Hepatitis A
Key Findings
The disease
Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It causes inflammation that affects the ability of the liver to function. It does not lead to long-term infection.
Transmission
Hepatitis A is transmitted mainly by the faecal–oral route. This can occur through eating food that is contaminated (including food that is handled by someone who is infectious), by drinking contaminated water, or via faecal material transferred directly from an infectious person’s hands or during sexual activity.
Signs and symptoms
Children under 5 years of age can have mild to no symptoms.
In adults, common signs and symptoms include the following:
- fever
- weight loss
- tiredness and nausea.
These are generally followed by:
- dark urine
- pale stools
- jaundice (yellowing of the eyeballs and skin).
Illness usually lasts for at least one month, followed by complete recovery.
Vaccination recommendations and coverage
Under the National Immunisation Program, Aboriginal and/or Torres Strait Islander children in the Northern Territory, Queensland, South Australia and Western Australia are recommended – and funded – to receive two doses of hepatitis A vaccine at 12 and 18 months of age.
In 2019, the hepatitis A vaccine coverage rate for Aboriginal and/or Torres Strait Islander children was 72.2%, a 1.4% increase since 2015.
Australia also recommends hepatitis A vaccine for people with an increased risk of acquiring hepatitis A, including:
- those who are planning to visit a country with endemic hepatitis
- men who have sex with men
- people who inject drugs.
Vaccine uptake for these groups is sub-optimal.
Who is most affected?
While people of all ages can be affected, those most at risk are:
- people who have travelled to endemic countries
- people who have been exposed to foodborne outbreaks
- men who have sex with men
- people who inject drugs.
How common is it?
There were 1042 cases of hepatitis A recorded during 2016–2019, with only 16 (1.5%) of these reported in Aboriginal and/or Torres Strait Islander people. The highest age-specific notification rate was seen in Aboriginal and/or Torres Strait Islander people aged 15–24 years (0.6 per 100,000 population per year). This was lower than that of other children (1.5 per 100,000 population per year).
- Hepatitis A has become a rare disease in Aboriginal and/or Torres Strait Islander people.
- Before the introduction of the hepatitis A vaccination program in 2005, the rate of disease was at least five times higher in Aboriginal and/or Torres Strait Islander people than in other Australians; now, this rate is lower than it is for other Australians.
Hospitalisations/deaths
There were 1335 hospitalisations relating to hepatitis A in Australia during 2016–2019, with 46 (3.4%) of these in Aboriginal and/or Torres Strait Islander people. There were 11 deaths reported where hepatitis A was recorded as the underlying or associated cause of death for the 2016–2019 period. Of these deaths, 1–5* were reported as having occurred in people identified as Aboriginal and/or Torres Strait Islander.
- There has been a sharp decrease in the hepatitis A hospitalisation rate among Aboriginal and/or Torres Strait Islander people since the introduction of the vaccine program in 2005.
Links and resources
* To comply with the Australian Coordinating Registry’s data release condition that death counts <6 be suppressed in published reports, counts between 1 and 5 are reported as a range.
Rates of hepatitis A have remained lower in Aboriginal and/or Torres Strait Islander people compared to other Australians since 2007.