5 things you need to know about hepatitis A

San Diego County experienced a public health emergency in 2017 due to an outbreak of hepatitis A. While hepatitis A is not a chronic condition like hepatitis C, the liver infection can cause loss of liver function and require hospitalization. In those with compromised health, it can even lead to death.

While most people in the region were not at risk, many were concerned. Dr. Fadi Haddad, an infectious disease specialist affiliated with Sharp Grossmont Hospital, addresses five common questions about hep A.

1. How does hepatitis A spread?
   Hepatitis A can easily spread from person to person, but only by touching objects or eating food handled by someone with the disease, or by having sex with an infected person.
   No common sources of food, beverage or drugs have been identified that have contributed to the outbreak in San Diego, though investigation is ongoing. The Centers for Disease Control and Prevention (CDC) notes that person-to-person transmission through close contact is the primary way people get hepatitis A in the United States.

2. What are the symptoms?
   The most obvious symptom of hepatitis A is jaundice, or yellowing of the skin or eyes. By the time a patient has this symptom, the disease is rather advanced.
   Other symptoms include:
   • Fever
   • Fatigue
   • Nausea and vomiting
   • Loss of appetite
   • Stomach pain
   • Dark urine or pale stools
   If you think you are infected with hepatitis A, see your doctor or visit the closest emergency room.

3. Who is at risk of infection?
   Hepatitis A is transmitted by fecal particles, so those who work in health care settings, work with at-risk populations, or lack access to clean water and restrooms are most at risk. Other risk factors include injection drug use and close contact with an infected person.

4. How can I prevent myself from getting infected?
   The easiest way to prevent infection is to wash your hands before and after eating or preparing food; and after using the restroom, changing a diaper or assisting someone with toileting. For people who live and work in infected areas, another precaution would be to disinfect the soles of shoes or remove shoes when walking around the home.
   For those at higher risk, a two-dose hepatitis A and B vaccine is available through your health provider or the County of San Diego.

5. Should I vaccinate myself and my family?
   The County of San Diego recommends that the following groups should be vaccinated against hepatitis A:
   • People traveling to a country with high or medium rates of hepatitis A
   • Men who have sex with men
   • Users of injection and non-injection illegal drugs
   • People with chronic liver disease who have an increased risk of poor outcomes if infected
   • People with blood-clotting disorders
   • People who are homeless or work with the homeless or users of illegal drugs
   • Food handlers
   • Health care workers

If you feel you are at risk of infection, talk with your primary care doctor or visit 211SanDiego.org for a list of community vaccination clinics.

The County of San Diego urges those vaccinated during the public health emergency to get their second dose, completing the series for long-term prevention. Although the first dose of the vaccine is considered to be around 95 percent effective, that protection will eventually begin to decrease. A second shot boosts immunity for between 20 and 40 years, according to the Center for Disease Control and Prevention.

For the news media: To talk with Dr. Haddad about hepatitis A for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.

This story was updated in March 2018.