Infection of the liver caused by Hepatitis A virus. Asymptomatic disease is common in children but jaundice (yellowing of the skin and eyes) may occur in 70–80% of those infected as adults. Severity tends to increase with age.
Occur around 4 weeks after becoming infected but may occasionally be as little as 15 or as much as 50 days. Symptoms include fatigue, joint and muscle pain, fever, loss of appetite, pain in upper-right part of tummy, jaundice, dark urine and pale stools, itchy skin.
Faecal–oral route through person-to person spread or contaminated food or drink. Ingestion of shellfish (feed by filtering large volumes of sewage polluted waters) and salad vegetables prepared and washed with contaminated water.
The highest risk areas for UK travellers are the Indian subcontinent and the Far East, but the risk extends to Eastern Europe although outbreaks have also been documented in a number of other European countries. There had been community-wide outbreaks even in the UK resulting from person-to-person transmission or, uncommonly, as point of source outbreaks related to contaminated food.
Vaccines are available as either monovalent, or combined with either typhoid or hepatitis B. The vaccines are inactivated, do not contain live organisms and cannot cause the diseases against which they protect.