Prevention

Prevention by isolation of patients and contacts is rarely effective as the virus is excreted in the faeces for as long as two weeks before the appearance of jaundice.

Advice on good hygiene is the cornerstone of prevention e.g. - thorough hand washing after toilet use and before handling food and avoiding exposure to contaminated food and water when in countries of high and intermediate endemicity (1).

Immunization against hepatitis A can be either

• passive immunisation with immune serum globulin
  • is recommended for providing post exposure prophylaxis to close personal contacts of sufferers
  • will provide protection against hepatitis A if given within 14 days of exposure and if given after may modify the disease (2)
  • provides protection for 4-6 months (2)
  • preliminary testing for anti-HAV avoids giving immunoglobulin indiscriminately.
• active immunisation with hepatitis A vaccines
  • has now replaced immune globulin in many non-emergency situations
  • the high incidence of hepatitis A is such that it is the most common infection in travellers that may be prevented by vaccination.
  • there is some evidence about hepatitis A vaccine providing effective prophylaxis in contacts of sufferers (if given soon enough) (2)

Both vaccine and immunoglobulins can be used together (but in different sites) when rapid and prolonged protection is required (2).

Reference:

• (1) Health Protection Agency (HPA) 2009. Guidance for the prevention and control of hepatitis A infection
• (2) Department of Health (DH 2019. Immunisation against infectious disease - "The Green Book". Chapter 17 - Hepatitis A