Frequent Questions About Hepatitis A

Community Update - Week of February 14th, 2022
By: Dr. Cynthia Morrow, Health Director, Roanoke City and Alleghany Health Districts

While the COVID-19 pandemic has grabbed headlines for the past two years, we continue to see cases, and even outbreaks, of other communicable diseases in the Roanoke City and Alleghany Health Districts (RCAHD). One current concern is that the number of cases of hepatitis A has steadily increased in our districts.

In a typical year, the RCAHD team investigates only 2-5 cases of this disease among RCAHD residents. In the fall of 2021, an investigation of over 50 cases of hepatitis A were associated with transmission of the disease at a local restaurant chain. This was the largest hepatitis A outbreak that has been recorded in our community.

While that outbreak resolved, since October 2021, there has been a slow but very steady increase in cases of hepatitis A reported to the RCAHD. Between October 2021 and February 10, 2022, we have investigated approximately 30 additional cases of hepatitis A, with over 70% of these individuals requiring hospitalization. The vast majority of these recent cases are associated with persons who use injection drugs.

What do you need to know about this potentially contagious virus? Here are some Frequently Asked Questions about hepatitis A:

What is hepatitis A?


Hepatitis is a term used to describe inflammation of the liver. Hepatitis A is a virus that attacks the liver, causing the liver to become inflamed. The primary way that it is spread is through the fecal-oral route.

What are the symptoms of hepatitis A?


Not everyone who is infected develops symptoms. For those who do develop symptoms, common symptoms include tiredness, poor appetite, fever, or nausea. Some people might also have vomiting, clay-colored stool, dark urine or jaundice (a yellowing of the skin and the whites of the eyes). While these symptoms can be severe, resulting in hospitalization, most people fully recover within a couple of months.

Can hepatitis A be prevented?


Yes! We have a safe and effective vaccine to prevent hepatitis A. In addition, hepatitis A is considered preventable via good personal hygiene habits such as thorough handwashing and safer sex practices. Always wash hands thoroughly with soap and water after using the toilet, changing a diaper or helping a child to use the toilet, before preparing food and beverages, and before eating.

Can hepatitis A turn into hepatitis B or C?


No, hepatitis A is caused by a different virus from the viruses that cause hepatitis B or C. Hepatitis A is typically an acute infection, while hepatitis B and hepatitis C can cause a chronic, persistent infection, which can lead to chronic liver disease. There are vaccines to prevent hepatitis A and B, however there is not one for hepatitis C.

Who should get the hepatitis A vaccine?


  •  All children at age 1 year. (12 – 23 months of age)
  •  Travelers to countries/areas with increased rates of hepatitis A. (visit cdc.gov/travel for more information)
  •  Men who have sex with men.
  •  People with existing chronic liver disease or clotting disorders.
  •  People who use injected or non-injected street drugs.
  •  Anyone who wants to protect themselves from getting hepatitis A.

Hepatitis A is the only vaccine-preventable foodborne illness. Two doses of the vaccine are needed for lasting protection.

How long has the hepatitis A vaccine been available?


Hepatitis A vaccines were licensed in 1995 and 1996. The number of acute hepatitis A infections in the U.S. significantly dropped in the early 2000s, largely because hepatitis A vaccination was recommended for children and persons in groups shown to be at high risk for infection, beginning in 1996. By 2006, the hepatitis A vaccine had been incorporated onto the list of recommended childhood vaccinations for all children in the United States.

What is RCAHD doing in response to this outbreak?


We are working closely with partners to increase health education about hepatitis A and to increase access to hepatitis A vaccine, particularly for vulnerable populations. We know that hepatitis A vaccination can prevent severe illness and death associated with the virus. Hepatitis A vaccines are available for the public at your local health department offices by appointment. Questions? Call 540-283-5050 or visit vdh.virginia.gov/immunization/hav/ for more information.