Hepatitis A in endemic countries

An endemic country has ongoing local transmission of hepatitis A, often linked to sanitation, clean water access and food handling. Risk is not identical in every town or setting, and visitors may have little immunity. The virus can spread through food, drinks, contaminated surfaces or close contact. Early illness may resemble a stomach upset, with nausea, poor appetite, fever or feeling generally unwell. Later, dark urine and yellowing of the eyes or skin can appear. A liver function test and other blood tests can help a clinician assess the illness.

Ask a travel or primary-care clinician whether hepatitis A vaccination is appropriate before visiting an endemic area, allowing time for personalised advice. Drink sealed or treated water, avoid ice when its source is uncertain, and choose food that is thoroughly cooked and served hot. Peel fruit yourself and wash hands with soap before eating. If you develop symptoms during or after travel, arrange medical assessment and mention the destination and dates. Do not prepare food for others if you may be infectious.

Seek urgent help if vomiting prevents drinking, urine becomes very limited, you feel confused or faint, abdominal pain is severe, or yellowing worsens quickly. People who are pregnant, very young, older, immunocompromised or living with liver disease should seek advice early after a possible exposure or when symptoms begin.

Ask whether your destination has meaningful local transmission, whether vaccination is suitable, what post-exposure steps exist, which foods and drinks need caution, and how to recognise dehydration.