Hepatitis A Immunisation

What is hepatitis A?

Hepatitis A is an illness caused by a virus. It mainly causes inflammation of the liver. Symptoms include: generally feeling unwell, jaundice, sometimes vomiting and a raised temperature. Some people who are infected do not develop symptoms (a 'subclinical illness'). The illness is not usually serious and full recovery is usual. However, the symptoms can be quite unpleasant for a while.

Hepatitis A occurs in the UK but is more common in other countries in areas of poor sanitation. If you catch hepatitis A, the illness would not usually be serious, but it may ruin a holiday or business trip. (Note: hepatitis A should not be confused with hepatitis B or C. Hepatitis B and C are caused by different viruses, and are more serious diseases.)

Who needs immunising against hepatitis A?

Travellers to countries outside Western Europe, North America, and Australasia should consider being immunised. The highest risk areas include the Indian Subcontinent, the Far East, Africa, Africa, Central and South America, and Eastern Europe. Your doctor or practice nurse can advise if you should be protected against hepatitis A for your travel destination.

Contacts. Occasional outbreaks of hepatitis A occur in the UK in institutions or in families. Contacts (for example, family members or other members of the institution) may be offered immunisation. This only happens rarely. The most important measure when dealing with anybody with hepatitis A is good personal hygiene. In particular, washing hands after going to the toilet or before eating. The virus is passed in the faeces (motions).

Note: If you have been infected with hepatitis A in the past, you are likely to be immune and not need further immunisation. A blood test can detect antibodies to check if you are already immune. This may be worthwhile doing if you have had a history of jaundice in the past, or come from an area which has a high incidence of hepatitis A.

Hepatitis A vaccine

A single injection of vaccine protects against hepatitis A for about one year. The vaccine causes your body to make antibodies against the virus. These antibodies protect you from illness should you become infected with this virus. Ideally, you should have an injection at least two weeks before travel to allow immunity to develop. However, the vaccine may still be advised even if there is less than two weeks before you travel.

A booster injection 6-12 months after the first injection gives protection for up to 10 years.

A combined vaccine against hepatitis A and typhoid fever is also available. This may be useful if you require protection against both diseases. The hepatitis A component gives protection for one year and the typhoid component gives protection for three years. (You can have a booster with the hepatitis A vaccine after 6-12 months to give protection against hepatitis A for up to 10 years.)

Are there any side-effects from the vaccine?
Some people develop a temporary soreness and redness at the injection site. Much less common is a mild fever, tiredness, headaches, and feeling sick for a few days. Severe reactions are rare.

Who should not receive hepatitis A vaccine?
If you have an illness causing a high temperature it is best to postpone immunisation until after the illness. You should not have a booster if you have had a severe reaction to this vaccine in the past.

Pregnant women may need individual advice from their doctor. There is a small risk that the hepatitis A vaccine may cause harm to a pregnancy. But this risk has to be balanced against the risk of getting hepatitis A.

Other points

Remember - immunisation for travellers is only one aspect of preventing illness. No immunisation is 100% effective. So when travelling to 'at risk' areas you should have very good personal hygiene, only drink water or other drinks that are known to be safe (bottled water, sterilised water, etc), and only eat foods that have been cleaned and/or prepared properly.

Further information

Health Advice for Travellers - from the Department of Health
All travellers going abroad are advised to get this booklet. You can get a free copy:

• From main post offices, or
• By writing, phoning, faxing or emailing the Department of Health (allow 10 days to get it).

  Department of Health, PO Box 777, London, SE1 6XH
  Telephone: 08701 555455    Fax: 01623 724524    Email doh@prolog.uk.com

• Or view the content on the web www.dh.gov.uk/PolicyAndGuidance/HealthAdviceForTravellers/fs/en

Immunisation Against Infectious Disease (The Green Book)
www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/GreenBook/fs/en
From the Department of Health. Aimed at health professionals but of interest to all.

Health Information for Overseas Travel (The Yellow Book)
www.archive.official-documents.co.uk/document/doh/hinfo/index.htm
From the Department of Health. Aimed at health professionals but of interest to all.

Information on immunisation
www.immunisation.org.uk
From the NHS aimed at the general public.

Patient UK Travel Health Page
www.patient.co.uk/travel.htm
Has a comprehensive list of links to UK websites on travel health.

© EMIS and PIP 2004   Updated: April 2004   Review Date: May 2005   CHIQ Accredited