How To Prevent, Treat Hepatitis A

Hepatitis A is a highly contagious disease that is caused by a virus and that often leads to inflammation of the liver, affecting that organ’s ability to function. It is far less common in the U.S. today than it once was, thanks to a vaccine that became available in 1995, but outbreaks continue to be reported around the country, including a recent outbreak in Arkansas that lasted several years.

To help prevent future outbreaks of hepatitis A, it is important for the public to practice basic prevention, recognize symptoms, and understand treatment options.

Hepatitis A in the U.S. and Arkansas

According to the Centers for Disease Control and Prevention (CDC), 2,265 new cases of hepatitis A and 118 hepatitis A-related deaths were reported in the U.S. in 2022.

As recently as 2017, Arkansas had only seven new cases of hepatitis A, but an outbreak in Missouri spilled into Northeast Arkansas in 2018. That year, Arkansas had 254 new cases.

Response efforts by the Arkansas Department of Health and local healthcare providers, including vaccination campaigns, helped to reduce the number of new cases to 203 in 2019. However, in 2020, as the healthcare system scrambled to respond to the COVID-19 pandemic, the number of hepatitis A cases increased. Arkansas experienced 396 new cases in 2020 and 468 in 2021, with the cases no longer concentrated in Northeast Arkansas. After peaking in 2021, the disease reverted to low levels in the state, with just 21 cases reported in 2022.

Between February 7, 2018, and January 11, 2023, Arkansas reported five hepatitis A-related deaths, according to the CDC.

Symptoms of Hepatitis A

Not everyone with hepatitis A develops symptoms. For those who do, symptoms may be mild and go away in a few weeks, causing no permanent liver damage. However, some people, especially older adults and people with chronic liver disease or HIV, may experience severe illness that can last months and, in rare cases, result in acute liver failure.

Common symptoms include:

• Abdominal pain
• Clay- or gray-colored feces
• Dark urine
• Diarrhea
• Fatigue
• Fever
• Jaundice (a yellowing of the skin and eyes)
• Joint pain
• Loss of appetite
• Nausea
• Vomiting

Hepatitis A Prevention and Treatment

The hepatitis A virus is commonly contracted through consumption of contaminated food or water or through contact with an infected person. The types of personal contact that most often result in infection are sharing drugs, especially injected drugs, with an infected person; having sex with an infected person; and caring for an infected person. Among the first clusters of cases in Arkansas’s outbreak that began in 2018, most patients reported having injected or otherwise used drugs, according to the Arkansas Department of Health.

The hepatitis A virus is found in the feces and blood of people who are infected. To prevent hepatitis A, wash your hands thoroughly with soap and water after using the bathroom, changing diapers, or caring for an infected person, and before preparing or eating food.

The most effective way to avoid hepatitis A is by being vaccinated. According to the CDC, the following people should be vaccinated against hepatitis A:

• Children

• • All children ages 12-23 months
  • All children and adolescents 2-18 years old who have not previously received the hepatitis A vaccine

• People at increased risk for hepatitis A

• • International travelers
  • Men who have sex with men
  • People who inject or otherwise use illegal drugs
  • People experiencing homelessness
  • People whose jobs increase the risk of exposure, such as those who work with the hepatitis A virus in a lab
  • People who anticipate close personal contact with an international adoptee

• People at increased risk for severe illness from hepatitis A infection

• • People with chronic liver disease, including hepatitis B and hepatitis C
  • People with HIV

• Pregnant women at risk for hepatitis A or at risk for severe outcomes from hepatitis A infection
• Any person who requests vaccination

If you experience symptoms of hepatitis A, or if you have been exposed to the hepatitis A virus within the past two weeks, talk to your doctor. Vaccination within two weeks of exposure can help prevent you from getting sick. There is no danger in receiving the vaccine again if you aren’t sure if you have received it before. Your doctor may also recommend a treatment called immune globulin injection.

For most people who develop hepatitis A, doctors recommend rest and adequate nutrition and fluids to treat symptoms, but some cases may require hospitalization.

Other Types of Hepatitis

Hepatitis B and hepatitis C are also liver diseases caused by viruses.

Hepatitis B is most commonly passed on from mothers to babies during childbirth, but it can also be transmitted when an infected person’s blood or other bodily fluids enter the bloodstream of another person. There is a very effective hepatitis B vaccine. In some people, especially young children, hepatitis B may become chronic. There is no cure for chronic hepatitis B, but people with chronic hepatitis B can live healthy lives with treatment. For information on hepatitis B in Arkansas, see our report.

Hepatitis C is transmitted through blood-to-blood contact. There is no hepatitis C vaccine, but the disease can be cured in most cases with currently available medication. See our report for information on hepatitis C in Arkansas.