Hepatitis - Hepatitis A

Preventing Hepatitis A Infections When Traveling to High-Risk Countries

Travelers should take the following precautions:

Be vaccinated against hepatitis A and possibly B if traveling for long periods of time to countries where epidemics occur.
Use only carbonated bottled water for brushing teeth and drinking. (It should be noted that ice cubes can carry infection.) Boiling water is the best method for eliminating infectious agents. There is some debate about how long to boil, but bringing the water to a good boil for at least a minute generally renders it safe to drink.
Heated food should be hot to the touch and eaten promptly.
Don?t buy food from street vendors.
Beware of sliced fruit that may have been washed in contaminated water. Travelers themselves should peel all fresh fruits and vegetables.
Avoid dairy products.
Avoid raw or undercooked meat and fish.

Vaccinations for Hepatitis A

Two vaccines (Havrix, Vaqta) are now available and both are very safe and effective for preventing hepatitis A (HAV). They can be given along with immune globulin and other vaccines. A 2001 study also strongly suggested they may be used interchangeably (i.e., if one is given as the first vaccination, the other may be safely used as the booster). A combination vaccine (Twinrix) that contains both Havrix and Engerix-B (a hepatitis B vaccine) is now approved for people with risk factors for both hepatitis A and B.

Click the icon to see a discussion of hepatitis A vaccine.

Candidates for HAV Vaccinations. Vaccinations for hepatitis A are recommended for the following individuals:

People in specific populations where outbreaks occur. Indeed, a 2001 study showed that widespread vaccination of children in one county in California led to dramatic decreases in the number of outbreaks among all adults in the community at large. Day care centers are highly associated with such outbreaks, although risks in such centers vary widely depending on the community, so universal immunization in day care centers is not recommended.
Sexually active homosexual men.
Patients with any form of chronic hepatitis. (It should be noted that the HAV vaccination should be given to patients before they reach advanced stages of liver disease, when there is a lower rate of response.)
Health care workers exposed to the virus.
Travelers to developing countries. (Travelers should also receive immune globulin if they are visiting high-risk areas within four weeks of the vaccination.)
Experts now recommend routine vaccinations for children and adolescents in high-risk states. These states are Arizona, Alaska, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah, Washington, Missouri, Texas, Colorado, Arkansas, Montana, and Wyoming.
People who have had intimate exposure to patients with hepatitis A may be protected with immune globulin or possibly with the vaccine itself.
People with chronic liver disease, including those with hepatitis C, should also be vaccinated, particularly if they have not been exposed to hepatitis A, since the infection can cause liver failure in these patients.