HAV is most infectious two weeks before illness to one week after the onset of jaundice (yellowing of eyes, skin).

HAV is transmitted via the fecal/oral route. This can happen by ingesting food and water that is contaminated with feces. It can also occur through close personal contact with an infected person. HAV can remain infectious for up to 10 months in water. For this reason, all shellfish should be thoroughly cooked.

Outbreaks due to HAV have been linked to:

• Contaminated water
• Food contaminated by infected persons where the food was not properly cooked or handled after cooking
• Raw or undercooked mollusks harvested from contaminated waters
• Contaminated produce

Groups at increased risk for hepatitis A or its complications include:

• International travelers (particularly high-risk itineraries like travel to rural areas in high-risk countries) 
• Recent international adoptees from countries where HAV is common
• Men who have sex with men
• Users of illegal drugs

You cannot tell apart HAV from other forms of acute viral hepatitis without lab testing. Symptoms vary from no symptoms to light stools, sudden onset of fever, malaise (feeling sick), anorexia (not eating), nausea, abdominal discomfort, jaundice (yellowing of the eyes/skin), and/or dark urine. 

Symptoms usually last less than (2) months.

A blood test is available to check if you are infected. Check with your physician if you suspect that you may have hepatitis of any form.

Average of 28-30 days (range 15-50 days).

• Foreign travel. HAV is associated with contaminated food and water supplies
• Household contact with an infected person
• Living in an area with an HAV outbreak
• Anal-oral sex with an infected person
• IV drug use

The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. Prevention through vaccination is the best strategy. Immune globulin can be administered for short-term protection. Practicing good hand hygiene is important in preventing the spread of hepatitis A. This includes washing hands after using the bathroom, changing diapers, and before preparing or eating food.

General guidelines include:

• Vaccination with two doses of vaccine to any uninfected individuals over two years old.
• Effective hand washing technique.
• Exercising caution when traveling to foreign countries.
• Drinking only safe water (canned, boiled, or bottled water). Avoid beverages made with ice. Boiling is the most effective method to ensure safe water. At high altitudes boil vigorously for a few minutes, then allow it to cool; do not add ice. You can chemically disinfect by using either iodine or chlorine. Iodine is the most effective disinfectant.
• Eat only safe food (food thoroughly cooked and prepared). Avoid uncooked shellfish, and uncooked fruit/vegetables not peeled or prepared by yourself.

You can protect household members through vaccination. Wash hands after going to the toilet. Clean surfaces contaminated with feces.

Vaccination Information:

• CDC Pink Book Hepatitis A Vaccine
  • Center for Disease Control and Prevention’s (CDC) Hepatitis A Vaccine Chapter within the Pink Book
• For Healthcare Professionals
  • Hepatitis A Vaccine information for healthcare professionals on the CDC website
• For the Public
  • Hepatitis A Vaccine information for the public  on the CDC website
• ACIP Recommendations
  • Most recent articles and recommendations for hepatitis A vaccination from the Advisory Committee on Immunization Practices

Report Hepatitis A (acute) within one working day to 800-705-8868.

CDC Viral Hepatitis Surveillance Report Form (PDF)

CDC Hepatitis A Case Definition 

Texas Law and Administrative Code requires doctors, hospitals, schools, and labs to inform the Texas Department of State Health Services (DSHS) if they think someone has a notifiable condition (25 Tex. Admin. Code §97.2).

Food-handlers and school children should not go to work or school for seven days after symptoms begin.
25 Tex. Admin. Code §97.7.  

Current finalized data are available through 2020. The number of hepatitis A cases declined in Texas through 2018 thanks to vaccination efforts. The biggest decrease occurred in counties that have historically experienced the highest number of new cases. These counties implemented vaccine requirements soon after the Advisory Committee on Immunization Practices (ACIP) recommendations for targeted immunization.

Mandatory hepatitis A vaccination for childcare enrollees began in 1999. For K - grade 1, it began in the school year 2010-2011. In 2018, there were 88 cases of hepatitis reported in Texas, the lowest total count at that time. In 2019 that count rose to 160 cases. In 2020 it rose to 223 cases due to an outbreak.