A STAMARIL Center
Hepatitis A (previously called infectious hepatitis) is
spread by food and water contaminated with human waste; it should be a concern
for anyone traveling to the developing world where water treatment or sewage
treatment may be inadequate. You don’t need to read the rest of this if you have
had documented hepatitis A in the past, have had a full series (two) of
hepatitis A vaccine (not immune globulin) or have had a blood test showing
immunity to hepatitis A. Some people who had jaundice in the past were presumed
to have infectious hepatitis. A hepatitis A antibody test should be confirmed if
it already has not been documented. Otherwise, please read this information
carefully before your visit so we can decide how best to protect you from
You will want to use careful food and water precautions (these are outlined for you in the handout on Diarrhea Treatment) to prevent hepatitis A and other diseases which can be transmitted by contaminated food or water. The vaccine is important to consider since there is no effective antibiotic treatment for hepatitis A and, as in many other viral diseases, once the infection is established we have no alternative but to allow it to run its course.
Hepatitis A vaccine (available since 4/95) is made from killed hepatitis A viruses and is very effective and safe. As an “active” vaccine, it stimulates the immune system to produce the recipient’s own antibodies, a process which takes several weeks. The schedule for this vaccine is two doses, the second six to twelve months after the first. The duration of protection is years or decades and probably lifelong. Hepatitis A vaccine is now considered a normal immunization, especially in Oregon which has had a high prevalence of hepatitis A in the US.
Since the vaccine series is somewhat expensive, you could have your blood antibody level checked first. The decision regarding whether to do the blood test is economic: “Would you want a blood test costing $40.00 or more if it might show that an expensive vaccine series were unnecessary?”. Entering into the analysis regarding whether to do the blood test first are the questions: 1)“What is the chance that you have had hepatitis A in the past?” 2)”Does your insurance pay for blood tests?” 3)”Does your insurance pay for this vaccine?”. It is safe and less trouble (but may be unnecessarily expensive) if you receive the vaccine and happen to be already immune.
Immune globulin (IG) has been used for hepatitis A protection in the past. IG gives “passive immunity”, meaning protection with someone else’s antibodies; it does not stimulate the recipient’s immune system. Protective antibody levels are achieved the same day. IG protects against hepatitis A (and measles) for only 3 months, and then disappears. Immune globulin use has almost completely been replaced by the vaccine, except in immunosuppressed travelers and other special situations.