<< Back

Hepatitis

Hepatitis
Hepatitis Risks in Regions Affected
Hepatitis A

Hepatitis A is common throughout the developing world, and its prevalance is related to poor hygienic and sanitary conditions. Hepatitis A is one of the most common vaccine-preventable diseases acquired during travel.
It is most prevalent in Africa and India, followed by Central and South America, the Middle East, and some parts of Eastern Europe and Asia.

For ease of visualization, please consult this map from the Centers for Disease Control and Prevention and Prevention (CDC) showing the countries where Hepatitis A is prevalent:

Hepatitis B

Hepatitis B risk is elevated in Africa, Asia, the South Pacific, Northern Canada, Greenland, and some parts of South America.

For ease of visualization, please consult this map from the Centers for Disease Control (CDC) showing the countries where Hepatitis B is prevalent:

Hepatitis C

Hepatitis C risk is elevated in Africa (with Egypt having the highest incidence) and some parts of Asia.

For ease of visualization, please consult this map from the Centers for Disease Control and Prevention (CDC) showing the countries where Hepatitis C is prevalent:


Hepatitis Risks based on Traveler Activities
Hepatitis A

In the countries affected, Hepatitis A risk is increased for travelers in rural areas or who frequently eat or drink in areas with poor sanitation and hygiene.
Transmission of Hepatitis A occurs through ingestion of tiny amounts of fecal matter from someone who is infected with the Hepatitis A Virus.
Usually this happens by eating or drinking contaminated food such as fruits, vegetables, shellfish, ice, or water, but this can also happen by handling objects contaminated by an infected person, especially if that person did not wash their hands properly after going to the bathroom, for instance.
The Hepatitis A Virus can live outside the body for many months in harsh conditions.

Hepatitis B

In general, risk to travelers is low, but the risk is activity-dependent.
Since this virus is spread through contact with infected blood or sexual contact, the risk is increased in travelers who engage in activities such as unprotected sex, injection drug use, blood transfusions, health care workers working with human blood, and so on.
The virus is not spread through skin contact or through coughing or sneezing.

Hepatitis C

In general, risk to travelers is low, but the risk is activity-dependent.
This virus is spread through contact with infected blood and uncommonly through sexual contact. Traveler activities with increased risk include receiving blood transfusions, receiving medical or dental work, receiving piercings or tattoos, using injection drugs, or being a health care worker with exposure to human blood.
The virus is not spread through skin contact or through coughing or sneezing.

Hepatitis Overview

What is Hepatitis?

Hepatitis is an inflammation of the liver, most often caused by a virus. It can be acute and / or chronic, which can sometimes lead to more serious long term illnesses such as liver cancer.

The Different Types of Hepatitis

There are different viruses which cause Hepatitis, causing different types of this disease, which are differentiated by letters. There are Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, Hepatitis E, and Hepatitis G. The viruses that cause them are abbreviated e.g. "HAV" for Hepatitis A Virus.

The most common types are Hepatitis A, Hepatitis B, and Hepatitis C, and these three types are what we'll cover here:
Hepatitis A causes an acute infection which does not become chronic, and people generally recover in a few months from Hepatitis A without treatment.
Hepatitis B begins as an acute infection, but in a small percentage of cases, depending on the patient's age, this illness may become chronic, resulting in long-term liver problems or more serious problems.
Hepatitis C begins as an acute infection, but in most cases, it will become chronic, resulting in serious life-long liver problems.

Each type of Hepatitis is characterized by different symptoms, methods of transmission, and prevention measures.

How do you get Hepatitis?

Hepatitis is most often caused by a virus, but can also be caused by alcohol and other toxins, and some medications and medical conditions.
This page will be referring to the viral Hepatitis types only, as these are the types travelers are more likely to encounter.
Hepatitis A can be contracted by ingesting tiny amounts of fecal matter from food or drink contaminated by an infected person.
Hepatitis B and Hepatitis C can be contracted by contact with the blood of infected individuals, or through sexual contact with an infected person.

What are the symptoms of Hepatitis?

Each type of Hepatits can have different symptoms, which also depend on whether the infection is acute or chronic, ranging from showing no symptoms to showing symptoms such as jaundice, stomach pain, loss of appetite, dark urine, fatigue, or even scarring of the liver or liver cancer. Please see the Symptoms section below for more information.

What are the treatments for Hepatitis?

People infected with Hepatitis A generally recover on their own, so there is usually no treatment required.
During the acute stage of infection for Hepatitis A, B, and C, there is no special medication available to treat the patient.
In the cases of Hepatitis B and Hepatitis C, if the infection becomes chronic, then more specialized, long term treatments by liver or Hepatitis specialists are required.

How can you prevent getting infected with Hepatitis?

There are vaccines available for preventing Hepatitis A (Hep A Vaccine) and Hepatitis B (Hep B Vaccine), but there are as yet no approved vaccines for preventing Hepatitis C, D, E, and G. Hepatitis B vaccinations are a part of the routine childhood immunization schedule in Canada, and is covered by Ontario Health Insurance (OHIP) for example.
There is also a commercially available combination Hep A and Hep B vaccine known as Twinrix which is effective against these two types of virus. For each type of Hepatitis, there are various non-medical preventative measures that can be exercised to reduce the risk of infection as well, as outlined below.

Hepatitis Symptoms

Hepatitis A

Some infected individuals show no symptoms. Adults tend to show symptoms more commonly than children.
The disease is still contagious even if symptoms are not showing.
If symptoms do occur, they occur from 2 to 6 weeks after first infection, and last from several weeks to 6 months, after which most people recover on their own.
Possible symptoms include fever, fatigue, jaundice, joint and abdominal pain, nausea, vomiting and loss of appetite, and dark urine.
There is no treatment for this disease, although most people recover on their own after feeling ill for several months.

Hepatitis B

Hepatitis B can be a short term acute illness lasting several weeks, or in some cases may develop into a more serious long term chronic illness of the liver.

Acute Hepatitis B

Not every infected individual will show symptoms. Adults and children over 5 years old are more likely to show symptoms.
Even if an infected person does not show symptoms, they are still carrying the virus and can still be contagious.
Symptoms include fever, fatigue, joint and abdominal pain, jaundice, nausea and vomiting, loss of appetite and dark urine.
Symptoms can appear 6 weeks to 6 months after first infection, and can last from a few weeks to 6 months.
There is no treatment for the acute form of Hepatitis B.

Chronic Hepatitis B

If infected as infants or young children, there is a 30% - 90% chance that chronic Hepatitis B illness can develop.
If infected as adolescents or adults, there is less than a 5% chance that chronic illness will develop.
While some people with the chronic form of Hepatitis B may show no symptoms for 20 or 30 years, in about 15% - 25% of cases, serious liver damage may still be occurring, leading to scarring of the liver, liver cancer and liver failure.
Those with the chronic form of Hepatitis B will need to consult liver or Hepatitis specialists for long term medical treatment and careful monitoring of their liver.

Hepatitis C

Hepatitis C can be a short term acute illness lasting several weeks, but in most cases will develop into a more serious long term chronic illness of the liver.

Acute Hepatitis C

About 80% of those with Acute Hepatitis C show no symptoms.
Even if an infected person does not show symptoms, they are still carrying the virus and can still be contagious.
If symptoms do occur, they may include fever, fatigue, joint and abdominal pain, jaundice, nausea and vomiting, loss of appetite and dark urine.
Symptoms can appear 2 weeks to 6 months after first infection.
Only about 15% - 25% of those with Acute Hepatitis C recover naturally from it. Most people develop chronic form of the disease.
There is no treatment for Acute Hepatitis C.

Chronic Hepatitis C

About 75% - 85% of infected people go on to develop the chronic form of the disease.
Most people with Chronic Hepatitis C do not have any symptoms, but in most cases, serious liver disease still quietly develops, in some cases over 20 to 30 years.
Long term liver health problems such as liver damage, liver failure, and liver cancer cause serious problems for most people with this disease.
About 1% - 5% of people with chronic Hepatitis C die from liver damage or liver cancer.
Those with the chronic form of Hepatitis C will need to consult liver or Hepatitis specialists for long term medical treatment and careful monitoring of their liver.

Hepatitis Prevention

Hepatitis A

The best way to prevent Hepatitis A is to be vaccinated against it with a "Hep A Vaccine" at your local travel health clinic, preferably at least 6 months before departure.
Hepatitis A vaccination involves 2 shots, given 6 months apart. A combination Hepatitis A and Hepatitis B vaccine (commercially named Twinrix) is available for adults which involves 3 shots given over a period of 6 months. Protection occurs about 2 to 4 weeks after the first injection.

Secondary measures of prevention include hygiene and sanitary measures such as frequent hand washing to reduce the chance of ingesting contaminated fecal matter.

Hepatitis B

The best way to prevent Hepatitis B is to be vaccinated against it with a "Hep B Vaccine" at your local travel health clinic, preferably at least 6 months weeks before departure.
Hepatitis B vaccination involves 3 or 4 shots over 6 months, and is better than 90% effective at preventing Hepatitis B infection. A combination Hepatitis A and Hepatitis B vaccine is available for adults which involves 3 shots given over a period of 6 months. Protection occurs about 2 to 4 weeks after the first injection. Hepatitis B vaccination is a part of routine immunization schedule for children in Canada, and is covered by Ontario Health Insurance (OHIP) for example.

Secondary measures of prevention include practising safe sex, avoiding sharing items which may be contaminated with blood such as toothbrushes, razors, and needles, and ensuring proper sterilization of medical tools and tattoo or piercing tools.

Hepatitis C

To date, there is no vaccine for immunization against the Hepatitis C Virus, although researchers are working towards this.

Therefore, it is important to employ other preventative measures such as avoiding sharing of items which may be contaminated with blood such as toothbrushes, razors, and needles; ensuring proper sterilization of medical and dental tools and tattoo or piercing tools; and carefully consider the health risks for blood transfusions while abroad.