The Hepatitis A Vaccine certificate
Some countries require visitors to have a valid Hepatitis A certificate before entering. This certificate can be issued by your health provider and proves that you have been vaccinated against the virus.
- Vaccine Effectiveness: The Hepatitis A vaccine is very effective, providing at least 20 years of protection against the disease once the full course of jabs is completed.
- How long before a trip do you have to get Hepatitis A vaccine? The CDC recommends that you get your Hepatitis A vaccine at least two weeks in advance of your trip. Even if you are leaving for your trip in a few days, you can still get the vaccine because it will provide some protection for most healthy people even if it is administered right before the trip. For long term protection, you are advised to get a second dose after 6 months.
- Who should get the Hepatitis A vaccine? MOH recommends that people at a high risk of contracting Hepatitis A get vaccinated against the disease. This includes travellers to developing countries, which may pose a risk of transmission of Hepatitis A, especially those staying for long periods. If you are visiting places with unsafe drinking water or poor levels of hygiene and sanitation, you are advised to get vaccinated. Sexually active homosexual men and people with chronic liver diseases are also advised to get the vaccine. Other groups at high risk are:
- People who inject illegal drugs
- Those being treated with clotting-factor concentrates
- Those who work with Hepatitis A-infected animals or in a Hepatitis A research laboratory
- Those who expect to have extended or close contact with individuals from countries that have a risk of Hepatitis A
- Children can be vaccinated from the age of 1 and above.
- Who should NOT get the vaccine: The vaccine should not be given to a child younger than 1 year old. It should also be avoided by anyone who has experienced an allergic reaction to an earlier dose of the vaccine or any of its ingredients. If you are moderately or severely ill, you should postpone your vaccination until you have recovered. If you are mildly ill, your doctor will be able to advise you on whether you can receive the vaccine.
- Side effects of the Hepatitis A vaccine: There will likely be some soreness and a reddening of the skin around the injection site. Less common side effects are fever, headache, loss of appetite and aching muscles
Do you plan to travel to a country where Hepatitis A is widespread? If so, and if you haven’t already been vaccinated, you may need to get vaccinated before you go. Read on to find out more about Hepatitis A and how you can prevent an infection.
What is Hepatitis A?
Hepatitis A is a mild to severe infection of the liver caused by the Hepatitis A virus. It originated in small mammals such as bats and later spread to primates and humans.
Hepatitis A infections are caused by some strains of hepatitis virus that attack the liver. These infections are commonly contracted through eating shellfish taken from sewage-contaminated water. It can also be acquired through close contact with individuals infected with the virus. Infections from Hepatitis A virus are usually mild, especially in the case of children.
The Hepatitis A infection never becomes chronic unlike some of the other hepatitis viruses.
Hepatitis A is not a major public health problem in Singapore due to our high standard of environmental hygiene and sanitation. However, travellers to countries with poor sanitation may run a higher risk of infection with Hepatitis A and should get vaccinated.
Hepatitis A symptoms
Children under 6 years old may present no symptoms at all, although they are still infectious to others.
Older children and adults can feel quite unwell however. All types of hepatitis present similar symptoms, which include nausea, vomiting, mild fever, stomach pain, gastrointestinal upset, dark colored urine and diarrhea. A yellowing of the skin and eyes (jaundice) can also occur.
Transmission
Hepatitis A is transmitted by ingesting food or drink contaminated by the feces of an infectious person, or by direct contact, including sexual contact, with an infectious person.
The disease can spread especially easily in places where there is lack of sanitation such as safe waste disposal, and a lack of hygiene, such as little to no toilets or hand-washing facilities.
Transmission seasonality
Cases of viral Hepatitis A infection are reported worldwide all year round, but the numbers peak in spring and summer months, according to a review of cases published in the Journal of Family Medicine and Primary Care.
This is most likely due to an increase of people traveling to places where Hepatitis A is more common during the summer months, and because people swim more frequently in hot weather. There may also be an increase in sexual contact, while poor hygiene and a lack of sanitation may spread the virus more easily in warmer weather.
Where is Hepatitis A found?
While Hepatitis A can be found all over the world, it is most common in:
- sub-Saharan and northern Africa
- the Indian subcontinent (in particular Bangladesh, India, Nepal and Pakistan)
- some parts of the Far East (excluding Japan)
- the Middle East
- South and Central America
The infection is least common in Scandinavia, Western Europe, Japan, New Zealand. Australia, and North America.
How to prevent Hepatitis A
As well as being vaccinated to prevent Hepatitis A infection, measures that reduce the risk of contracting the disease include:
- Practicing safe hygiene by washing hands after visiting the toilet and before touching food
- If soap and water is not available, using hand sanitizer to clean hands
- Washing fresh food in clean water, peeling it and cooking it thoroughly
- Drinking clean, potable water
As Hepatitis A is often transmitted through contaminated water and food, in high risk areas you are recommended to avoid consuming:
- Unpasteurized dairy produce
- Raw fruits and vegetables, including salads
- Peelings from fruits and vegetables
- Raw or undercooked (rare) meat and fish
- Fresh or cooked food that has been left out or exposed to flies, incuding buffets
- Food from street vendors, unless it is cooked thoroughly in your sight, and served hot on clean plates
- Unboiled tap water
- Ice made from tap water
