Your chances of getting infected by the hepatitis A virus increase if you travel often and consume plenty of raw or partially cooked shellfish. But you don’t have to quell your wanderlust or your love of seafood if you take some basic precautions against hepatitis A infection.

“Plan to have hepatitis A vaccination one to two weeks before travelling, particularly if you are visiting places where sanitary conditions and hygienic practices are poor,” says Dr Limin Wijaya, Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), a member of the SingHealth group.

A booster shot (given six months later) could give you immunity for another 20 years.

Maintaining good personal hygiene, such as washing your hands after visiting the toilet, and avoiding raw foods and unbottled water when you are overseas, are among other precautions you can take to prevent a hepatitis A infection.

Most reported cases of hepatitis A infection acquired in Singapore are due to eating contaminated raw or partially cooked cockles or oysters.

According to government statistics, a total of 3,023 cases of acute hepatitis A were reported between 1989 and 2010. Overall, 49 per cent of these cases were classified as imported (acquired abroad). The rate was highest between the ages of 25 to 34. For every female, 2.3 males were infected.

What is hepatitis A?

Hepatitis A presents as inflammation of the liver as a result of the hepatitis A virus (HAV). Although hepatitis A is rarely fatal and will not lead to permanent liver damage, it is still an uncomfortable disease with severe symptoms that can last up to six months, says Dr Wijaya.

The good news is that you can only be infected once. Your body will naturally develop antibodies to give you lifelong immunity from future hepatitis A infection.

How is the hepatitis A virus transmitted?

Hepatitis A usually spreads by faecal-oral transmission.

This means eating food, and drinking water and other fluids (including ice), that are contaminated by the stools of an infected person. Eating raw or undercooked shellfish such as cockles, clams and mussels that come from sewage-contaminated sea water will also put you at risk of hepatitis A infection.

Poor personal hygiene such as not washing your hands with soap after using the toilet and before preparing food (or eating food prepared by a person with such poor hygiene) can cause the viral infection to spread.

Symptoms of hepatitis A infection

The hepatitis A virus will usually stay in your body for two to six weeks before you show any signs and symptoms of the disease. Symptoms include:

  • Fatigue
  • Muscle aches
  • Abdominal pain
  • Diarrhoea
  • Nausea
  • Vomiting
  • Jaundice (yellowing of skin and whites of eyes)
  • Dark urine
  • Light or grey-coloured stools
  • Fever

Treatment for hepatitis A infection

There is no specific treatment.

Most patients will recover in less than two months by taking plenty of rest and fluids, although some may experience discomfort even after nine months. Take fever and pain-relief medications as prescribed.

Hospitalisation is only required if patients suffer from dehydration or show signs of liver failure.

“If you have hepatitis A, avoid fatty foods and alcohol as these will overwork your already inflamed liver,” says Dr Wijaya.

Read on to find out prevention tips you can take against the hepatitis A virus.

The SGH Travel Clinic is run by specialists from the Department of Infectious Diseases. It is a designated Yellow Fever Centre. The team of doctors and nurses will offer comprehensive travel advice and country-specific recommendations prior to your trip.

Ref: S13