Protecting your liver on your travels
Hepatitis A is a viral infection which affects the human liver. The hepatitis A virus is usually ingested via contaminated food or water and is endemic to many countries where sanitation and access to safe food and water is poor.
Areas affected by hepatitis A include the South American continent, the African continent as well as most countries in Asia. The hepatitis risk in any area depends on local hygiene practices and the local sanitation system. The hepatitis risk in any area depends on local hygiene practices and the local sanitation system.
Hepatitis A usually clears up on its own within 3 to 6 months.
Vaccination is the best way to prevent hepatitis A. The hepatitis A vaccine isn’t routinely given because the risk is so low in the UK, but if you are travelling to a country with a risk of the disease, vaccination is recommended.
The vaccine we use to immunise against hepatitis A is Havrix Monodose® which provides protection against the virus. The course consists of one dose injected into your upper arm. You should aim at getting vaccinated at least two weeks before you travel.
All unvaccinated people, along with those who have never had hepatitis A, should be vaccinated before traveling to countries where hepatitis A is common. Travelers to urban areas, resorts, and luxury hotels in countries where hepatitis A is common are still at risk.
Health Plus Pharmacy make the hepatitis A vaccinations convenient and accessible for all the community in Cardiff and Pontypool. Book an appointment with your local Health Plus Pharmacist to keep you safe.
Check the risks of a country you’re travelling to on the TravelHealthPro website
About the Hepatitis A vaccine
Price: £55 per dose
Doses per course: 1
Price per course: £55
Course: The course consists of one dose.
Who to get vaccinated: You should get vaccinated at least two weeks before travelling.
Boosters: The vaccine protects you for one year. If you have another booster after 6 -12 months, you won’t need any further boosters for 25 years thereafter.
How it is given: Injection in the upper arm.
Side effects: Side effects can include a high temperature, feeling tired and soreness at the injection site.
Children: The hepatitis A vaccine is suitable for children over the age of one.
Additional precautions: You need to practise food safety as well as water and hand hygiene while in an area where hepatitis A is endemic.
Risk if you contract hepatitis A: Hepatitis A can cause mild to severe symptoms, including fever and digestive issues. It can cause complications such as liver failure.
About the hepatitis A vaccination
Hepatitis A vaccines are safe and effective at preventing hepatitis A infections.
The vaccine we use to immunise against hepatitis A is Havrix Monodose® which provides protection against the virus. Havrix Monodose® is a vaccine containing hepatitis A virus. It is used to boost the body’s immune system to help protect against hepatitis A infection in adults and adolescents (16 years of age and above).
- The virus is not alive so this vaccine cannot cause hepatitis A infection.
- When you are given Havrix Monodose® vaccine your body will make antibodies (the body’s natural defence system) against the hepatitis A virus.
- After 2 to 4 weeks, these antibodies will have been produced and will protect you against hepatitis A infection.
- To ensure long term protection, you should receive a second (booster) vaccination 6 to 12 months after your first dose. As long as you receive the booster within 5 years, you should still be fully protected. Once you have had your booster vaccination, you are not expected to need an additional dose of Havrix.
- Having this vaccine will only protect against hepatitis A and not against any other type of hepatitis virus or any other illness that can cause hepatitis (inflammation of the liver).
Hepatitis A vaccination schedule
Havrix Monodose® is for use in adults and adolescents 16 years of age and above. Children (1 to 15 years of age) are given Havrix Junior Monodose.
The hepatitis A vaccine (1 ml) is injected into the muscle in the upper arm.
The first dose of vaccine should protect you from infection with hepatitis A virus within 2 to 4 weeks after the injection. Protection should last for at least 1 year.
The best way to ensure that protection continues for at least 40 years is to receive a second (booster) dose of the vaccine. This should be given 6 to 12 months after the first injection.
If a second dose is not given within 5 years of the first dose, the doctor may decide that vaccination should start again, with 2 doses of vaccine within 1 year.
How effective is the hepatitis A vaccination
Chickenpox is a common childhood infection. Usually, it’s mild and complications are rare.
Almost all children develop immunity to chickenpox after infection, so most only catch it once. It can be more severe in adults.
But some people have a higher chance of developing serious complications from chickenpox.
These include:
- adults
- pregnant women
- babies under four weeks old
- people who have weakened immune systems through illnesses such as HIV or treatments like chemotherapy
Who should have the hepatitis A vaccination
It is recommended that adults and children 12 months of age and older to be vaccinated with hepatitis A vaccine when traveling to the following parts of the world:
- Africa.
- Asia (except Japan).
- Parts of the Caribbean.
- Central and South America.
- Eastern Europe.
- The Mediterranean basin.
- The Middle East.
- Mexico.
Its also recommended that the following people get the hepatitis A vaccine:
- All children aged 12–23 months
People at increased risk for hepatitis A
Its also recommended that the following people get the hepatitis A vaccine:
- International travelers
- Men who have sex with men
- People who use or inject drugs (all those who use illegal drugs)
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
People at increased risk for severe disease from hepatitis A infection
It's also recommended that the following people get the hepatitis A vaccine:
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Who cannot have the hepatitis A vaccine
People who have ever had a life-threatening allergic reaction to the hepatitis A vaccine or who are known to be allergic to any part of the hepatitis A vaccine should not receive the vaccine.
Extra precautions when travelling abroad
To protect yourself from hepatitis A when travelling, you need to:
- Pay strict attention to your hand hygiene
- Practice safe food precautions like, avoiding eating shellfish and uncooked fruit and vegetables
- Practice safe water precautions like, drinking bottled water
- Consider if you need to be vaccinated against Hepatitis A before you go
- Find out what the risks are where you intend to travel and check if you need any vaccinations before travelling – vaccines can prevent some illnesses spread by insects, such as yellow fever. You can use the Travel Health Pro website to do this
Avoiding travel to a hepatitis A risk area
If you have a contraindication to the hepatitis A vaccine or the risk of serious side effects is high, and there is a significant risk of contracting hepatitis A on your trip you are likely to be advised to cancel or change your travel plans. Healthcare practitioners are not obliged to administer hepatitis A vaccine if they believe it unsafe to do so, or it is not required for your trip. If you have any medical conditions, it is best to seek travel advice before you book your trip.
If you have recently received the hepatitis A vaccine and feel unwell please contact your GP or the 111 service if your GP practice is closed.
In a medical emergency, when someone is seriously ill and their life is at risk, dial 999.
What is hepatitis A?
Hepatitis A is highly contagious, short term liver infection caused by the hepatitis A virus. An unpleasant virus which can cause fever, malaise, nausea, abdominal pain, jaundice and even in rare cases liver failure. The virus is found in the blood and poo of people when they are infected. If infected poo enters water supplies, then people who are drinking, swimming or washing in the water will get infected. If you eat fruit and vegetables washed in this water, you will catch the infection.
If people with hepatitis A do not wash their hands after going to the toilet, they will transfer the virus to their hands and then to other objects or people that they touch. This can spread the infection.
Young children are at increased chance of catching hepatitis A during travel because they tend to put objects and their unclean hands in their mouth.
Hepatitis A occurs worldwide, mostly in countries where hygiene and sanitation is poor. Most cases caught during travel from the UK occur in Bangladesh, India, Nepal and Pakistan.
Which countries are affected by hepatitis A?
Hepatitis A is found across the world, but some countries have higher incidences than others, in particular South America, Africa, Russia and Asia (see map)
Map adapted from the World Health Organization. Hepatitis A, countries or areas at risk. 2012.
How serious is hepatitis A?
In most cases, hepatitis A is not serious. People usually get better within a few months and suffer no long-term effects. In rare cases, hepatitis can cause life-threatening complications such as liver failure, especially for the elderly and those with pre-existing liver problems. Recovering from hepatitis A can disrupt daily life for months and lead to long periods off work. Precaution is the best remedy.
What are the symptoms of hepatitis A?
Not everyone with hepatitis A infection gets symptoms and in those that do, they are mild. Older people and those who have a weakened immune system have a higher chance of severe hepatitis A infection.
The most common symptoms include:
- Feeling tired
- Generally feeling unwell
- Pain in joints and muscles
- High temperature
- Decrease or loss of appetite
- Nausea or vomiting
- Tummy pain in the upper-right area
- Yellowing of skin and eyes
- Dark urine and pale stools
- Itchy skin
For most people, symptoms usually clear up completely within a few days to weeks without causing any long term liver damage.
Rarely some people might go on to develop more serious symptoms which can cause the liver to stop functioning properly (liver failure).
People who recover from hepatitis A illness will develop lifelong immunity meaning they cannot catch it again.
Treatment for hepatitis A
Hepatitis A usually clears up on its own within 3 to 6 months. Your doctor may offer you medicines to help with the symptoms, such as painkillers or medicines to stop you feeling sick or itchy.
A small number of people with hepatitis A may get liver problems. You may need blood tests to check your liver is working properly.
People who recover from hepatitis A illness will develop lifelong immunity meaning they cannot catch it again.
Things you can do if you have hepatitis A
There are some things you can do when you have hepatitis A to help ease the symptoms, and to stop infecting others.
You’re usually infectious for either:
- 7 days after yellowing of the skin and eyes (jaundice) started
- 7 days after your symptoms started, if you’ve not had jaundice
Do
- limit contact with other people for 7 days after your symptoms started or 7 days after jaundice started (adults should stay off work and children should stay off from school or nursery)
- rest and drink plenty of fluids
- take painkillers like ibuprofen and paracetamol - ask your doctor for advice on how much paracetamol you should take because you may not be able to take a normal dose
- keep your room well ventilated, wear loose-fitting clothing, and avoid hot baths and showers if you feel itchy
- wash your hands thoroughly after going to the toilet
Don’t
- do not drink alcohol
- do not prepare food or drink for others
- do not have sex without a condom or dam until you’re no longer infectious
- do not share needles with others
What are the side effects of the hepatitis A vaccination?
Like all medicines, this vaccine can have side effects, although not everybody gets them.
Allergic reactions
(these may occur with up to 1 in 10,000 doses of the vaccine)
See your doctor straight away, if you have an allergic reaction. The signs may include:
- local or widespread rashes that may be itchy or blistering
- swelling of the eyes and face
- difficulty in breathing or swallowing
- a sudden drop in blood pressure
- a very fast heart beat
- loss of consciousness.
These signs usually start very soon after the injection has been given to you. See a doctor straight away if they happen after leaving the clinic.
Very common
(these may occur with more than 1 in 10 doses of the vaccine):
- Headache
- Pain and redness at the injection site
- Fatigue
Common
(these may occur with up to 1 in 10 doses of the vaccine):
- Loss of appetite
- Stomach upset e.g. diarrhoea and nausea
- Swelling or hard lump at the injection site
- Generally feeling unwell
- Fever
Uncommon
(these may occur with up to 1 in 100 doses of the vaccine):
- Upper respiratory tract infection, runny or blocked nose
- Dizziness
- Vomiting
- Aching muscles, muscular stiffness not caused by exercise
- Flu-like symptoms, such as high temperature, sore throat, runny nose, cough and chills
Rare
(these may occur with up to 1 in 1000 doses of the vaccine):
- Abnormal sensation such as of burning, prickling, tickling or tingling, pins and needles, loss of feeling or numbness
- Itching
- Chills