Hepatitis A is an ongoing epidemic in underdeveloped countries that is caused by the hepatitis A virus (HAV). It is an acute infectious virus of the liver. This illness is highly contagious, and infects an estimated 1.4 million people each year. Hepatitis A is common in areas where food and water is unsafe and poor sanitation is prevalent. This disease is often transmitted through food and water, which includes ice. Specifically, it is transmitted during breakdowns in sanitation due to natural disasters/floods, infected food handlers, ingestion of raw shellfish harvested from sewage-contaminated waters, ingestion of uncooked and unpeeled fruits and vegetables. In rare cases, Hepatitis A can be transmitted through blood transfusions, sexual relation, or needle sharing.
Once you are infected, it takes anywhere from 2-6 weeks for symptoms to show up. Symptoms include fatigue, fever, abdominal pain, nausea, appetite loss, jaundice (a yellowing of the skin), and clay colored feces. In addition to these symptoms, bile from your blood stream is removed and comes out through your urine which causes your urine to be a dark amber color.
When traveling, having an extended stay will put you at a higher risk to being subjected to Hepatitis A. Areas where risk for Hepatitis A are high include; Africa, Asia, Mexico, Middle East, Caribbean, Central America, and South America. Although Hepatitis A most commonly occurs in underdeveloped countries, it could also occur in smaller pockets of developed countries.
Vaccinations for the Hepatitis A virus are recommended, and adult travelers should receive an injection followed by a booster shot 6 months later. An accelerated schedule should be considered if time is short before travel. Twinrix combines Hepatitis A and Hepatitis B into a series of 3 shots. However, check with a Passport Health Travel Medicine Specialist in order to determine which would be the best choice for you.