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 men.

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 unprotected 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 jaundice to one week after
Important sequelae Rarely, severe hepatitis and acute liver failure
Direct benefit of detection and treatment of contacts Active immunisation against hepatitis A
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. However, vaccination is recommended in preference to NHIG for use in postexposure prophylaxis in persons >12 months of age who are immunocompetent (as per the NHMRC Australian Immunisation Handbook, last updated Jul 2015) Ref: 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

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