Protect Yourself From Hepatitis A When Travelling

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Protect Yourself From Hepatitis A When Travelling

Topic Overview

Immunization against the hepatitis A virus (HAV) is recommended for anyone travelling to any country or area except:1

  • Australia.
  • Canada.
  • Japan.
  • New Zealand.
  • The United States.
  • Western Europe and the Scandinavian countries (Norway, Sweden, and Finland).

Talk to your doctor before visiting any other areas.

If you plan to travel to a part of the world where sanitation is poor or where hepatitis A is a known problem, see your doctor about receiving the hepatitis A vaccine, immunoglobulin (IG), or the combination hepatitis A and B vaccine. (Risk of hepatitis B increases if you go to a high-risk country frequently or stay for a long time.)

  • If you complete the hepatitis A vaccination series, it is believed that you will be protected against hepatitis A virus (HAV) for at least 20 years.2 In adults (people older than 18 years of age), it is best if the first shot is given at least 4 weeks before a person may be exposed to the hepatitis A virus. But the vaccine does provide some protection shortly after the first shot.3 A second shot should be given 6 to 18 months later to prolong protection. (Immunization with hepatitis A vaccine is recommended for all children who are at high risk for being exposed to the virus beginning at 1 year of age or as recommended by your provincial health authority. Two separate doses are given at least 6 months apart. The second shot should be given 6 to 18 months after the first shot.)4, 5
  • If you receive IG and are planning an extended stay in an area where hepatitis A is a problem, you should get a higher dose of IG. You will need to get additional injections of the same high dose of IG every 3 to 5 months.
  • Immunoglobulin is made from components of human blood. There is no risk of getting a blood borne disease from IG made in Canada or the United States. The safety of IG manufactured in other countries cannot be guaranteed.
  • People who are allergic to the components of the hepatitis A vaccine and children younger than 1 year of age should receive IG.

When travelling in an area where hepatitis A is a known problem or where water quality is questionable:

  • Boil water before drinking it. Bring the water to a rolling boil for 1 minute. If you are at an elevation of 2000 m (6562 ft) or higher, boil the water for 3 minutes. Do not drink tap water or well water or beverages containing ice cubes.
  • Do not brush your teeth with tap water or well water.
  • Make sure all foods are cooked well, especially shellfish.
  • Eat only raw fruits and vegetables that you have washed in uncontaminated water and peeled yourself.
  • Don't swim in water that has not been treated with chlorine.
  • Don't drink bath or shower water.

Related Information

References

Citations

  1. Centers for Disease Control and Prevention (2008). Prevention of specific infectious diseases: Hepatitis, viral, type A. Yellow Book: Health Information for International Travel 2008. Available online: http://wwwn.cdc.gov/travel/yellowbook/ch4/hep-a.aspx.
  2. Craig AS, Schaffner W (2004). Prevention of hepatitis A with the hepatitis A vaccine. New England Journal of Medicine, 350(5): 476–481.
  3. Centers for Disease Control and Prevention (2007). Update: Prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 56(RR-41): 1080–1084. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm.
  4. National Advisory Committee on Immunization (NACI) (2006). Canadian Immunization Guide, 7th ed., pp. 1–372. Ottawa: Public Health Agency of Canada. Also available online: http://publications.gc.ca.
  5. Centers for Disease Control and Prevention (2007). Recommended immunization schedules for persons aged 0–18 years—United States, 2007. MMWR, 55(51 and 52): Q1–Q4. Also available online: http://www.cdc.gov/mmwr/pdf/wk/mm5551-Immunization.pdf. [Erratum in MMWR, 56(02): 32. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5602a6.htm.]

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Adam Husney, MD, MD - Family Medicine
Last Revised November 2, 2010

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.