What is it

Hepatitis A is a viral disease that affects the liver. It occurs worldwide and is common in countries where hygiene and sanitation standards are low, representing a potential risk to the health of Canadian travellers.1 It is one of the most common vaccine preventable diseases in travellers.1

Who is at risk

Anyone who comes into contact with contaminated food or water is at risk, although adults tend to suffer more severe symptoms than children. The disease initially incubates for a period of 15 to 50 days (28 days on average).1 Certain people may be at increased risk of infection or severe hepatitis A:1,2

  • Travellers to Hepatitis A-endemic countries
  • Individuals with chronic liver disease
  • Men who have sex with men (MSM)
  • Injectable and non-injectable illicit drug users
  • Individuals living in communities at risk of hepatitis A outbreaks or in which hepatitis A is endemic
  • Household or close contacts of children adopted from hepatitis A-endemic countries

What are the symptoms

The first symptom is a general feeling of unwell followed by fever, headaches, muscle aches, fatigue and gastrointestinal disorders. Jaundice, which is the yellowing of skin and eyes, is a symptom for many adults. The acute phase of hepatitis A lasts for approximately one month although it can take up to six months to recover completely. Hepatitis A may be asymptomatic in younger children.1,2

How is it spread

Hepatitis A is primarily spread when an uninfected (and unvaccinated) person ingests food or water contaminated with faeces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation and poor personal hygiene.1

How is it prevented

Since 1998, Hepatitis A vaccine is included in the routine immunization program in Israel.3 The vaccine is given at one and a half years of age and at two years.

recommended for one year-olds and above, for travelers for any travel period, to Asian countries (except Japan), Africa, South and Central America, eastern Europe and the former USSR, who have not had hepatitis A in the past and have not been vaccinated actively against this disease.5 Travelers are advised to consult a healthcare provider or travel clinic 6 weeks before travelling overseas to discuss suitable vaccination options1

Travelers should always drink bottled water and avoid ice in drinks where possible. Raw foods like salad and fruits that can’t be peeled should also be avoided in case of water contamination6

How is it treated

Doctors can diagnose Hepatitis A with blood tests and a physical examination. There is no specific treatment for hepatitis A. Recovery from symptoms can take several weeks and, in some cases, even months; about 25% of adult cases require hospitalization. A focus is placed on nutritional balance and replacement of fluids lost from vomiting and diarrhoea.2 Medical advice is recommended for the onset of symptoms. For further information regarding Hepatitis A and immunization, please speak with your healthcare provider.


  1. Public Health Agency of Canada. Hepatitis A https://travel.gc.ca/travelling/health-safety/diseases/hepatitis-a
  2. World Health Organization. Hepatitis A Fact Sheet http://www.who.int/mediacentre/factsheets/fs328/en/
  3. Ministry of Health Israel. Vaccination of Infants. Hepatitis A. https://www.health.gov.il/Subjects/pregnancy/Childbirth/Vaccination_of_infants/Pages/Hepatitis_A.aspx
  4. Ministry of Health Israel. Vaccination of Infants. Vaccines Babies. https://www.health.gov.il/Subjects/pregnancy/Childbirth/Vaccination_of_infants/Pages/vaccines_babies.aspx
  5. Ministry of Health Israel. Traveling abroad Vaccines. Hepatitis A. https://www.health.gov.il/Subjects/vaccines/Vaccines_abroad/traveling_abroad_Vaccines/Pages/Hepatitis-A.aspx
  6. Government of Canada. Eat and Drink Safely. https://travel.gc.ca/travelling/health-safety/food-water