How is viral hepatitis A usually transmitted?

The virus is shed in stool. It can spread when hand hygiene is poor, food is prepared by someone who is infected, or water and food become contaminated. Close household or sexual contact can also transmit it. Many people first notice feeling generally unwell, nausea, loss of appetite, discomfort under the ribs, fever or tiredness; dark urine and yellowing of the skin may appear later. Symptoms can be mild, especially in children, so someone may spread infection without realising it.

Wash hands thoroughly with soap and water after using the toilet and before preparing food. Do not prepare food for others while unwell, and avoid sharing drinks, utensils or towels. Contact a clinician promptly after a known exposure because vaccination may be considered. A clinician can assess symptoms and may arrange a liver function test or other tests. Rest and drink fluids; avoid alcohol and check before taking medicines that may affect the liver.

Arrange prompt assessment for yellow skin or eyes, dark urine, persistent vomiting, increasing abdominal pain, marked drowsiness, confusion, or inability to keep fluids down. Seek urgent help if severe dehydration, fainting or unusual bleeding develops. Tell the clinician about travel, food or water exposure, close contacts, and any pregnancy or liver condition.

Ask whether your symptoms need testing, whether household or sexual contacts need advice, when you can return to food handling, and whether hepatitis A vaccination is appropriate after exposure.