Causes

Hepatitis A is caused by the hepatitis A virus, which is spread in the poo of someone with the infection.

Most infections occur in parts of the worldwhere standards of sanitation and food hygiene are generally poor, although there is a small risk of becoming infected in the UK.

How hepatitis A is spread

You can get hepatitis A from:

• eating foodprepared by someone with the infection who hasn't washed their hands properly, or washed them in water contaminated with sewage
• drinking contaminated water (including ice cubes)
• eating raw or undercooked shellfishfromcontaminated water
• close contact with someone who has hepatitis A
• having sex with someone who has theinfection particularly if you touch their rectum (back passage)with your fingers,mouth or tongue
• injecting drugs using equipment contaminated with the hepatitis A virus

Someonewith hepatitis A is most infectious from around two weeks before they start to develop symptoms until about a week afterwards.

At-riskdestinations

Hepatitis A is found worldwide, butareaswhereit's most widespread include:

• sub-Saharan and northern Africa
• the Indian subcontinent (particularly India,Bangladesh, Pakistan andNepal)
• some parts of the Far East (excluding Japan)
• the Middle East
• South and Central America

For information about the potential health risks in a specific country, check thecountry information on the Travel Health Pro website.

People at risk ofhepatitis Ain the UK

Although the chancesof getting hepatitis A in the UKare much smaller than in other parts of the world, certain groups are at an increased risk.

These include:

• close contacts of someone with hepatitis A
• men who have sex with other men
• people who inject illegal drugs
• people who may be exposed to hepatitis A through their job this includessewage workers, staff ofinstitutions where levels of personal hygiene may be poor (such as a homeless shelter) and people working withmonkeys, apes and gorillas (these animals may be infected with hepatitis A)

People in these groups are usually advised to have thehepatitis A vaccine to minimise their risk of infection.