Cause
Hepatitis A is
caused by a virus (hepatitis A virus, or HAV) that multiplies in liver cells
and is shed in stool.
How HAV is spread
Hepatitis A virus is found in
the stool (feces) of a person who has hepatitis A. The virus is spread most
commonly when people put food or objects contaminated with stool containing HAV
into their mouths.
Large numbers of people get the virus after
drinking contaminated water because, in many parts of the world, drinking water
is contaminated with raw sewage. The virus also may be spread by eating
uncooked food (such as raw shellfish) and unpeeled fruits and vegetables washed
in contaminated water. Hepatitis A outbreaks caused by contaminated drinking
water are rare in the United States because water supplies are treated to
destroy the virus and other harmful organisms.
In the U.S., HAV is
spread mainly among people who have close contact with someone who has the
virus. You can become infected with HAV if you:
- Eat food prepared by someone who does not
wash his or her hands well after using the bathroom or changing a
diaper.
- Don't wash your hands after changing a
diaper.
- Eat raw or undercooked shellfish that was harvested from
waters contaminated with raw sewage.
- Are a man and have sex with men.
Outbreaks of hepatitis A among children in day care
facilities occur because children, especially those who wear diapers, may get
stool on their hands and then touch objects that other children put into their
mouths. Caregivers in day care centers can spread the virus if they do not wash
their hands thoroughly after changing a child's diaper.
It is very
rare for hepatitis A virus to be spread by infected blood or blood products. It
is not known to be spread through saliva or urine.
Some people
fear that hepatitis A infection is related to or increases the risk of
contracting acquired immunodeficiency syndrome (AIDS). This is
not true. The hepatitis A virus is not related to the human immunodeficiency
virus (HIV), which causes AIDS, nor does it increase your
risk of HIV infection. A person can be infected with both hepatitis A and HIV,
but the two infections have nothing to do with each other.
Incubation and contagious periods
After the
hepatitis A virus enters your body, the amount of virus grows for 2 to 7 weeks.
The average
incubation period is about 4 weeks.
Your
stools and body fluids contain the highest levels of the virus 2 weeks before
symptoms start. This is the time when you are most contagious, but you still
may spread the virus after symptoms appear.