Transmission of hepatitis A virus (HAV) is through a fecaloral route. Fecal shedding followed by poor hand washing contaminates water and foods, leading to infection of household and sexual contacts. Infected children are often asymptomatic, contributing to spread of infection. To reduce transmission, advise hand washing with soap and water after bathroom use or changing diapers, and before preparing or eating food. Diluted bleach can be used to clean environmental surfaces. HAV infection is rarely fatal—fewer than 100 deaths occur each year—and usually only in people with other liver diseases; it does not cause chronic hepatitis.

CDC Recommendations for Hepatitis A Vaccination

● All children at age 1 year

● Individuals with chronic liver disease

● Groups at increased risk of acquiring HAV: travelers to areas with high endemic rates of infection, men who have sex with men, injection and illicit drug users, individuals working with nonhuman primates, and persons who have clotting factor disorders.

The vaccine alone may be administered at any time before traveling to endemic areas.

Postexposure Prophylaxis. Healthy unvaccinated individuals should receive either a hepatitis A vaccine or a single dose of immune globulin (preferred for those ≥age 40 years) within 2 weeks of being exposed to HAV. These recommendations apply to close personal contacts of persons with confirmed HAV, coworkers of infected food handlers, and staff and attendees (and their household members) of child care centers where HAV has been diagnosed in children, staff, or households of attendees.

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