transmission of hepatitis A virus hepatitis

Last reviewed 01/2018

Transmission

HAV is spread by the faeco-oral route.

It can be

  • person to person - occurs between children, or in adults during certain sexual practices and when using injection drugs (4)
  • contaminated food or drink - under cooked or raw oysters and clams which are contaminated or infected food handlers who are shedding the virus (4)
  • in developed countries, person-to-person spread is the most common while in developing countries faeces-contaminated food and water are common sources of infection (1)

Transmission to older family members in a household is common with children often being the source of infection (especially under the age of 6 years) (1,2).

The virus is thought to be excreted with bile and shed in the stools of an infected person (1)

  • peak excretion occurs approximately 14 to 21 days before the onset of jaundice and a further 8 days thereafter (2). The patients are most infectious during this stage (3)
  • asymptomatic infected children may excrete the virus in their stools for up to 6 months (4)
  • immunocompromised patients may shed the virus for a longer time (3)

Other routes of transmission include

  • parenteral spread - may rarely follow transfusion of blood or blood products (factor VIII and factor IX concentrates) from a donor who is in the incubation stage of the disease (1,5)
  • during sexual intercourse (1)
  • intravenous drug users - outbreaks have been reported in many countries amongst IV drug users (5)

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