By: Margaret Ikeda, MD, MS, FAAP
Hepatitis A is a type of inflammation of the liver caused by the hepatitis virus. This virus lives in the feces (poop) of infected people.
Hepatitis A is very contagious. It can spread through contaminated food or water when they are not handled carefully. The virus can survive on fresh and frozen food, sewage and drinking water that has not been treated adequately.
Before the vaccine was available, hepatitis A infections were very common in childcare centers. Today, the vaccine against hepatitis A, along with an
effective cleaning routine, protects your child from this disease so they can focus on learning and growing.
Where we stand: Hepatitis A vaccine for children
The American Academy of Pediatrics (AAP) believes that a federal advisory panel's decision to make the hepatitis A vaccine optional for children is dangerous and could put them at risk. AAP still strongly recommends that all children get all doses of the Hepatitis A vaccine as part of routine care.
How do you get hepatitis A?
Hepatitis A spreads when traces of feces from an infected person make their way into the mouth of a non-infected person.
The hepatitis A virus can be present in the feces of someone infected for 1 or 2 weeks before the symptoms start. That means they can infect other people before they know they are sick.
Outbreaks may happen in restaurants, health care buildings, schools and child care facilities. Some outbreaks have been associated with eating foods such as green onions, lettuce, spinach, berries, pomegranate seeds, fruit smoothies and shellfish.
Drinking water contaminated with the virus has also caused outbreaks, but it's less common than food related infections.
People can become infected with hepatitis A through:
Contaminated food, especially when food handlers or food processing plant workers don't wash their hands well after using the bathroom.
Close contact with caregivers who don't wash their hands after changing diapers.
Contact between very young children. They can give each other hepatitis A while playing or sharing a space because most don't know how to wash their hands well.
Close contact with an infected person. For example, contact with droplets of their saliva, snot or other body fluids.
Traveling to places with poor sanitation.
Signs and symptoms of hepatitis A
Many children younger than 6 years old infected with the hepatitis virus have only a few if any symptoms at all.
It's possible that parents don't realize their child is sick.
Symptoms start between 14 and 40 days after exposure to the virus. An infection with hepatitis A typically lasts less than 2 months, but some people have symptoms for as long as 6 months.
Symptoms of hepatitis A include:
Jaundice happens when the liver cells are damaged and can't process and rid the body of a substance called bilirubin. It builds up in the blood, causing yellow discoloration.
Jaundice is less common on infected children younger than 6 years old.
Paying close attention to their symptoms should be a priority.
What parents can do to prevent hepatitis A
The hepatitis A vaccine is one of the recommended childhood immunizations. Here's what to know:
Children receive the vaccine between 12 and 23 months of age.
Children and adolescents ages 2 to 18 years old who have not received the vaccine previously can still get vaccinated.
Your pediatrician might recommend one of the two versions of the hepatitis A vaccine currently available in the U.S.: Havrix or Vaqta.
Your pediatrician might recommend Twinrix if you have an older teen or young adult. Twinrix is a combination of the hepatitis A and B vaccines. It's available for people 18 years and older.
Heating or cooking to at least 185 degrees F for one minute destroys the virus. Freezing, drying, or warming food does
not kill the virus.
Why the hepatitis A vaccine is important for all of us
Hepatitis A can be fatal for children and adults with other types of liver disease or other types of hepatitis. It can also be fatal for the elderly and those with vulnerable immune systems (immunosuppressed) or with poor health.
The vaccine was first recommended for children in 1996, and by 2011, hepatitis A infections were down 95%. Sadly, infections in the U.S. began increasing again in 2016. Person-to-person outbreaks have kept happening since then.
If we want to reverse this trend and keep our communities safe, we need to make sure our kids get vaccinated.
Talk with your doctor
Call your pediatrician if your child develops any of the symptoms associated with hepatitis, including jaundice, or if they have contact with someone who has hepatitis.
Tell your doctor if someone getting the hepatitis A vaccine has any life-threatening allergies. Do the same if they are sick. People with minor illnesses, like a common cold, can get vaccinated.
Possible effects after vaccination
There have been no serious adverse events attributed to the hepatitis A vaccine. Occasionally, people have redness, swelling or feel soreness where they got the shot. Children usually receive the shot in their thigh or arm. For any signs that concern you, call your doctor.
If someone has a serious reaction to a vaccine, there are two government agencies that monitor vaccine reactions and safety through the Vaccine Adverse Reporting System (VAERS).
More information
About Dr. Ikeda
Margaret Ikeda, MD, MS, FAAP, is a board-certified pediatrician working in primary care at the Yale University School of Medicine. She has been a member of the American Academy of Pediatrics Section on Infectious Diseases for many years. Her interests include travel, medicine, adoption and sports medicine. She supports members of the Armed Forces.