Is Hepatitis A contagious?
Hepatitis A is contagious and spread from person to person by exposure through oral contact with the feces of an infected person.1 Infection can occur from exposure to water or foods that are contaminated with the virus. Contamination sources may include raw shellfish, vegetables, fruits, and even contaminated ice.2 Transmission of the virus through blood is very rare. 3 Hepatitis A thrives in areas that lack proper sanitation and where personal hygiene habits are poor. 4 Contaminated water sources can also be a source of transmission. Hepatitis A may infect drinking water through several sources including malfunctioning sewage systems, pollution from storm runoff, and through the overflow of sewage. Wells may also become contaminated if they are shallow or if floodwaters have submerged them for long periods of time.5
Hepatitis A rarely occurs in the United States, however, the virus is endemic in many areas of the world including Africa, the Middle East, the Western Pacific, Asia, and Central and South America. 6 Individuals traveling to developing countries with high or intermediate levels of hepatitis A are at higher risk for contracting the virus and developing infection.7
In the United States, outbreaks are often traced to contaminated food sources and may affect restaurants, grocery stores, and work places. In the U.S., between 1998 and 2017, 97 reported outbreaks of hepatitis A from water or food sources have been reported. These outbreaks have been associated with 2,896 illnesses, 399 hospitalizations, and 8 deaths.8
Since 2016, multiple states have reported hepatitis A outbreaks linked primarily to persons experiencing homelessness and among individuals who use drugs. Since these outbreaks were first identified in 2016, over 15,000 cases have been reported, resulting in over 8,500 hospitalizations, and 140 deaths.9 It is believed that the higher number of hospitalizations and deaths that have occurred during this ongoing outbreak may be attributed to cofactors such as pre-existing health conditions, hepatitis B and hepatitis C co-infections, age, and additional risk behaviors found within this particular population.10
IMPORTANT NOTE: NVIC encourages you to become fully informed about Hepatitis A and the Hepatitis A vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
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1 MedlinePlus Hepatitis A Feb. 7, 2019
2 WebMD Hepatitis A FAQ. Nov. 18, 2018
3 Nelson NP, Murphy TV, Hepatitis A: The Changing Epidemiology of Hepatitis A. Clin Liver Dis (Hoboken). 2013 Dec; 2(6): 227–230.
4 WHO Hepatitis A Sep. 19, 2018
5 CDC Diseases and Contaminants - Hepatitis A and Drinking Water from Private Wells. July 1 , 2015
6 CDC Hepatitis A – Epidemiology Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.
7 CDC Travelers’ Health-Hepatitis A. Jan. 15, 2019
8 CDC National Outbreak Reporting System (NORS) Dashboard. Dec. 10, 2018 See Etiology – Hepatitis
9 CDC Emergency Preparedness and Response - Update: Widespread Outbreaks of Hepatitis A among People Who Use Drugs and People Experiencing Homelessness across the United States. Health Alert Network. Mar. 25, 2019
10 CDC Hepatitis A Virus Outbreaks Associated with Drug Use and Homelessness — California, Kentucky, Michigan, and Utah, 2017 MMWR Nov. 2, 2018; 67(43);1208–1210