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HEPATITIS A

 

Causative organism

Hepatitis A virus
Note: hepatitis A is transmitted by the faecal-oral route. This may be food- or water-borne or via sexual contact, particularly between unvaccinated gay and bisexual men (cis and trans).

Incubation period 15-50 days (mean 28 days)
How far back to trace 50 days from onset of symptoms
Usual testing method Serology for hepatitis A (Hepatitis A IgM positive)
Common symptoms Acute hepatitis with jaundice, malaise, abdominal pain, dark urine

Likelihood of transmission per

act of condomless intercourse

Probably high if any faecal contamination of mouth
Likelihood of long-term sexual partner being infected High, if susceptible
Protective effect of condoms Nil (transmission is faecal-oral)
Transmission by oral sex Possible if faecal contamination is present
Duration of potential infectivity

Two weeks before the onset of prodromal symptoms to either one week after the onset of jaundice (if it occurs), OR

two weeks after the onset of prodromal symptoms (if jaundice does not occur.

Important sequelae Rarely, severe hepatitis and acute liver failure
Direct benefit of detection and treatment of contacts

Vaccination and prophylaxis for contacts.

Reduced family and community transmission.

Usual management of contacts

Post-exposure prophylaxis using hepatitis A vaccine or normal human immunoglobulin (NHIG) (passive immunisation) can be used to prevent secondary cases in close contacts of hepatitis A cases.

Healthy contacts aged 1-40 years use monovalent hepatitis A vaccine.

Contacts aged over 40 years or immunosuppressed give NHIG and vaccine.

Contacts aged < 1 give NHIG.

Other groups see references:

Hepatitis A National Guidelines for Public Health Units 2018

The Australian Immunisation Handbook

Contact tracing priority High including sexual contacts, domestic contacts, close social contacts, and food handlers
Notification

Acute viral hepatitis A is notifiable by all doctors and laboratories in all Australian states and territories, and New Zealand.
If locally acquired, telephone a public health unit within 24 hours

Page last updated April 2021

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