when travelling. In older children and adults, it typically causes a range of symptoms described above.There is a vaccine against hepatitis A and is recommended as a part of routine vaccinations in Uganda.